2023 年第 1 期 第 18 卷

补肾活血方联合常规西药治疗肾虚夹瘀型不明原因复发性流产临床效果

Effect of Bushenhuoxue recipe combined with conventional western medicine on the treatment of unexplained recurrent abortion with kidney deficiency and blood stasis syndrome

作者：陆丽丹1蔡奚梅1张丽萍1冯晓玲2

英文作者：Lu Lidan1 Cai Ximei1 Zhang Liping1 Feng Xiaoling2

单位：1南京中医药大学常熟附属医院妇产科，常熟215500；2黑龙江中医药大学附属第一医院妇科，哈尔滨150036

英文单位：1Department of Obstetrics and Gynecology Changshu Hospital Affiliated to Nanjing University of Chinese Medicine Changshu 215500 China; 2Department of Gynecology First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin 150036 China

关键词：不明原因复发性流产；肾虚夹瘀；补肾活血方；炎性因子；免疫平衡

英文关键词：  Unexplainedrecurrentabortion;Kidneydeficiencywithbloodstasis;Bushenhuoxuerecipe;Inflammatoryfactors;Immunebalance

• 摘要：

• 目的  探讨补肾活血方联合常规西药治疗肾虚夹瘀型不明原因复发性流产的临床效果。方法选取南京中医药大学常熟附属医院2016年1月至2020年12月收治的112例患者，经中医辨证为肾虚夹瘀型不明原因复发性流产。按照随机数字表法将患者分为对照组和观察组，各56例。对照组采用常规西药治疗，观察组采用补肾活血方联合常规西药治疗。对比2组治疗前后中医症状评分、临床疗效、白细胞介素4（IL-4）、IL-17A、IL-22、孕酮、雌二醇水平，记录2组保胎成功率和不良反应发生情况。结果  治疗后，2组中医症状评分中主症、次症评分及总分均低于治疗前，且观察组均低于对照组；观察组总有效率高于对照组（均P＜0.05）。治疗后，2组IL-4、孕酮及雌二醇水平均高于治疗前，且观察组均高于对照组［（84±12）ng/L比（75±12）ng/L、（191±40）nmol/L比（171±35）nmol/L、（6 785±1 325）ng/L比（6 144±1 110）ng/L］；2组IL-17A、IL-22水平均低于治疗前，且观察组均低于对照组（均P＜0.05）。观察组保胎成功率高于对照组［83.9%（47/56）比66.1%（37/56）］（P=0.029）。2组不良反应发生率比较差异无统计学意义（P=0.696）。结论  补肾活血方联合常规西药治疗肾虚夹瘀型不明原因复发性流产患者，能够减轻患者临床症状，改善患者雌孕激素水平，提高保胎成功率，调节免疫平衡，安全性良好。

• Objective  To investigate the effect of Bushenhuoxue recipe combined with conventional western medicine on the treatment of unexplained recurrent abortion with kidney deficiency and blood stasis syndrome. Methods  From January 2016 to December 2020, totally 112 patients of unexplained recurrent abortion with kidney deficiency and blood stasis syndrome admitted to Changshu Hospital Affiliated to Nanjing University of Chinese Medicine were enrolled. Patients were divided into control group and observation group according to the random number table method, with 56 cases in each group. The control group was treated with conventional western medicine, while the observation group was treated with Bushenhuoxue recipe combined with conventional western medicine. The traditional Chinese medicine symptom score before and after treatment, clinical efficacy, the levels of interleukin-4 (IL-4), IL-17A, IL-22, progesterone and estradiol were compared between the two groups. The success rate of fetal protection and the incidence of adverse reactions were recorded. Results  After treatment, the scores of primary and secondary symptoms and the total score of traditional Chinese medicine symptom score of both groups were lower than before treatment and those scores of the observation group were lower than those of the control group; the total effective rate of the observation group was higher than that of the control group (all P＜0.05). After treatment, the levels of IL-4, progesterone and estradiol of both groups were higher than those before treatment, and the levels of the observation group were higher than those of the control group ［（84±12）ng/L vs （75±12）ng/L,（191±40）nmol/L vs （171±35）nmol/L,（6 785±1 325）ng/L vs （6 144±1 110）ng/L］; the levels of IL-17A and IL-22 of both groups were significantly lower than those before treatment, and the levels of the observation group were lower than those of the control group (all P<0.05). The success rate of fetal protection of the observation group was higher than that of the control group ［83.9%（47/56） vs 66.1%（37/56）］(P=0.029). There was no significant difference in incidence of adverse reactions between the two groups (P=0.696). Conclusions  Bushenhuoxue recipe combined with conventional western medicine can reduce the clinical symptoms of patients with unexplained recurrent abortion with kidney deficiency and blood stasis syndrome, increase estrogen and progesterone levels, improve the success rate of fetal protection, regulate the immune balance, and it is safe.