消支助孕汤联合干扰素栓治疗解脲支原体感染性不孕的临床观察

Treatment of Ureaplasma urealyticumInfection Infertility by Xiaozhi Zhuyun Decoction Combined Recombinant Human Interferon α-2a Vaginal Suppository

目的观察消支助孕汤联合重组人干扰素α-2a栓阴道外用治疗支原体感染性不孕的临床疗效。方法选取支原体阳性不孕患者226例,随机分为治疗组和对照组,治疗组应用消支助孕汤口服联合重组人干扰素α-2a栓阴道外用;对照组应用多西环素口服加重组人干扰素α-2a栓阴道外用。观察两组解脲支原体(Uu)转阴率,治疗前后抗精子抗体(AsAb)、抗子宫内膜抗体(AEMAb)变化,妊娠率及不良反应情况。结果治疗组妊娠率67.8%(80/118),明显优于对照组[37.9%(41/108)],差异有统计学意义(χ2=20.18,P<0.01);治疗组Uu转阴率为92.4%(109/118)、流产率2.5%(2/80),对照组Uu转阴率93.5%(101/108)、流产率7.3%(3/41),两组比较,Uu转阴率及流产率差异均无统计学意义(P>0.05);治疗后两组AsAb和AEMAb阳性率较治疗前均下降(P<0.05),且治疗组阳性率明显低于对照组(P<0.05),治疗组转阴率优于对照组(P<0.05);治疗后抗体阴性者妊娠率78.5%(106/135),明显优于抗体阳性者[16.5%(15/91)],差异有统计学意义(χ~2=84.10,P<0.01);抗体阴性者流产率1.9%(2/106),低于抗体阳性者[20.0%(3/15)],差异有统计学意义(χ~2=10.88,P<0.05)。结论消支助孕汤口服联合重组人干扰素α-2a栓阴道外用治疗支原体感染不孕患者,能有效清除Uu,降低自身免疫激活状态,从而提高了妊娠率,降低了流产率。

Objective To observe the clinical curative effect for treatment of Ureaplasma urea- lyticum （Uu） infection infertility by taking Xiaozhi Zhuyun Decoction （XZD） and external application of re- combinant human interferon α-2a vaginal suppository （RHIα-2aVS）. Methods Recruited were 226 infer- tility patients infected by Uu. They were randomly assigned to the treatment group and the control group. Patients in the treatment group took XZD and externally used RHIα-2aVS, while those in the control group took Doxycycline and externally used RHIα-2aVS. Uu negative conversion rate was observed in the two groups. Changes of antisperm antibody （AsAb） and antiendometrial antibody （AEMAb） were detected before and after treatment. The pregnancy rate and adverse reactions were also observed. Results The pregnancy rate of the treatment group was 67.8% （80/118）, obviously higher than that of the control group [37.9% （41/108） ], with statistical difference （χ2 =20.18,P〈0.01）.The Uu negative conver- sion rate of the treatment group was 92.4% （109/118） and the abortion rate was 2.5% （2/80）, and they were 93.5% （101/108） and 7.3% （3/41） in the control group. There was no significant difference in the Uu negative conversion rate or the abortion rate between the two groups （P 〉0.05）. The positive rates of AsAb and AEMAb in the two groups were lower than those before treatment （P 〈0.05）. The positive rate of the treatment group was lower than that of the control group （P 〈0.05）. The negative conversion rate of the treatment group was better than that of the control group （P 〈0.05）. The pregnancy rate of anti-body negative patients was 78.5% （106/135）, obviously better than that of antibody positive patients [16.5% （15/91） ], with statistical difference （X2=84.10, P 〈0.01 ）. The abortion rate in antibody nega- tive patients was 1.9% （21106）, lower than that of antibody positive patients [20.0% （3/15） ] ,with sta- tistical difference （χ2=10.88, P 〈0.05）. Conclusions XZD combined with external application of RHIα- 2aVS was effective in treating Uu infection infertility patients. They could effectively clear Uu, reduce their immune activation states, thus elevating the pregnancy rate and lowering the abortion rate.