不明原因复发性流产的中西医研究进展

Research Progress of Traditional Chinese and Western Medicine in the Treatment of Unexplained Recurrent Spontaneous Abortion

不明原因复发性流产(Unexplained recurrent spontaneous abortion,URSA)是严重影响女性身心健康的疾病,其病因复杂,诊断困难,尚无统一治疗方法。笔者总结中西医研究发现,中医认为此病多与肾虚、血瘀、血虚等因素相关,采取辨证论治补肾、活血、健脾等。西医认为URSA的发生与母胎界面的免疫失衡相关,涉及子宫蜕膜间质细胞、滋养细胞与自然杀伤(Natural killer,NK)细胞、T细胞、巨噬细胞等免疫细胞之间的相互作用。治疗方案主要是针对母胎微环境的免疫因素进行的一些尝试,包括孕激素、抗凝药物、免疫治疗等。中西医联合用药在提高疗效、改善不良反应等方面具有显著优势,具有较好治疗效果。

Unexplained recurrent spontaneous abortion(URSA)is a disease that seriously affects the physical and mental health of women.Its etiology is complex,its diagnosis is difficult,and there is no unified treatment.Traditional Chinese medicine believes that this disease is mostly related to kidney deficiency,blood stasis,deficiency of blood and other factors,and the treatment is based on syndrome differentiation and treatment,such as tonifying kidney,activating blood,and invigorating spleen.Modern medicine believes that the occurrence of URSA is related to the immune imbalance at the maternal-fetal interface,involving the interaction between uterine decidual mesenchymal cells,trophoblast cells,natural killer(NK)cells,T cells,macrophages and other immune cells.The treatment plan is mainly aimed at the immune factors of the maternal and fetal microenvironment,including progesterone,anticoagulant drugs,immunotherapy and so on.The combination of traditional Chinese and western medicine has significant advantages in improving curative effect and adverse reactions,and has good therapeutic effect.