补肾通络汤治疗血栓前状态所致的复发性流产临床疗效观察

Clinical efficacy observation of Bushen Tongluo Decoction in the treatment of recurrent spontaneous abortion caused by pre-thrombotic state

目的:探讨补肾通络汤治疗血栓前状态(PTS)所致的复发性流产(RSA)的临床疗效。方法:选取血栓前状态复发性流产患者160例,随机分为两组,每组80例,对照组于晚饭后半小时口服阿司匹林肠溶片,50 mg,日1次,治疗组在此基础上联合补肾通络汤治疗,日1剂,早晚分服,两组患者均治疗3个月经周期,比较两组患者治疗前后中医证候积分、凝血指标、纤溶指标及子宫动脉血流阻力值的变化,并评估临床疗效。结果:与本组治疗前比较,两组患者治疗后中医证候积分均降低,且治疗组较对照组低(P<0.05);治疗后治疗组和对照组总有效率分别为90%、76.25%,治疗组高于对照组(P<0.05);两组患者治疗后凝血酶原时间(PT)、凝血酶时间(TT)均较本组治疗前降低,且治疗组低于对照组,活化部分凝血活酶时间(APTT)较本组治疗前升高,且治疗组治疗后高于对照组(P<0.05),差异均有统计学意义;两组患者治疗后抗凝血酶Ⅲ(AT-Ⅲ)水平较本组治疗前升高,且治疗组治疗后高于对照组,D-二聚体(D-D)、纤维蛋白原(FIB)、同型半胱氨酸(Hcy)水平均较本组治疗前降低,且治疗组治疗后低于对照组(P<0.05);两组患者治疗后左侧子宫动脉血流搏动指数(PI)、右侧阻力指数(RI)以及双侧收缩期峰值/舒张末期流速(S/D)之和均较本组治疗前降低,且治疗组治疗后均低于对照组(P<0.05)。结论:补肾通络法可以有效治疗血栓前状态所致的复发性流产,改善妊娠结局。

Objective:To explore the clinical efficacy of Bushen Tongluo Decoction in the treatment of recurrent spontaneous abortion caused by pre-thrombotic state.Methods:160 patients with RSA in PTS were randomly divided into two groups with 80 patients in each group.The patients in the control group took aspirin enteric-coated tablets 50 mg once a day half an hour after dinner.The patients in the treatment group took Bushen Tongluo Decoction on the basis of having aspirin,which was 1 decoction a day and taken separately in the morning and evening.Both groups were treated for 3 menstrual cycles.Then,the changes of TCM syndrome score,coagulation index,fibrinolysis index and uterine artery blood flow resistance before and after treatment were compared between the two groups,and the clinical efficacy was evaluated.Results:Compared before treatment in the same group,the TCM syndrome scores of the two groups were decreased after treatment,and the treatment group was lower than the control group(P<0.05);after treatment,the total effective rates of the treatment group and the control group were 90%and 76.25%,respectively,and the treatment group was higher than the control group(P<0.05);after treatment,the prothrombin time(PT)and thrombin time(TT)of the two groups were lower than those before treatment,and the treatment group was lower than the control group.The activated partial thromboplastin time(APTT)was higher than that before treatment,and the treatment group was higher than the control group(P<0.05).The differences were all statistically significant;after treatment,the levels of antithrombinⅢ(AT-Ⅲ)in the two groups were higher than those before treatment,and the treatment group was higher than the control group.The levels of D-dimer(D-D),fibrinogen(FIB)and homocysteine(Hcy)were lower than those before treatment,and the treatment group was lower than the control group(P<0.05);after treatment,the left uterine artery pulsation index(PI),right resistance index(RI)and the sum of bilateral peak systolic/end-diastolic flow velocity(S/D)in the two groups were lower than those before treatment,and those in the treatment group were lower than those in the control group(P<0.05).Conclusion:Bushen Tongluo Decoction can effectively treat recurrent spontaneous abortion caused by pre-thrombotic state and improve pregnancy outcomes.