保胎颗粒联合地屈孕酮片治疗黄体功能不全所致复发性流产临床研究

Clinical Study on Therapy of Baotai Granules Combined with Dydrogesterone Tablets in the Treatment of Recurrent Abortion Caused by Iuteal Insufficiency

目的:观察保胎颗粒联合地屈孕酮片用于治疗黄体功能不全致复发性流产的临床疗效。方法:选取150例黄体功能不全所致复发性流产患者为研究对象,按照随机数字表法分为研究组和对照组各75例。对照组予以地屈孕酮片口服治疗,研究组在对照组基础上增加保胎颗粒内服。记录2组患者治疗期间的药物不良反应情况,比较2组患者治疗前和妊娠8周血清孕酮(P)、人绒毛膜促性腺激素(HCG)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)和白细胞介素-10(IL-10)水平变化情况,评价患者治疗后总体疗效,统计患者妊娠成功率和再次流产发生率。结果:治疗前,2组血清P和HCG水平比较,差异无统计学意义(P>0.05)。妊娠8周后,2组血清P和HCG水平较治疗前显著提高,且研究组血清P和HCG水平高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组血清TNF-α、IL-2、IL-6、IL-10水平比较,差异无统计学意义(P>0.05)。妊娠8周后,2组血清TNF-α和IL-2水平较治疗前降低,血清IL-6和IL-10水平较治疗前升高;且研究组血清TNF-α和IL-2水平低于对照组,血清IL-6和IL-10水平高于对照组;差异均有统计学意义(P<0.05)。研究组总有效率为90.67%,显著高于对照组69.33%,差异有统计学意义(P<0.05)。研究组共有64(85.33%)例患者妊娠成功,对照组共有47(62.67%)例患者妊娠成功,2组比较,差异有统计学意义(P<0.05)。结论:保胎颗粒联合地屈孕酮片可显著升高黄体功能不全所致复发性流产患者血清P和HCG水平,有效调节炎症相关因子水平,提高总体疗效,缓解患者相关临床症状,降低再次流产发生率,且安全性较高,值得临床推广使用。

Objective:To observe the clinical effect of the therapy of Baotai granules combined with dydrogesterone tablets in the treatment of recurrent abortion caused by iuteal insufficiency. Methods: A total of 150 patients with recurrent abortion due to luteal insufficiency were selected as the study subjects and were divided into the study group and the control group according to random number table method, 75 cases in each group. The control group was treated with diprogesterone tablets orally, and the study group was additionally treated with oral Baotai granules based on the treatment of the control group. Adverse drug reactions during treatment were recorded in the two groups, and levels of progesterone(P), human chorionic gonadotropin(HCG), tumor necrosis factor-α(TNF-α), interleukin-2(IL-2), interleukin-6(IL-6) and interleukin-10(IL-10) in serum were compared between the two groups before treatment and at eight weeks of gestation. The total effect of the patients after treatment was evaluated, and the pregnancy rate and the incidence of secondary abortion were calculated. Results: Before treatment, there was no significant difference in the comparisons of levels of P and HCG in serum between the two groups(P > 0.05). After eight weeks of gestation, the above two levels in the two groups were significantly increased when compared with those before treatment,and those in the study group were higher than those in the control group,differences being statistically significant(P <0.05). Before treatment, there was no significant difference in the comparisons of levels of TNF-α, IL-2, IL-6 and IL-10 in serum(P > 0.05). After eight weeks of gestation, levels of TNF-α and IL-2 in serum in the two groups were decreased when compared with those before treatment, while levels of IL-6 and IL-10 were increased;levels of TNF-α and IL-2 in serum in the study group were lower than those in the control group, while levels of IL-6 and IL-10 were higher;differences were statistically significant(P < 0.05). The total effective rate in the study group was 90.67%, significantly higher than that of 69.33% in the control group, the difference being statistically significant(P < 0.05). A total of 64(85.33%) patients in the study group had a successful pregnancy, and 47(62.67%) patients in the control group did, the difference being statistically significant(P < 0.05).Conclusion: The therapy of Baotai granules combined with dydrogesterone tablets in the treatment of recurrent abortion caused by iuteal insufficiency has better clinical effect, which can effectively regulate the levels of inflammatory factors, improve the total effect,relieve the related clinical symptoms of patients,reduce the incidence of secondary abortion,has relatively good safety and is worthy of clinical promotion and application.