寿胎丸合四君子汤联合依诺肝素治疗抗心磷脂抗体阳性复发性流产患者的效果

Effects of Shoutai pills,Sijunzi decoction combined with Enoxaparin in treatment of ACA positive recurrent abortion patients

目的:观察寿胎丸合四君子汤联合依诺肝素治疗抗心磷脂抗体(ACA)阳性复发性流产(RSA)患者的效果。方法:选取2020年10月至2022年10月该院收治的86例ACA阳性RSA患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各43例。对照组采用依诺肝素钠注射液治疗,观察组在对照组基础上加用寿胎丸合四君子汤治疗,比较两组临床疗效、中医证候积分、D-二聚体水平、纤维蛋白原水平、白细胞介素(IL)-10水平和妊娠成功率。结果:观察组治疗总有效率为88.37%,明显高于对照组的69.77%,差异有统计学意义(P<0.05);治疗后,观察组头晕耳鸣、腰酸膝软、神疲肢倦等中医证候积分和D-二聚体、纤维蛋白原水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05);随访1年,观察组妊娠成功率为83.72%,明显高于对照组的62.79%,差异有统计学意义(P<0.05)。结论:寿胎丸合四君子汤联合依诺肝素治疗ACA阳性RSA患者可提高治疗总有效率、妊娠成功率和IL-10水平,降低中医证候积分、D-二聚体水平和纤维蛋白原水平,效果优于单纯依诺肝素治疗。

Objective:To observe effects of Shoutai pills,Sijunzi Decoction combined with Enoxaparin in treatment of anticardiolipin antibody(ACA)positive recurrent spontaneous abortion(RSA).Methods:A prospective study was conducted on 86 patients with ACA positive RSA admitted to the hospital from October 2020 to October 2022.According to the random number table method,they were divided into observation group and control group,43 cases in each group.The control group was treated with Enoxaparin sodium injection,while the observation group was treated with Shoutai pills combined with Sijunzi decoction on the basis of that of the control group.The clinical efficacy,the Traditional Chinese Medicine(TCM)symptom score,the D-dimer level,the fibrinogen level,the interleukin(IL)-10 level,and the pregnancy success rate were compared between the two groups.Results:The total effective rate of the observation group was 88.37%,which was significantly higher than 69.77%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as dizziness and tinnitus,soreness of waist and knees,fatigue of spirit and limbs,and the levels of D-dimer and fibrinogen in the observation group were lower than those in the control group,the level of IL-10 was higher than that in the control group,and the differences were statistically significant(P<0.05).After 1 year follow-up,the pregnancy success rate of the observation group was 83.72%,which was significantly higher than 62.79%of the control group,and the difference was statistically significant(P<0.05).Conclusions:Shoutai pills,Sijunzi decoction combined with Enoxaparin in the treatment of the ACA positive RSA patients can improve the total effective rate,the pregnancy success rate and the IL-10 levels,and reduce the TCM syndrome scores,the D-dimer levels and the fibrinogen levels.Moreover,it is superior to single Enoxaparin treatment.