低分子肝素联合固肾安胎丸治疗肾虚血瘀型复发性流产的临床疗效观察

Clinical observation on low molecular weight heparin combined with Gushen Antai Pill in the treatment of recurrent spontaneous abortion with kidney deficiency and blood stasis

目的研究低分子肝素联合固肾安胎丸治疗肾虚血瘀型复发性流产(RSA)的临床疗效,及对患者激素水平、凝血功能和免疫功能指标的影响。方法选取2017年6月至2019年6月皖北煤电集团总医院产科收治的120例RSA患者作为研究对象。按随机数字表法分成观察组(n=60)和对照组(n=60)。对照组给予低分子肝素皮下注射治疗,研究组在对照组基础上给予固肾安胎丸口服治疗。确认妊娠后用药持续至临床或流产、早产。对比两组的治疗效果及各项指标情况。结果治疗后,观察组保胎成功率高于对照组,观察组HCG、P、E 2水平高于对照组,观察组凝血功能指标PAI-1、D-D、纤维蛋白原水平显著低于对照组,观察组免疫指标IL-2、IFN-γ、Th1/Th2水平明显低于对照组,差异具有统计学意义(P<0.05)。结论低分子肝素联合固肾安胎丸应用于肾虚血瘀型RSA患者可以有效提高激素水平,改善患者血液高凝状态,调节免疫功能,有效提高保胎成功率。

Objective To study the clinical efficacy of low molecular weight heparin combined with Gushen Antai Pill in the treatment of recurrent spontaneous abortion(RSA)with kidney deficiency and blood stasis,and the effects on hormone levels,blood coagulation function and immune function indexes of patients.Methods A total of 120 patients with RSA admitted to the Department of Obstetrics,Wanbei Coal-Electricity Group General Hospital from June 2017 to June 2019 were selected and divided into observation group(n=60)and control group(n=60)according to random number table method.The control group was given subcutaneous injection of low molecular weight heparin,and the research group was added oral treatment of Gushen Antai Pill.After confirmation of pregnancy,medication continued to delivery or abortion,premature delivery.The therapeutic effects and various indicators of the two groups were compared.Results After treatment,the success rate of fetal preservation in the observation group was higher than that in the control group,the levels of hormones HCG,P and E 2 in the observation group were higher than those in the control group,the levels of coagulation function indexes PAI-1,D-D and fibrinogen in the observation group were significantly lower than those in the control group,the levels of immune indexes IL-2,IFN-γand Th1/Th2 in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusions Low molecular weight heparin combined with Gushen Antai Pill can effectively increase hormone levels,improve blood hypercoagulability,regulate immune function and effectively improve the success rate of fetal preservation in RSA patients with kidney deficiency and blood stasis.