加味安胎合剂治疗复发性流产合并血栓前状态患者的临床观察

Clinical observation of Jiawei Antai Mixture for treatment of patients with recurrent spontaneous abortion with prethrombotic state

目的 探讨加味安胎合剂治疗复发性流产合并血栓前状态患者的临床疗效。方法 40例就诊于苏州市中医医院妇二科(生殖健康)门诊的不孕症患者随机分为研究组和对照组,每组20例,对照组常规保胎+阿司匹林治疗,研究组在对照组基础上加用加味安胎合剂,观察至妊娠12周。检测中医证候评分、凝血-纤溶指标[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(Fbg)、D-二聚体(D-D)、抗凝血酶Ⅲ(ATⅢ)、血小板最大聚集率(ADP)]、双侧子宫动脉血流动力学指标[双侧收缩期峰值流速/舒张期流速(S/D)、搏动指数(PI)、阻力指数(RI)]、孕12周妊娠结局。结果 治疗后两组中医证候评分降低(P<0.05),PT、APTT、ATⅢ指标值均较治疗前升高(P<0.05),Fbg、D-D、ADP指标值均较治疗前下降(P<0.05),两组双侧子宫动脉S/D、PI、RI指标值均较治疗前下降(P<0.05),研究组孕12周胚胎存活率与治疗前相比差异无统计学意义(P>0.05),研究组中医证候评分、Fbg、D-D、ADP、双侧子宫动脉S/D、PI、RI降低较为明显(P<0.05),PT、ATⅢ升高较为明显(P<0.05),APTT升高不明显(P>0.05)。孕12周胚胎存活率研究组为90%,对照组为80%,两组间比较差异无统计学意义(P>0.05)。结论 加味安胎合剂治疗复发性流产合并血栓前状态患者疗效显著,可明显改善其血栓前状态,缓解临床症状。

Objective To explore the clinical effects of Jiawei Antai Mixture in patients with recurrent spontaneous abortion with prethrombotic state.Methods Totally 40 patients were randomly divided into treatment group and control group,with 20 cases in each group.The control group was treated with aspirin+conventional fetal preservation therapy,while the treatment group was treated with moddufued Jiawei Antai Mixture on the basis of the control group.Both groups were observed until 12 weeks'gestation.The traditional Chinese medical(TCM)syndrome score,coagulation-fibrinolytic indexes(PT,APTT,Fbg,D-D,ATⅢ、ADP),bilateral uterine arterial hemodynamic indexes(S/D,PI,RI),and pregnancy outcome at 12 weeks'gestation were detected.Results After treatment,the scores of TCM syndrome in the two groups decreased significantly(P<0.05),and the values of PT,APTT and ATⅢ were higher than those before treatment (P<0. 05), while the values of Fbg, D-D and ADP decreased compared with before treatment (P<0. 05). The values of bilateral uterine artery S/D, PI and RI in both groups decreased compared with before treatment (P<0. 05), and the survival rate of embryos at 12 weeks of pregnancy in the treatment group was not significantly different from that before treatment (P>0. 05). TCM Syndrome Score, Fbg, D-D, ADP, bilateral uterine artery S/D, PI and RI decreased significantly (P<0. 05), PT and ATⅢ were significantly increased (P<0. 05), and APTT was not significantly increased in the treatment group (P>0. 05). The embryo survival rate at 12 weeks' gestation was 90% in the treatment group and 80% in the control group, and there was no significant difference between the two groups (P>0. 05). Conclusion The Jiawei Antai Mixture has a significant effect on the treatment of patients with recurrent spontaneous abortion and prethrombotic state, which can significantly improve their prethrombotic state, relieve clinical symptoms.