扶正化痰活血方联合二甲双胍治疗复发性流产伴胰岛素抵抗患者疗效

Curative efficacy of Fuzheng huatan huoxue decoction for treating women with recurrent spontaneous abortion and insulin resistance

目的:探讨扶正化痰活血方联合二甲双胍治疗复发性流产伴胰岛素抵抗脾肾两虚、痰湿血瘀型患者的疗效。方法:选择2017年1月—2018年1月就诊于浙江省立同德医院生殖免疫科的108例复发性流产伴胰岛素抵抗患者,均给予基础治疗,随机数表法分为西医组(二甲双胍治疗)32例,中医组(扶正化痰活血方治疗)35例,中西医组(二甲双胍联合扶正化痰活血方治疗)41例,均连续治疗3个月,比较治疗前后体质量指数(BMI)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、血清同型半胱氨酸(Hcy)变化及不良反应。结果:治疗后3组BMI指数、HbA1c、FINS、HOMA-IR、Hcy均较治疗前降低,且中西医组最低(均P<0.05);治疗期间3组不良反应发生率(8.6%、2.5%、5.0%)比较无差异(P>0.05)。结论:复发性流产伴胰岛素抵抗患者在西药治疗基础上,联合扶正化痰活血方可有效调节机体胰岛素抵抗和高凝状态,安全性好,值得临床应用。

Objective: To study the curative efficacy of Fuzheng huatan huoxue decoction for treating women with recurrent spontaneous abortion and insulin resistance. Methods: 120 women with recurrent spontaneous abortion and insulin resistance were selected and divided into group A (35 cases), group B (40 cases), and group C (45 cases) by random number table method from January 2017 to January 2018. The women in the group A were given metformin for 3 months, the women in the group B were given Fuzheng huatan huoxue decoction metformin for 3 months, and women in the group C were given metformin combined with Fuzheng huatan huoxue decoction for 3 months. The changes of the body mass index value (BMI) and levels of HbA1, fasting insulin (FINS), insulin resistance index (HOMA IR), serum homocysteine (Hcy) of women before and after treatment, and the adverse reaction rate of women were compared among the three groups. Results: After treatment, the BMI value and levels of HbA1c, FINS, HOMA IR, Hcy of women in the three groups significantly decreased ( P <0.05). And the BMI value and levels of HbA1c, FINS, HOMA IR, Hcy of women in the C group were lowest ( P <0.05). The incidence of adverse reactions of group A, group B and group C was 8.6%(3/35), 2.5%(1/40) and 5.0%(2/45), respectively, which had no significant different ( P >0.05). Conclusion: Fuzheng huatan huoxue decoction combined with metformin can effectively regulate insulin resistance and hypercoagulable state of women, and has highly safety, so it is worth of popularizing.