Medication Rules of Traditional Chinese Medicine for Treating Threatened Abortion in the Early Stage of Pregnancy with Subchorionic Haematoma Based on Data Mining

Objective:Using data mining technology to explore the rules of traditional Chinese medicine(TCM)in the treatment of threatened abortion in the early stage of pregnancy with sub-chorionic haematoma(SCH).Methods:Literature of TCM in the treatment of threatened abortion in the early stage of pregnancy with SCH were retrieved from CNKI,VIP,WANFANG and Pubmed,EMBASE.The literature information database was established to be used for descriptive analysis,association rule analysis and cluster analysis of relevant data.Results:A total of 100 literatures were included,involving 114 Chinese herbs.The efficacy of Chinese herbs were mainly tonic drugs,hemostatic drugs,heat-clearing drugs,dissolving blood stasis and hemostatic drugs.The medicinal properties were mostly mild and warm,and the taste of the drug was mainly sweet,bitter and pungent.The liver meridian,spleen meridian and kidney meridian were frequently used.The commonly used drug pair combination was"Xu duan(Radix dipsaci,续断)-Tusizi(Semen Cuscutae,菟丝子)",and the core combination was"Tusizi-Xu duan-Ejiao(Donkeyhide gelatin,阿胶)-Baizhu(Atractylodes macrocephala,白术)-Dangshen(Codonopsis pilosula,党参)".Commonly used drugs for removing blood stasis and hemostasis were with Sanqi(Panax notoginseng,三七),Puhuang(cattail pollen,蒲黄),and Qiancao(Radix Rubiae,茜草).Conclusion:Data mining traditional Chinese medicine for the treatment of threatened abortion in the early stage of pregnancy with SCH clinically commonly used drug efficacy,taste,meridian,commonly used drug pairs,core combination and commonly used blood stasis hemostatic drugs,has important reference significance for the treatment of threatened abortion in the early stage of pregnancy combined with SCH.

Clinical application of Bushen Jianpi Gutai Decoction in threatened abortion

Objective:To discuss the clinical application of the"seven,five and three"odd-numbered law theory and analyze the effect on serum sex hormone level.Methods:A total of 100 patients with early threatened abortion admitted from January 2021 to October 2021 were randomly divided into study group and control group,with 50 patients in each group.Patients in the control group were treated with dydrogesterone tablets,while patients in the study group were treated with Bushen JianpiGutai Decoction combined with dydrogesterone tablets.Clinical efficacy and progesterone level before and after treatment were observed and compared between the two groups,as well as clinical symptom relief time of the two groups,including hemostasis time,abdominal pain relief time and lumbar acid relief time,and sex hormone level of the two groups were observed and compared.Results:The clinical efficacy was significantly better than control patients(P<0.05),no significant difference in progesterone level comparison before treatment(P>0.05),significantly better than control patients(P<0.05),hemostasis,abdominal pain remission and waist acid remission were significantly shorter than control patients(P<0.05),and both significantly better sex hormone levels after treatment(P<0.05).Conclusion:Traditional Chinese medicine has certain advantages in the treatment of threatened abortion,odd-numbered law theoryguidesthe regulation of Yin and Yang in the female menstrual cycle and reproductive function is mainly the regular change of Yin and Yang.Under the guidance of"seven,five,three"odd-numbered law theoryof Traditional Chinese medicine master Xia Guicheng,master the key date and the best time of its transformation,regulate Yin and Yang in the female body,to prevent the occurrence and development of menstrual diseases and adverse childbirth.Bushen Jianpi Gutai decoction can effectively treat threatened abortion,significantly improve the clinical symptoms,improve the level of serum sex hormone,worthy of clinical promotion.

A clinical protocol: A double-blinded, randomized controlled trial on the effect of traditional Chinese medicine formula Shoutai Pill in the treatment of threatened abortion

for about 20%of all clinically confirmed pregnancy.It is the main cause of early abortion.Vaginal bleeding is the main clinical manifestation,which seriously affects the mental health and quality of life of pregnant women.Currently,there is effective treatment for this condition.A recent meta-analysis showed that Shoutai Pill(ST Pill),a traditional Chinese medicine(TCM)formula,can effectively decrease the rate of threatened abortion.However,high heterogeneity was found among the studies included in the meta-analysis,this conclusion on the efficacy of TCM is not definitive.Although several have been conducted,some of them do not describe randomization and blinding methods.To address these problems,this article proposes an improved clinical treatment scheme based on ST Pill,which is to be tested through a well-designed randomized controlled trial,for the treatment of threatened abortion.Methods:This is a double-blinded,randomized,placebo-controlled trial to be conducted in a public Three-A hospital in China's Mainland.A total of 200 people will be enrolled.Using computer-generated random numbers,the participants will be randomly divided into two groups at a ratio of 1:1(treatment group(treated with ST Pill group)and placebo group).Both groups will receive medication to the end of the 20th gestational week or 1 week after vaginal bleeding stops,depending on which is longer.Participants in the treatment group will be treated with ST Pill(20 pills/time,once a day),and those in the placebo group will receive a placebo drug which is similar in appearance and smell with ST Pill.The main observation index is the live birth rate.Discussion:Although the efficacy of ST Pill in threatened abortion is well-known,no study has tested its efficacy through a double-blinded,randomized trials.Therefore,there is an urgent need for a standardized randomized double-blinded controlled trial to evaluate the clinical efficacy of ST Pill.ST Pill is likely to be a convenient and effective TCM pill for the prevention of threatened abortion.

Plasma β-Endorphin Levels in Women with Early Threatened Abortion before and after the Treatment of Integrated Chinese and Western Medicine

To observe plasm a β-endorphin (β-EP) and gonadotrophin releasing horm one (GnRH), hum an chorionic gonadotrophin (hCG), progesterone (P4) levelsin w om en w ith early threatened abortion and w ith a history of recurrent spontaneous abortions (RSA). Tw enty patientsw ith threatened abortion at7～8 w eeksof gestation w ere re- cruited, allof them had a history of 3 or m ore recurrentunexplained abortions. They w ere treated w ith psychologicalconsultation accompanied by traditionalChinese herbs. Blood samples w ere taken to m easure β-EP, GnRH, hCG and P4 levels by radioim - m unoassay (RIA). The treatm ents w ere continued till10～12 w eeks, blood w astaken during this period to compare changes in these peptides / horm ones. Tw enty norm al pregnantw om en at7～8 and 10～12 w eeksand 20 patientsw ith incompleteabortion at 10～12 w eeksw ererecruited for comparativestudies. Results: (1) In norm alpregnant w om en, plasm a β-EP, GnRH, hCGand P4 levelsat10～12 w eeksw ere significantly higher than thatat7～8 w eeks (P< 0.01). (2) In patients w ith threatened abortion and a history of RSA, plasm a β-EP levels at7～8 w eeks w ere significantly higher than those of norm al pregnantw om en (P< 0.01); on the contrary, plasm a GnRH, hCGand P4 levelsin these patientsw ere significantly low er than thosein norm alcases (P< 0.01). After treatm ent, 16 of the 20 patients succeeded in m aintaining their pregnancies, the levels of the four plasm a contents at10～12 w eeks w ere sim ilar to thosein norm alpregnantw om en (P> 0.05). (3) Plasm a β-EPlevelsin patientsw ith incomplete abortionsat10～12 w eeksw ere dram atically higher and GnRH, hCGand P4 levelsw ere low er than in norm alpregnantw om en (P< 0.01). β-EP m ightplay a role in the pathophysiology of spontaneousabortion.

Network pharmacology of threatened abortion treated by ShouTaiWan

Objective: To explore the mechanism of ShouTaiWan's intervention in the treatment of Threatened Abortion based on Network Pharmacology. Methods: The effective active ingredients and targets in ShouTaiWan were obtained by searching in TCMSP database, BATMAN-TCM database and Uniprot database. The target of threatened abortion was obtained by searching for 'threatened abortion' in GeneCards. And the co-target gene of ShouTaiWan and threaten abortion can be obtained through the use of gene mapping in Venn diagram. Then an interaction network "disease-drug-target" can be constructed through a software called Cytoscape. Upload the Co-targeted gene to the STRING database to construct the protein interaction network map (PPI) , which would be screened for the key genes by using R language. Finally, used the R language to analyze gene ontology (GO) enrichment and kyoto encyclopedia of genes and genome (KEGG) pathway enrichment. Result: It is predicted that 21 effective active ingredients for the treatment of threatened abortion and 89 common effective targets are expected. Quercetin, kaempferol, beta-sitosterol, and isorhamnetin were the most effective components. As for the targets, prostaglandin endoperoxidase receptor (PTGS2), progesterone receptor (PGR), prostaglandin endoperoxidase receptor 1 (PTGS1), and Peroxisome proliferator activates receptor gamma (PPARG) were the most effective ones. The core targets in PPI network are Interleukin-6 (IL-6), protein kinase (AKT1), vascular endothelial growth factor A (VEGFA), etc. GO enrichment analysis shows that the activity of cytokines, regulatory functions, nuclear protein receptors and transcription of genes would be affected. KEGG pathway enrichment analysis illustrates that advanced glycation end products-receptor for AGE (AGE-RAGE) pathways are of the highest significance, followed by the fluid shear stress and atherosclerosis pathways. Conclusion: ShouTaiWan can achieve anti-inflammatory, increase vascular permeability,improve endometrial receptivity and other aspects of regulation to treat threatened abortion and embryo implantation through regulating cytokine.

Effect of Chinese Herbal Treatment on Th1- and Th2-Type Cytokines,Progesterone andβ-Human Chorionic Gonadotropin in Early Pregnant Women of Threatened Abortion

Objective： To study the clinical effects of Prescription Zhuyun-Ⅲ （助孕3号方, ZYⅢ） on early pregnant women diagnosed as threatened abortion, and its mechanism in immunity and endocrine by determining serum Th1- and Th2-type cytokines, progesterone, and β-human chorionic gonadotropin （β-HCG）. Methods： The treatment group comprised 30 early pregnant women diagnosed as threatened abortion of deficiency syndrome of Pi （脾）, Shen （肾）, or both. The control group consisted of 20 normal early pregnant women of similar gestational age. Patients in the treatment group were administered with ZYⅢ for 4 weeks. Peripheral blood samples were collected pre- and post-treatment from both the treatment and the control groups. Serum Thl-type cytokine [interleukin-2 （IL-2）] and Th2-type cytokine [interleukin-10 （IL-10）] were determined by flow cytometry, and serum progesterone and 13-HCG were determined by ELISA. Results： （1） The treatment was effective in 26 and ineffective in 4 patients of the treatment group. Therefore, the cure percentage was 86.67%. （2） In the treatment group before the treatment, IL-2 was significantly higher, IL-10 tended to be less, and the Th1/Th2 balance shifted toward Thl compared with those in the control group. （3） After the treatment, IL-2 was decreased, IL-10 was increased, and IL-2/IL-10 was decreased. Both progesterone and β-HCG were increased. Changes of progesterone were positively correlated with changes of IL-10, whereas changes of β-HCG were negatively correlated with changes of IL-2. Conclusions： Our study suggests that ZYⅢ has an evident function of protecting the fetus, and one of its mechanisms is inhibiting the secretion of Thl cytokines, promoting the secretion of Th2 cytokines, and recovering the pathological shift of the Th1/Th2 balance. The other possible mechanism is increasing serum progesterone and β-HCG concentrations. Moreover, there are some correlations between the above two effects.

DEVELOPMENT OF ACUPUNCTURE TREATMENT AND CLINICAL RESEARCH OF THREATENED ABORT ION

In the present paper, the authors review rece nt development of acupunct ure treatment of threatened abortion from 1) clinical application of "Linggui Ba fa"(灵龟八法Eight Methods of Intelligent Turtle), 2) body acupoints , and 3) acup uncture combined with Chinese materia medica, and clinical study from 1) effect of acupuncture on the blood flow of uterus, and 2) effect of acupuncture on plas ma progesterone level. In addition, acupuncture therapy is also used to help wom en in gestation and can effectively raise the pregnant rate. "Lingg ui Bafa" is r ather effective in preventing threatened abortion and should be studied further.

Effects of Perinatal Complications on Coagulation Function in Pregnant Women

Objectives:To investigate the effects of various complications on the coagulation function of perinatal women.Methods:A total of 210 pregnant women between November 2016 and June 2017 were recruited.The coagulation function indexes,including prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),and thrombin time(TT),were evaluated in pregnant women with group B Streptococcus(GBS),positive nonstress test(NST),scarred uterus,prenatal fever,macrosomia,gestational hypertension,gestational diabetes,premature rupture of membranes(PROMs),threatened abortion,and oligohydramnios.Results:No significant differences were found in PT,APTT,FIB,and TT in pregnant women with GBS,positive NST,scarred uterus,macrosomia,gestational hypertension,gestational diabetes,PROMs,and oligohydramnios.Moreover,significantly decreased PT and APTT and significantly increased TT were found in pregnant women with prenatal fever compared to normal controls,whereas significantly increased TT was also observed in those with threatened abortion.Conclusions:Among the complications that occur in pregnant women,prenatal fever and threatened abortion have important effects on coagulation function.