朱氏补肾活血方治疗血栓前状态早期复发性流产

Effect of Zhu's Bushen Huoxue Recipe in the treatment of early recurrent abortion in the prethrombotic state

目的探究朱氏补肾活血方联合西药标准化治疗血栓前状态早期复发性流产的作用及其可能机制。方法选取98例血栓前状态属肾虚血瘀型早期复发性流产患者,采用随机数字表法分为对照组与试验组,各49例。分孕前、孕后两个阶段观察治疗。第一阶段:避孕治疗3个月,期间对照组采用阿司匹林+地屈孕酮治疗,试验组在对照组的基础上加服补肾活血方一.第二阶段:确认妊娠后,对照组采用阿司匹林+地屈孕酮+低分子肝素治疗,试验组在对照组的基础上加服补肾活血方二比较2组避孕治疗3个月前后的中医症状积分、治疗前及妊娠6周血管内皮相关因子;妊娠6〜7周、10-11周B超相关指标、妊娠12周通过率。结果与本组治疗前比较,避孕治疗3个月后2组中医症状积分均较治疗前下降(P<0.05),且试验组低于对照组(P<0.05)。与对照组妊娠6周同期比较,试验组HA低于对照组(P<0.05),NO、VEGF无统计学意义(P>0.05)。与对照组妊娠6~7周同期比较,PI低于对照组(P<0.05)、孕囊及胚芽大于对照组(P<0.05)。与对照组妊娠10〜11周同期比较,PL、RI均低于对照组(P<0.05),孕囊、胚芽无统计学意义(P>0.05)。2组S/D在各期无统计学意义(P>0.05).试验组妊娠12周通过率为94.87%,高于对照组的75%(P<0.05)。结论朱氏补肾活血方能够明显提高妊娠12周通过率,其作用可能与维持妊娠前后血管屏障机能完整性、改善妊娠后子宫动脉血流有关。

Objective To explore the effect and possible mechanism of Zhu's Bushen Huoxue Recipe combined with standardized western medicine in the treatment of early recurrent abortion in the prethrombotic state.Methods A total of 98 cases of early recurrent abortion patients in the prethrombotic state with the syndrome of kidney deficiency and blood stasis were randomly divided into a control group and an experimental group,with 49 cases in each group.They were treated and observed before and after pregnancy.The first stage:Undergoing a contraceptive treatment for 3 months,during which the control group was treated with aspirin+dydrogesterone,while the experimental group was treated with Bushen Huoxue Recipe I on the basis of the control group.The second stage:After a pregnancy was confirmed,the control group was treated with aspirin+dydrogesterone+low molecular weight heparin,while the experimental group was treated with Bushen Huoxue Recipe II on the basis of the control group.The TCM symptom scores before and after 3 months of contraceptive treatment,vascular endothelial-related factors before treatment and after 6 weeks of pregnancy,B-ultrasound-related indicators in the 6th,7th week of pregnancy,and in the 10th,11th week of pregnancy,and the pregnancy pass rate in the 12th week were compared between the two groups.Results Compared with before treatment,after 3 months of contraceptive treatment,the TCM symptom scores in both groups were decreased(P<0.05),and the experimental group was lower than the control group(P<0.05).Compared with the control group in the 6th week of pregnancy,HA in the experimental group was lower(P<0.05),while there was no difference in NO and VEGF(P>0.05).Compared with the control group in the 6th,7th week of pregnancy,PI in the experimental group was lower(P<0.05),while gestational sacs and embryos were larger(P<0.05).Compared with the control group in the 10th,11th week of pregnancy,PI and RI were lower in the experimental group(P<0.05),while there was no difference in gestational sacs and embryos(P>0.05).There was no difference in S/D between the two groups at the two stages of treatment(P>0.05).The pregnancy pass rate in the 12th week in the experimental group was 94.87%,higher than 75%in the control group(P<0.05).Conclusion Zhu's Bushen Huoxue Recipe can significantly improve the 12-week pregnancy passage rate,which may be related to maintaining the integrity of the vascular barrier function before and after pregnancy,and improving the uterine artery blood flow after pregnancy.