补脾固肾安胎汤治疗复发性流产对患者性激素、免疫功能及妊娠结局的影响

Effects of Bupi Gushen Antai Decoction(补脾固肾安胎汤)on Sex Hormones,Immune Function and Pregnancy Outcomesin Patients with Recurrent Abortion

目的探讨补脾固肾安胎汤治疗复发性流产(recurrent abortion,RA)对患者性激素、免疫功能及妊娠结局的影响。方法选取2021年1月—2023年6月收治的100例RA患者,随机分为观察组和对照组各50例,对照组采用阿司匹林+泼尼松治疗,观察组在对照组的基础上采用补脾固肾安胎汤治疗,比较两组临床疗效、中医证候积分、性激素[雌二醇(estradiol,E2)、孕酮(progesterone,P)、人绒毛促性腺激素(human chorionic gonadotropin,HCG)]、免疫功能[CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)]、凝血功能[凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)]及妊娠结局。结果观察组总有效率高于对照组(P<0.05);治疗后,观察组的中医证候积分低于对照组(t=6.708;t=4.243;t=3.532;t=3.138;t=3.947;t=2.383;t=4.650,P<0.05);治疗后,观察组血清E2、P水平高于对照组,HCG水平低于对照组(t=5.619;t=5.638;t=11.360,P<0.05);治疗后,观察组CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于对照组,CD_(8)^(+)水平高于对照组(t=6.155;t=5.228;t=7.327,P<0.05);治疗后,观察组PT、APTT水平高于对照组,FIB水平低于对照组(t=3.012;t=2.681;t=6.412,P<0.05);观察组妊娠成功率高于对照组(χ^(2)=5.198,P<0.05)。结论补脾固肾安胎汤治疗RA患者效果显著,可有效改善性激素、免疫功能和凝血功能,提高妊娠成功率。

Objective To explore the effects of Bupi Gushen Antai Decoction(补脾固肾安胎汤)on sex hormones,immune function and pregnancy outcomes in patients with recurrent abortion(RA).Methods A total of 100 patients with RA were enrolled as the research objects between January 2021 and June 2023.They were randomly divided into observation group and control group,50 cases in each group.The control group was treated with aspirin and prednisone,whilethe observation group was additionally treated with Bupi GushenAntai Decoction.The clinical curative effect,scores of TCM syndromes,sex hormones[estradiol(E2),progesterone(P),human chorionic gonadotropin(HCG)],immune function(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)),coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)]and pregnancy outcomes were compared between the two groups.Results The total response rate of the observation group was higher than that of the control group(P<0.05).After treatment,scores of TCM syndromes(dizziness and tinnitus,soreness and weakness of waist and knees,mental fatigue,shortness of breath and laziness to speak,anorexia and loose stool/frequent nocturnal urination,orbital darknessor dark spot on the face)in the observation group were lower than those inthe control group(t=6.708;t=4.243;t=3.532;t=3.138;t=3.947;t=2.383;t=4.650,P<0.05).After treatment,the levels of serum E2 and P in the observation group were higher than those in the control group.TheHCG level in the observation group was lower than that in the control group(P<0.05),the levels of CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) were lower than those in the control group,while CD_(4)^(+) was higher than that in the control group(P<0.05).PT and APTT in the observation group were longer than those in the control group,while FIB was lower than that in the control group(P<0.05).The success rate of pregnancy in the observation group was higher than that in the control group(P<0.05).Conclusion The curative effect of Bupi Gushen Antai Decoction is significant in RA patients,which can effectively improve sex hormones,immune function and coagulation function,and increase the success rate of pregnancy.