低分子肝素联合加味寿胎丸治疗肾虚血瘀型子宫动脉血流阻力升高的复发性流产临床研究

Clinical Study on the Treatment of Recurrent Abortion with Low Molecular Weight Heparin Combined with in the Treatment of Recurrent Abortion with Increased Blood Flow Resistance in Uterine Artery of Kidney Deficiency and Blood Stasis Type

目的:探讨低分子肝素联合加味寿胎丸治疗肾虚血瘀型复发性流产的疗效。方法:选择2018年1月至2019年6月绵阳市中医医院就诊的肾虚血瘀型复发性流产患者84例为研究对象。随机分为对照组和实验组,各42例。对照组给予加味寿胎丸口服治疗,实验组在对照组基础上给予低分子肝素钠皮下注射治疗,比较两组治疗前后生殖激素变化、血栓指标水平变化及随访妊娠结局的情况。结果:两组的总体疗效对比,实验组的总体疗效优于对照组,两者对比有统计学意义(P<0.05);治疗前雌二醇(Estradiol,E2)、活化部分促凝血酶原激酶时间(activated partial thromboplastin time,APTT)及D-二聚体(D-Dimer,D-D)水平比较差异无统计学意义(P>0.05);治疗后实验组的E2水平高于对照组,D-D水平低于对照组(P<0.05),APTT比较无明显差异(P>0.05);治疗后子宫动脉血流频谱参数均较对照组明显下降,差异有统计学意义(P<0.05);治疗后流产率明显低于对照组(P<0.05)。结论:低分子肝素联合加味寿胎丸可达到改善肾虚血瘀型复发性流产患者体内激素水平及凝血功能的效果,进而改善妊娠结局。

Objective:To explore the effect of low molecular weight heparin combined with Jiawei Shoutai Pill on recurrent abortion of kidney deficiency and blood stasis type.Methods:From January 2018 to June 2019,84 patients with recurrent abortion of kidney deficiency and blood stasis type were selected as the study object.Randomly divided into control group and experimental group,42 cases each.The control group was treated with jiawei shoutai pill orally,and the experimental group was treated with low molecular weight heparin on the basis of the control group.Result:Compared with the control group,the overall effect of the experimental group was better than that of the control group,with statistical significance(P<0.05);there was no statistical significance in the comparison of E2,APTT and D-D levels before treatment(P>0.05);but after treatment,the E2 level of the experimental group was higher than that of the control group,and the D-D level was lower than that of the control group(P<0.05),and there was no significant difference in the comparison of APTT(P>0.05);after treatment,there was no significant difference in the comparison of uterine artery.After treatment,the parameters of blood flow resistance were significantly lower than those of the control group(P<0.05),and the abortion rate was significantly lower than that of the control group(P<0.05).Conclusion:Low molecular weight heparin combined with modified Shoutai Pill can improve the level of hormone levels and coagulation function in patients with recurrent abortion of kidney deficiency and blood stasis type,so as to improve the outcome of pregnancy.