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.

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.

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.

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.

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.

Study on prevention effect of Zishen Yutai pill combined with progesterone for threatened abortion in rats

Objective:To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats.Methods:After pregnancy,50 SPF female SD rats were selected and divided into control group,model group,progesterone group,Zishen Yutai pill group,and progesterone plus Zishen Yutai pill group(combination group),with 10 rats in each group.The rats of control group and abortion model group were lavaged with 2 mL/kg normal saline on pregnancy day 1 for continuous 10 days.Rats in Zishen Yutai pill group were given 1.575 g/kg/d of Zishen Yutai pill for intragastric administration for continuous 10 days.Rats in progesterone group were given intramuscular injection treatment of 0.1 mL/d progestin,continuous for 10 days.Rats in combination group were given injection therapy of aqueous solution of Zishen Yutai pill for continuous 10 days,and other treatments were the same as previous two groups.Abortion model were established then and live births,numbers of abortion and average rate of abortion were compared between the five groups.Peripheral blood was collected to detect the estradiol(E2) and progestational hormone(P),and obtain ratio of Th1/Th2 cytokines(IL-2,INF-γ,IL-4,IL-10).Results:Significant more live births of rats were found in the control group compared with other four groups(P<0.05).The numbers of live births of the rats in abortion model group were significantly less than that of progesterone group,Zishen Yutai pill group and joint group(P<0.05).The numbers of live births of rats in joint group were significant more than that of progesterone group and Zishen Yutai pill group.The serum E2 level of P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were significant higher than that of abortion model group(P<0.05).Serum levels of E2 and P of rats in the control group,progesterone group,Zishen Yutai pill group and joint group were not significant different(P>0.05) but these levels in the control group and Zishen Yutai pill group were significant lower than that of progesterone group and joint group(P<0.05).The maternal-fetal interface IL-4/IL-2,IL-10 / IL-2 of model group were balanced deviating to Th1,while the IL-4/IL-2,IL-10/IL-2 of progesterone group,Zishen Yutai pill group and joint group were balanced deviating to Th2,and joint group' deviation was better than progesterone group and Zishen Yutai pill group(P<0.05).Conclusions:Zishen Yutai pill combined with progesterone has a significant control effect for threatened abortion,which can obviously increase contents of maternal serums E2 and P,and regulate the Thl/Th2 balance with a remarkable effect.

Routine Progesterone Supplementation in Threatened Abortion: Is It a Sound Practice?

Aim: To evaluate the benefits and hazards of routine progesterone supplementation in threatened abortion and whether it is a sound practice or not. Materials and Methods: This study was conducted at Obstetrics and Gynecology Department, Tanta University in the period from January 2018 to December 2018. Eligible patients (n = 190) were randomly allocated into 2 groups: study group who will receive progesterone supplementation (prog. group) and control group who will receive no treatment (place. group). Results: No significant differences were found between both groups regarding all demographic data and pregnancy characteristics. Abortions were higher in place. group 17 (23.94%) than in prog. group 12 (16.44%) with no significant difference p value = 0.263. The incidence of preterm labour was also higher in the place. group 22 (30.99%) in comparison to the prog. group 17 (23.29%) with no significant difference p value = 0.300. Conclusion: Progesterone supplementation in threatened abortion was not beneficial although it reduced abortion and preterm labour rates.

Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

Chinese and Western medicine treatment of blocking antibody in recurrent spontaneous abortion

The causes of recurrent spontaneous abortion are complex traditional Chinese medicine holds that its etiology is losses of spleen and kidney qi, qi and xue deficiency, in addition to secretion, genetic, anatomical, infection, systemic diseases, environmental factors and other related immune factors, the deficiency of blocking antibody is also one of the reasons for the lack of immune factors. In treating it, Chinese medicine treatment combines the patients personal constitution and treatment based on syndrome differentiation; Western medicine treatment mainly applies Aspirin, active immune lymphocyte treatment, low molecular heparin, gamma globulin protein passive immune treatment and psychological intervention therapy. In this paper, a review of the treatment methods for closed antibodies in the past 5 years is made.

Effect of Yangxue Antai Granule (养血安胎冲剂) in Prevention and Treatment of Abortion and Short Life T-Suppressor Cell

Objective: To study the influence of T suppressor cell activity on habitual abortion (HA) and to observe the regulatory effect of Yangxue Antai Granule (YXATG) on T suppressor cell and its effect on fetus preservation. Methods: T suppressor cell activities of 56 pregnant women with HA history were tested with method of short life T suppressor cell activity (MTT method) during early pregnancy, and were followed up in middle and late pregnancy in 20 cases of them. All the 56 patients received YXATG treatment. Groups of normal early pregnant, normal non pregnant women and those non pregnant but with history of habitual abortion were involved in this study as control. Results: T suppressor cell activity in early pregnancy was lower than that of middle and late pregnancy ( P <0.01, P <0.001) and also lower than that of the control groups ( P <0.01, P <0.001). The successful rate of fetus preservation of YXATG was 98.2%, and 98.0% of the cases got normal delivery. Conclusion: Low T suppressor cell activity might be the immunologic etiology of HA. The fetus preservative effect of YXATG might be due to its regulatory effect on T suppressor cell activity.

Effect of Traditional Chinese Medicine Treatment on Levels of Blocking Antibody, β-hCG, Progesterone and Estradiol in Spontaneous Abortion

Objective: To explore the effect of traditional Chinese medicine (TCM) on abnormalmaternal-fetal immune and endocrine in 24cases of threatened abortion (TA) and 68 cases of recurrent spontaneous abortion (RSA).Methods: The levels of blocking effect (BE),antiidiotype antibody (AIA), cytotoxin antibody (CTA), β-human chorionic gonadotropin(β-hCG), progesterone (P), estradiol (E2)were measured in all 92 patients. Results: Incidence rates of the lack of BE, AIA and CTAin 92 cases were 60. 87%, 57. 61 % and 72.83% respectively. The lower levels of BE,AIA and CTA were elevated significantly (P< 0. 05 ～0. 01 ), and the serial levels β- hCG, P and E2 were markedly increasing (P< 0. 01 ) in all successful pregnant patients.The rate of the successful pregnancy of 92 cases was 89. 13 % (to TA 91. 67%, to RSA 88.24 % respectively). Conclusions: It suggeststhat the lack of blocking antibody (BA) andendocrine hormone deficiency may result inspontaneous abortion during early pregnancy.The therapeutic mechanism of those herbs intreating spontaneous abortion was associatedwith the growing levels of BA and hormone byregulating the maternal-fetal immunity and endocrine.

补肾固胎方联合黄体酮注射液治疗肾虚型早期先兆流产疗效及对妊娠激素水平和Th1/Th2细胞因子的影响

目的 观察补肾固胎方联合黄体酮注射液治疗肾虚型早期先兆流产疗效及对妊娠激素水平和Th1/Th2细胞因子的影响。方法 采用随机数字表法将符合入选标准的120例肾虚型早期先兆流产患者分为观察组和对照组。对照组予黄体酮注射液治疗,观察组同联合补肾固胎方治疗。连续治疗2周后,比较两组中医证候积分(妊娠期阴道流血、小腹坠胀或疼痛、腰酸痛、膝关节酸软)、妊娠激素水平[雌二醇(Estradiol, E_(2))、人绒毛膜促性腺激素(Human chorionic gonadotropin, β-HCG)、孕酮(Progesterone, P)]、Th1/Th2细胞因子[白细胞介素2(interleukin-2,IL-2)、白细胞介素4(interleukin-4,IL-4)、γ干扰素(Interferon-γ,INF-γ)]改善情况,统计两组治疗总有效率、妊娠结局及不良反应发生率。结果 两组治疗后妊娠期阴道流血、小腹坠胀或疼痛、腰酸痛、膝关节酸软积分,IL-2、INF-γ水平均低于治疗前(P<0.05),且观察组治疗后以上中医证候积分和IL-2、INF-γ水平均低于对照组(P<0.05);两组治疗后IL-4水平均高于治疗前(P<0.05),且观察组治疗后IL-4水平高于对照组(P<0.05);观察组总有效率为(91.7%,55/60),高于对照组(75.0%,45/60)(P<0.05);观察组足月分娩率为(85.0%,51/60),高于对照组(56.7%,34/60)(P<0.05);观察组不良反应发生率为3.3%,低于对照组(25.0%)(P<0.05)。结论 补肾固胎方联合黄体酮注射液能够有效调节肾虚型早期先兆流产患者妊娠激素水平和Th1/Th2细胞因子水平,纠正免疫功能紊乱,降低患者流产率,提高足月妊娠率,改善妊娠结局。

盐酸利托君联合硫酸镁对高龄二胎先兆流产患者免疫调节功能、性激素水平及母婴结局的影响

目的探讨盐酸利托君联合硫酸镁对高龄二胎产妇先兆流产的治疗效果,并分析其可能的作用机制。方法选取2020年3月至2021年12月河北省邯郸市妇幼保健院产三科就诊的100例高龄二胎先兆流产患者,按照随机数字表法均分为对照组和观察组,每组50例。对照组在一般干预措施(卧床休息,给予间歇性吸氧、营养摄入及心理护理等)基础上采用硫酸镁治疗;观察组在一般干预措施基础上采用盐酸利托君联合硫酸镁治疗。比较2组治疗效果,治疗前后免疫调节功能指标[血清封闭抗体(BA)和抗心磷脂抗体(ACA)]、性激素[孕酮(P)、雌二醇(E2)、β-人绒毛膜促性腺激素(β-h CG)]、相关细胞因子[妊娠相关蛋白A(PAPP-A)、人类白细胞抗原G(HLA-G)、白细胞介素-10(IL-10)]水平、母婴结局及不良反应。结果观察组总有效率高于对照组(96%vs.80%,P<0.05)。与治疗前比较,2组治疗后血清BA阳性率显著升高,ACA阳性率显著下降(均P<0.05);而治疗后观察组血清BA阳性率高于对照组,ACA阳性率低于对照组(均P<0.05)。与治疗前比较,2组治疗结束时、治疗后2周血清P、E2、β-hCG、PAPP-A、HLA-G、IL-10水平均显著升高;治疗结束和治疗后2周性激素和相关细胞因子水平观察组均高于对照组(均P<0.05)。观察组保胎成功、足月分娩、自然分娩比例均高于对照组;而流产、早产、剖宫产、新生儿不良结局发生率均低于对照组(均P<0.05)。2组不良反应发生率比较差异无统计学意义(P<0.05)。结论盐酸利托君联合硫酸镁治疗高龄二胎产妇先兆流产效果显著,能改善母体免疫调节功能,调节性激素及PAPP-A、HLA-G、IL-10水平,减少不良母婴结局且不增加不良反应。

加味寿胎贴脐片释药动力学与药效学研究

本研究旨在通过体外透皮试验考察加味寿胎贴脐片的透皮效果,以大鼠先兆性流产模型的流产率、脏器指数、胚胎个数和血清激素水平为评价指标,进一步确定其疗效,以期为临床治疗先兆性流产提供疗效显著且使用方便的新制剂。试验采用Franz扩散池法进行体外透皮试验,考察贴脐片中金丝桃苷、槲皮素、大黄素和川续断皂苷Ⅵ的透皮吸收情况,以评价经皮渗透效果。建立大鼠先兆性流产模型,动物随机分为4组,即空白组、空白贴脐片对照组(只含辅料,不含药)、阳性组及加味寿胎贴脐片组,以流产率、脏器指数、胚胎个数、雌二醇(E2)、孕酮(P)、人绒毛膜促性腺激素(β-HCG)、前列腺素(PGF-2α)水平考察加味寿胎贴脐片对模型动物先兆性流产的影响。结果表明,加味寿胎贴脐片中4种指标成分24h累计透过量为142.68μg/cm^(2)、3.44μg/cm^(2)、3.78μg/cm^(2)、718.77μg/cm^(2),累计透过速率分别为0.0497μg/(cm^(2)·h)、0.0485μg/(cm^(2)·h)、0.0544μg/(cm^(2)·h)、0.045μg/(cm^(2)·h)。4种指标成分的透过率规律均符合一级动力学方程。金丝桃苷透过百分率为23.9%、槲皮素透过百分率为17.6%、大黄素透过百分率为27.7%、川续断皂苷Ⅵ透过百分率为27.1%。药效学试验结果显示,与空白贴脐片对照组相比,各给药组大鼠血清中E2、P、β-HCG的含量均有上调,PGF-2α的含量均有下调,贴脐片组在治疗先兆流产的作用上疗效显著,保胎效果更优。加味寿胎贴脐片具有体外经皮渗透的特性,对大鼠先兆性流产的治疗具有一定的改善作用,说明该制剂具有一定的临床开发价值。

体外受精-胚胎移植患者用药分析与处方点评

目的分析体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)患者的用药情况,旨在为促进临床合理用药、发展新的药学服务模式奠定基础。方法选取2022年1月至12月在浙江中医药大学附属杭州市中医院就诊的513例IVF-ET患者的西药和中成药处方,实施用药分析和处方点评。结果在选取的1377张门诊处方中,处方诊断最多的是先兆流产(47.36%),其他诊断有易栓症、带下病和自身免疫病等。药物使用频次最高的是保胎药物(38.51%),其次是抗凝药物(16.96%)和辅助生殖用药(16.87%)。门诊IVF-ET患者的处方用药情况基本合理,不合理处方主要是适应证不适宜(2.83%)。结论门诊IVF-ET患者用药基本合理,建议强化临床医师和药师合理用药知识培训,探索以患者为中心的多种药学服务新模式。

滋肾育胎丸联合盐酸屈他维林片治疗绒毛下血肿的效果研究

目的:探讨滋肾育胎丸联合盐酸屈他维林片治疗绒毛膜下血肿(SCH)的临床效果,并观察治疗前后调节性T细胞/辅助性T细胞17(Treg/Th17)表达情况。方法:选取2023年1月至2023年12月新疆医科大学第一附属医院收治的早期先兆流产合并SCH,并伴有下腹痛和阴道流血的97例患者作为研究对象,采用随机数字表法随机分为观察组(n=47)和对照组(n=50)。对照组单纯给予屈他维林治疗;观察组在对照组的基础上加用滋肾育胎丸进行治疗。比较2组患者的一般临床资料、临床治疗有效率、止血止痛相关指标、治疗前后绒毛膜下血肿超声检测结果及治疗前后外周血Treg/Th17表达水平。结果:2组治疗后的绒毛膜下血肿面积/孕囊面积均低于治疗前(P<0.01),且观察组低于对照组(P<0.01)。观察组止血控制时间短于对照组(P<0.01);观察组临床治疗有效率高于对照组(P<0.05)。治疗后2组患者TGF-β水平高于治疗前,且IL-17水平低于治疗前(P<0.01);治疗后观察组TGF-β水平高于对照组,而IL-17水平低于对照组(P<0.01)。结论:滋肾育胎丸联合盐酸屈他维林片在早孕期SCH患者中的临床应用效果显著,提高临床治疗有效率,促进T细胞向Treg转化。

自拟固肾安胎汤联合黄体酮注射液治疗肾虚证早期先兆流产的临床价值

目的:探讨自拟固肾安胎汤联合黄体酮注射液治疗肾虚证早期先兆流产的临床价值。方法:选取2021年1月—2022年12月九江市妇幼保健院收治的第一诊断为早期先兆流产的92例患者,随机分为两组,对照组(n=46)采用黄体酮注射液治疗,观察组(n=46)在对照组基础上联合自拟固肾安胎汤治疗。比较两组疗效、临床症状评分、血清内分泌激素水平、不良反应。结果:观察组总有效率为91.30%,对照组为76.19%,两组治疗总有效率比较,差异有统计学意义(P<0.05)。治疗后,观察组阴道出血、小腹坠痛、腰膝酸软、头晕耳鸣评分均低于对照组,β-人绒毛膜促性腺激素(β-hCG)、孕酮(P)水平均高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:自拟固肾安胎汤联合黄体酮注射液治疗肾虚证早期先兆流产能提高治疗效果,有效改善患者临床症状,调节内分泌生殖功能,且安全性良好。