中西医结合治疗早期先兆流产伴亚临床甲状腺功能减退症的临床观察

Integrated Traditional Chinese and Western Medicine in the Treatment of Early Threatened Abortion with Subclinical Hypothyroidism

目的探讨亚临床甲状腺功能减退症(以下简称“亚临床甲减”)对妊娠早期血清孕酮(P)、雌二醇(E_(2))、人绒毛膜促性腺激素(β-hCG)水平的影响,并探讨早期先兆流产伴亚临床甲减的中西医结合治疗方法。方法选取2019年9月—2021年6月期间,76例于山东中医药大学附属医院治疗的孕龄在4~12周的孕早期妇女。根据是否符合先兆流产的诊断、是否伴有亚临床甲减分为2组,符合先兆流产诊断、不符合亚临床甲减诊断标准的为对照组,同时符合先兆流产、亚临床甲减诊断标准的为亚甲减组。治疗前后抽取空腹静脉血,应用化学发光法分别对血清中P、E_(2)、β-hCG、促甲状腺激素(TSH)水平进行检测。结果治疗前后对照组E_(2)、β-hCG水平均高于亚甲减组,治疗后2组P、E_(2)、β-hCG水平差异均无统计学意义(P>0.05)。治疗后2组P、E_(2)、β-hCG水平均优于治疗前,差异有统计学意义(P<0.05)。治疗前后亚甲减组TSH水平均高于对照组,差异有统计学意义(P<0.05),治疗后2组TSH水平差异减小。结论亚临床甲减会造成妊娠期激素水平的变化,积极治疗后激素水平会向正常水平靠拢,积极治疗亚临床甲减是推进良好妊娠结局的必要条件。

Objective To investigate the effect of subclinical hypothyroidism on the serum P,E2,andβ-hCG levels in early pregnancy,and to explore the treatment of early threatened abortion with subclinical hypothyroidism in integrated traditional Chinese and Western medicine.Methods From September 2019 to June 2021,76 early pregnancy women who were treated in Affiliated Hospital of Shandong University of Traditional Chinese Medicine with a gestational age of 4~12 weeks were selected.According to whether they meet the diagnosis of threatened abortion and whether they are accompanied by subclinical hypothyroidism,they were divided into 3 groups.Those who do not meet the diagnostic criteria of threatened abortion were the control group,and those who meet the diagnosis of threatened abortion and do not meet the diagnostic criteria of subclinical hypothyroidism were the treatment group.At the same time,the treatment group 2 met the diagnostic criteria of threatened abortion and subclinical hypothyroidism.The fasting venous blood was drawn,and the levels of P,E_(2),β-hCG and TSH in serum were detected by chemiluminescence method.Results The levels of E_(2) andβ-hCG in control group were higher than those in subhypothyroidism group before and after treatment,and there was no significant difference in P,E_(2) andβ-hCG levels between 2 groups after treatment(P>0.05).After treatment,the levels of P,E_(2) andβ-hCG in 2 groups were better than those before treatment,and the differences were statistically significant(P<0.05).TSH level in subhypothyroidism group was higher than that in control group before and after treatment,and the difference was statistically significant(P<0.05),and the difference in TSH level between the two groups decreased after treatment.Conclusion Subclinical hypothyroidism can cause changes in hormone levels during pregnancy,and hormone levels will be close to normal levels after active treatment.Active treatment of subclinical hypothyroidism is a necessary condition for promoting good pregnancy outcomes.