中药胎敏灵合并西药治疗抗磷脂抗体致复发性流产的临床研究

Clinical Studies of Taiminling Combined with Western Medicine in Treating Recurrent Abortion Induced by Anti-phospholipid Antibody

【目的】探讨中药胎敏灵(由寿胎丸去阿胶,加郁金、丹参、芍药组成)合并西药治疗抗磷脂抗体(ACA)致复发性流产的治疗效果。[方法]以酶联免疫吸附试验(ELISA)测定血清ACA滴度,将87例血清ACA阳性患者随机分为中西药组、中药组、西药组进行治疗。中药组24例,口服胎敏灵,隔天1次。西药组28例,口服强的松5mg,阿斯匹林50mg,每日1次;肌注肝素钠6125U,隔天1次;静脉滴注人血丙种球蛋白2.5g,隔21d 1次。中西药组口服胎敏灵和强的松、阿斯匹林及静脉滴注丙种球蛋白,用法与上两组相同。用药时间均从妊娠30余天至预产期前15 d。观察各组治疗前后血清ACA滴度的改变和患者的妊娠成功率。[结果]在抗体滴度方面,各组患者治疗后ACA滴度均较治疗前为低(均P<0.01),其中以中西药组疗效最好(与中药组和西药组比较,P<0.05或P<0.01);在妊娠成功率方面,中西药组的妊娠成功率为 94.2％,优于中药组的 41.6％和西药组的 75.0％(P<0.01或 P<0.05)。[结论]中药胎敏灵合并强的松、阿斯匹林和丙种球蛋白对抗磷脂抗体所致复发性流产有较好的治疗效果。

【Objective】To observe the therapeutic effect of Taiminling combined with western medicine in treating re- current abortion (RA) induced by anti-phospholipid antibody (APA). Taiminling is mainly composed of Semen Cuscu- tae, Herba Taxilli, Radix Dipsaci, Cortex Eucommiae, Radix Remanniae, Cortex Lycii, Radix Curumae, Radix Salviae Milti and Radix Glycyrrhizae. 【Methods】 Eighty-seven cases of RA with postive APA were randomized into Group A, Group B and Group C. Group A (n = 24) was treated with oral use of Taiminling every other day; Group B (n = 28) was treated with oral use of prednisone 5mg and aspirin 50mg (qd), heparin sodium 6125U (intramuscular injection, ev- ery other day) and intravenous drip of gamma globulin 2.5g (every 21days); Group C (n = 35) was treated with Taiminling and western medicine, medication time from about the 30th day of pregnancy to the 15th day before the ex- pected date of delivery. Serum APA titer was detected with enzyme-linked immunosorbent assay (ELISA) and pregnant rate was also observed before and after treatment. 【Results】 Serum APA titer was lower in the three groups after treat- ment than that before treatment (P < 0.01) and the titer in Group C was the lowest (P < 0.05 compared to Group A and P < 0.01 compared to Group B). The pregnant rate was 94.2% in Group C, which was higher than that in Group A (41.6%, P < 0.05) and Group B (75. 0%, P < 0.01). 【Conclusion】 Taiminling combined with prednisone, aspirin and gamma globulin exerts a good effect in treating RA induced by anti-phospholipid antibody.