双宝煎剂对先兆流产患者内分泌及细胞因子的影响

Effect of Double Treasure Decoction on Endocrine and Cytokines of Patients with Threatened Abortion

目的:通过观察双宝煎剂对血清孕酮(progestone,P),β-人绒毛膜促性腺激素(human chorionic gonadotropin,β-HCG),细胞因子γ-干扰素(interferon-γ,INF-γ),白细胞介素(IL)-2,IL-4,IL^(-1)0含量的影响,以及治疗先兆流产的临床疗效,探讨双宝煎剂对患者内分泌及细胞因子的影响,从母胎免疫调控及内分泌角度探讨双宝煎剂的安胎机制。方法:采用随机对照研究方法,以2013年4月—2013年11月在河南省中医院妇科门诊就诊的患者为研究对象,按照纳入、排除标准共纳入140例确诊为先兆流产的患者,采用SAS 8.2统计软件产生的随机分组表,将140例患者随机分为两组,中药组(70例),西药组(70例)。中药组给予双宝煎剂量口服,西药组给予口服地屈孕酮和肌注HCG针。采用化学发光酶免疫分析法检测P,β-HCG的浓度;采用酶联免疫吸附试验(Enzyme-linked immunosorbent assay,ELISA)法检测血清中细胞因子INF-γ,IL-2,IL-4,IL^(-1)0的浓度。结果:中药组血清中P,β-HCG含量明显高于西药组(P<0.05);与西药组比较,中药组血清中IL-4,IL^(-1)0含量明显升高(P<0.05),INF-γ,IL-2含量明显下降(P<0.05)。结论:双宝煎剂能明显改善先兆流产患者内分泌激素及细胞因子的水平,极大地提高了保胎成功率,进一步论证了固肾安胎是中医治疗先兆流产的大法。

Objective： To observe the effect of double treasure decoction on serum progesterone （P） ,β- human chorionic gonadotropin （β-HCG）, interferon-γ （INF-γ）, interleukin （IL） -2, IL-4, IL-10 levels, as well as its clinical efficacy for threatened abortion, investigate its effect on endocrine and cytokines and explore its tocolysis mechanism from the angle of maternal-fetal immune regulation and endocrine. Method： This prospective, randomized controlled study was conducted on the patients in Gynecology Outpatient Department of Henan Province Hospital of Traditional Chinese Medicine from April 2013 to November 2013. A total of 140 threatened abortion patients were recruited for the study. The volunteers were screened before enrollment and randomly allocated into two groups： 70 cases of Chinese medicine group and 70 cases of western medicine group. Patients in Chinese medicine received oral administration of double treasure decoction, and patients in western medicine group received oral administration of progesterone and intramuscular injection of HCG. Method of chemiluminescence was used to detect the concentration of P and β-HCG; enzyme-linked immunosorbent assay （ELISA） was used to detect the concentration levels of serum cytokines INF-T, IL-2 and IL-4, IL-10. Result： The concentration levels of serum P and β-HCG in Chinese medicine group were significantly higher than those in western medicine group （ P 〈 0.05 ） ; as compared with western medicine group, the contents of serum cytokines INF-γ and IL-2 were decreased significantly, while the contents of IL-4 and IL-10 were increased significantly in Chinese medicine group （P 〈 0.05）. Conclusion ： The double treasure decoction can significantly improve the endocrine hormone and the levels of cytokines in patients with threatened abortion, and greatly improve the success rate of preventing miscarriages, further demonstrating that Strengthen Kidney for Fetus-soothing is the major solution of traditional Chinese medicine in the treatment of threatened abortion.