固肾安胎丸辅助泼尼松及阿司匹林治疗不明原因复发性流产及对外周血免疫细胞、FDP、D-D影响

Influence of prednisone and aspirin assisted by Gushen antai pill for treating women with unexplained recurrent miscarriage on their peripheral blood immune cells, and their levels of fibrin degradation products and D-dimer

目的:探讨固肾安胎丸辅助泼尼松及阿司匹林治疗不明原因复发性流产效果及对患者外周血免疫细胞、纤维蛋白降解产物(FDP)、D-二聚体(D-D)的影响。方法:2019年11月-2020年11月本院收治的不明原因复发性流产患者92例,随机数字表法分为联合组和对照组各46例,确认宫内妊娠后两组均予以泼尼松及阿司匹林治疗,联合组辅以固肾安胎丸治疗,两组均持续治疗至孕12周。对比两组治疗前后子宫内膜容受性[子宫内膜下动脉的血流阻力指数(RI)、搏动指数(PI)与子宫内膜厚度]、外周血免疫细胞(T细胞、NK细胞)及FDP、D-D水平,统计疗效、不良反应,治疗后1年随访妊娠结局。结果:两组治疗后子宫内膜下动脉的RI、PI均降低且联合组(0.63±0.05、1.80±0.22)均低于对照组(0.75±0.07、2.07±0.27),子宫内膜厚度均增加且联合组(7.72±1.17mm)高于对照组(7.15±1.06mm),两组T细胞水平均提高,NK细胞、FDP、D-D水平均降低且联合组改善幅度大于对照组(均P<0.05);总有效率联合组(91.3%)高于对照组(73.9%)(P<0.05),不良反应联合组(8.7%)与对照组(13.0%)无差异(P>0.05);1年后随访,活产率联合组(91.1%)高于对照组(75.0%)(P<0.05)。结论:固肾安胎丸辅助泼尼松及阿司匹林治疗不明原因复发性流产可增加患者子宫内膜容受性,调节机体免疫细胞与FDP、D-D水平,改善机体内环境,改善妊娠结局,用药安全。

Objective: To investigate the effect of prednisone and aspirin assisted by Gushen antai pill for treating women with unexplained recurrent miscarriage(URM), and to study its influence on their peripheral blood immune cells, and their levels of fibrin degradation products(FDP) and D-dimer(D-D). Methods: A total of 92 women with URM were selected as the research objects and were divided into two groups(46 cases in each group) according to the random number table method from November 2019 to November 2020. After the intrauterine pregnancies of the women in the two groups were confirmed, the women in control group were treated with prednisone and aspirin, and the women in the study group were treated with prednisone and aspirin assisted by Gushen antai pill. And the treatments of the women in the two groups were continued until their 12 gestational weeks. The endometrial receptivity indexes, such as the subendometrial artery resistance index(RI), pulsatile index(PI), and the endometrial thickness, the levels of the peripheral blood immune cells(T cells and NK cells), FDP, and D-D of the women before and after treatment were compared between the two groups. The curative effect, the adverse reactions rate, and the pregnancy outcomes of the women in the two groups within 1 year of follow up after treatment were analyzed. Results: After treatment, the values of RI and PI of the subendometrial artery of the women in the two groups had decreased significantly, and which of the women in the study group(0.63±0.05 and 1.80±0.22) were significantly lower than those (0.75±0.07and 2.07±0.27)of the women in the control group.The endometrial thickness of the women in the two groups had increased significantly,and which of the women in the study group(7.72±1.17mm)was significantly higher than that(7.15±1.06 mm)of the women in the control group.The T cell level of the women in the two groups had increased significantly,the levels of NK cell,FDP and D-D of the women in the two g roups had decreased significantly,and the improvement degrees of which of the women in the study group were significantly more than those of the women in the control group(all P<0.05).The total effective rate(91.3%)of the women in the study group was significantly higher than that(73.9%)of the women in the control group(P<0.05),and there was no significant difference in the adverse reactions rate(8.7% vs.13.0%)of the women between the two groups(P>0.05).After 1 year of follow-up,the live birth rate(91.1%)of the women in the study group was significantly higher than that(75.0%)of the women in the control group(P<0.05).Conclusion:The application of prednisone and aspirin assisted by Gushen antai pills for treating the women with URM can increase their endometrial receptivity,regulate their levels of immune cells,FDP,and D-D,and improve the internal environment of their body,thereby which can improve their pregnancy outcomes safely.