安胎防漏汤对多囊卵巢综合征早孕先兆流产患者凝血纤溶系统功能及性激素水平的影响

Effects of Antai Fanglou Decoction on Coagulation and Fibrinolysis System and Sex Hormone Levels in Patients with Early Threatened Abortion and Polycystic Ovary Syndrome

目的:探讨安胎防漏汤对多囊卵巢综合征(PCOS)早孕先兆流产患者凝血纤溶系统功能及性激素水平的影响。方法:选取2013年9月至2017年9月襄阳市妇幼保健院收治的PCOS早孕先兆流产患者81例进行回顾性分析。按照治疗方案不同分为对照组(n=44)和观察组(n=37),对照组接受常规保胎治疗,观察组接受安胎防漏汤联合常规保胎治疗。2组患者持续治疗21 d后比较其凝血纤溶系统功能指标、性激素水平的差异,治疗后进行长期随访并记录流产、早产、足月分娩等妊娠结局的发生情况。结果:治疗21 d后,观察组外周血中凝血纤溶系统功能指标活化部分凝血活酶时间(APTT)的水平较对照组高,凝血因子X(FX)活性、纤溶酶原活化剂抑制物(PAI-1)、组织型纤溶酶原活化剂(t-PA)的水平较对照组低;血清中β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E 2)的水平较对照组高,差异有统计学意义(P<0.05)。治疗后随访期内,观察组患者治疗后流产发生率较对照组低,足月分娩发生率较对照组患者高,差异有统计学意义(P<0.05)。结论:PCOS早孕先兆流产患者在西医治疗同时加入中药安胎防漏汤联合治疗,可有效抑制机体凝血纤溶系统活性并优化性激素水平,最终增加成功分娩概率。

Objective:To explore the effects of Antai Fanglou Decoction on coagulation and fibrinolysis system and sex hormone levels in patients with early threatened abortion and polycystic ovary syndrome(PCOS).Methods:A total of 81 cases of PCOS combined with early threatened abortion patients treatment methods in Xiangyang Maternal and Child Health Hospital from September 2013 to September 2017 were retrospective analyzed.According to difference treatment plan,all patients were divided into a control group(n=44)that underwent conventional fetal treatment,and an observation group(n=37)that received Antai Fanglou Decoction combined with conventional fetal treatment.After continuous treatment of 21 d,difference of coagulation fibrinolysis system function indexes and sex hormones levels were compared between the 2 groups.After treatment,long-term follow-up was carried out and the outcome of abortion,preterm delivery and full term delivery were recorded.Results:After the treatment of 21 d,the level of coagulation fibrinolysis system function indexes such as APTT in the study group was higher than that in the control group,FX,PAI-1 and t-PA in the study group were lower than those in the control group,and the level of serum sex hormones such asβ-HCG,P and E2 in the study group were higher than those in the control group(P<0.05).During the follow-up period after treatment,the incidence of miscarriage after treatment in the study group was lower than that in the control group,and the incidence of full-term delivery in the study group were higher than those in control group(P<0.05).Conclusion:The combination of western medicine and Antai Fanglou Decoction in patients with early threatened abortion and PCOS can effectively inhibit the activity of coagulation fibrinolysis system and optimize the level of sex hormone,eventually increase the probability of successful delivery.