益肾祛瘀方辅助西药治疗先兆流产伴宫腔积血的疗效及对超声指标的影响

Effect of Yishen Quyu Decoction combined with Western medicine in the treatment of threatened abortion with uterine haematocele and its influence on ultrasound indexes

目的研究益肾祛瘀方治疗先兆流产伴宫腔积血的疗效,为临床治疗提供依据。方法选择2019年1月—2020年6月在温州市中医院治疗的先兆流产伴宫腔积血患者126例,采用随机数表法分为西医组(63例)和联合组(63例)。西医组患者给予低分子肝素联合地屈孕酮治疗,联合组患者加用益肾祛瘀方治疗。比较2组患者的中医证候积分、超声指标、妊娠结局、性激素、糖类抗原125及炎性因子水平。结果治疗后2组患者的主症积分和次症积分均明显下降,联合组低于西医组(均P<0.05)。治疗后2组患者的超声指标均明显改善,联合组患者的子宫螺旋动脉舒张末期血流速度和收缩期峰值血流速度水平高于西医组,阻力指数低于西医组(均P<0.05)。治疗后2组患者的血清性激素和糖类抗原125水平均明显改善,联合组患者的孕酮、雌二醇和人绒毛膜促性腺激素水平高于西医组,糖类抗原125水平低于西医组(均P<0.05)。治疗后2组患者的炎性因子水平均明显改善,联合组患者白细胞介素-4、白细胞介素-10、干扰素-γ和白细胞介素-2水平低于西医组(均P<0.05)。联合组保胎成功率为93.65%,西医组仅为80.95%(P<0.05)。结论益肾祛瘀方辅助西药治疗可以明显改善先兆流产伴宫腔积血患者的临床症状,调节血清性激素和Th1/Th2细胞因子水平,改善子宫动脉供血,降低糖类抗原125水平,保胎成功率更高。

Objective To study the effect of Yishen Quyu Decoction on threatened abortion with uterine haematocele,so as to provide basis for clinical treatment.Methods From January 2019 to June 2020,126 patients with threatened abortion and intrauterine haematocele admitted in Wenzhou Traditional Chinese Medicine Hospital were selected and randomly divided into the Western medicine group(63 cases)and combined group(63 cases).The Western medicine group was treated with low-molecular-weight heparin combined with didroxyprogesterone,and the combined group was treated with Yishen Quyu Decoction and Western medicine.The traditional Chinese medicine(TCM)syndrome score,ultrasound index,pregnancy outcome,sex hormone,carbohydrate antigen 125(CA125)and inflammatory factor levels of the two groups were compared.Results After treatment,the main symptom and secondary symptom scores of the two groups were significantly decreased,and the scores of the combined group were lower than those of the Western medicine group(all P<0.05).After treatment,the ultrasound indexes of the two groups were significantly improved.The end diastolic blood flow velocity(EDV)and peak systolic blood flow velocity(PSV)levels of the combined group were higher than those of the Western medicine group,and resistance index(RI)was lower than that of the Western Medicine group(all P<0.05).After treatment,the levels of serum sex hormone and CA125 in the two groups were significantly improved.The levels of progesterone(P),estradiol(E_(2))and human chorionic gonadotropin(HCG)in the combined group were significantly higher than those in the control group,and the CA125 level in the combined group was lower than that in Western medicine group(all P<0.05).After treatment,the levels of inflammatory factors in both groups were significantly improved.The levels of IL-4,IL-10,INF-γand IL-2 in the combined group were lower than those in the Western medicine group(all P<0.05).The success rate of foetus preservation in the combined group was 93.65%,which was only 80.95%in the Western medicine group(P<0.05).Conclusion Yishen Quyu Decoction combined with Western medicine can significantly improve the clinical symptoms of threatened abortion patients with uterine haematocele,regulate the levels of serum sex hormones and Th1/Th2 cytokines,improve the blood supply of the uterine artery and reduce the CA125 level,and has a higher success rate of foetal protection.