加味寿胎丸治疗多囊卵巢综合征合并复发性流产临床效果及对血栓前状态的影响

王世帅; 叶利群; 单丽华; 吴淋淋

doi:10.16766/j.cnki.issn.1674-4152.003118

加味寿胎丸治疗多囊卵巢综合征合并复发性流产临床效果及对血栓前状态的影响

doi: 10.16766/j.cnki.issn.1674-4152.003118

1.
宁波市中医院妇科，浙江宁波 315010
2.
金华市人民医院妇科，浙江金华 321000

基金项目:

浙江省卫生健康科技计划项目 2021KY1184

宁波市科技计划项目 2019A610358

详细信息

通讯作者:
叶利群，E-mail：yeliqunnb@sina.com

中图分类号: R711.75 R714.21 R242
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- PDF下载量: 12
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出版历程
- 收稿日期: 2023-03-29
- 网络出版日期: 2023-09-13

Clinical efficacy of Jiawei Shoutai Pills in the treatment of polycystic ovary syndrome with recurrent miscarriage and its impact on pre thrombotic state

1.
Ningbo Traditional Chinese Medicine Hospital Gynecology, Ningbo, Zhejiang 315010, China

摘要

摘要: 目的分析加味寿胎丸治疗多囊卵巢综合征合并复发性流产患者的临床疗效，及对患者血栓前状态的影响，为临床治疗提供依据。方法选取2019年7月—2021年6月宁波市中医院收治的150例多囊卵巢综合征合并复发性流产患者组作为研究对象，采用随机数表法分为A组(低分子肝素钙注射液治疗)、B组(加味寿胎丸治疗)及C组(加味寿胎丸联合低分子肝素钙注射液治疗)，每组50例。比较各组患者治疗前后中医症候评分、内分泌指标、凝血-纤溶指标、抗心磷脂抗体及子宫动脉血流动力学状态变化。结果治疗后，C组患者中医症候评分为4.00(1.46，8.00)分，明显低于A组的10.00(3.75，11.25)分及B组的11.21(4.60，12.18)分，P < 0.05；C组血清人绒毛膜促性腺激素(β-HCG)、孕激素(P)、雌二醇(E₂)均高于B组和A组(均P < 0.05)；C组活化部分凝血活酶时间(APTT)及抗凝血酶Ⅲ(ATⅢ)均高于B组及A组，纤维蛋白原(FIB)、D-二聚体(DD)均低于B组及A组(均P < 0.05)；C组患者抗心磷脂抗体阳性率为10.0%(5/50)，低于A组的28.0%(14/50)及B组的28.0%(14/50)，P < 0.05。结论加味寿胎丸联合低分子肝素钙注射液治疗多囊卵巢综合征合并复发性流产能有效改善患者血浆黏度、凝血、纤溶系统及子宫动脉血流动力学状态，值得临床应用。
- 多囊卵巢综合征 /
- 复发性流产 /
- 血栓前状态 /
- 加味寿胎丸 /
- 凝血-纤溶
Abstract: Objective Analyze the clinical efficacy of Jiawei Shoutai Pills in treating patients with polycystic ovary syndrome combined with recurrent miscarriage, and its impact on the patient's pre thrombotic state, providing a basis for clinical treatment. Methods A total of 150 patients with polycystic ovary syndrome and recurrent miscarriage admitted to Ningbo Traditional Chinese Medicine Hospital from July 2019 to June 2021 were selected as the study subjects, They were randomly divided into A team (low molecular weight heparin calcium injection treatment), B team (modified Jiawei Shoutai Pills treatment) and C team (modified Jiawei Shoutai Pills combined with low molecular weight heparin calcium injection treatment), with 50 patients in each team.Compare the TCM syndrome score and endocrine index, coagulation- fibrinolysis index, anticardiolipin antibody. Results After treatment, the C team score of patients was 4.00 (1.46, 8.00) points, lower than the 10.00 (3.75, 11.25) points in the A team and the 11.21 (4.60, 12.18) points in the B team, P < 0.05; C team serum β-human chorionic gonadotropin (β-HCG), progesteroneon (P), estradiol (E₂) were all higher than the B team and A team, P < 0.05; The activated partial thromboplastin time (APTT) and AntithrombinⅢ (ATⅢ) levels in the C team were higher than the traditional Chinese medicine and A team, while fibrinogen (FIB) and d-dimmer (DD) levels were lower than the B team and A team, with P < 0.05; The positive rate of anticardiolipin antibodies in the C team was 10.0% (5/50), which was lower than the LMWH and the Chinese medicine team, all were 28.0% (14/50), P < 0.05. Conclusion Jiawei Shoutai Pills combined with low-molecular-weight heparin calcium injection can effectively improve plasma viscosity, coagulation, fibrinolysis system and uterine artery hemodynamics in patients with polycystic ovary syndrome complicated with recurrent abortion, worthy of clinical application.
- Polycystic ovary syndrome /
- Recurrent abortion /
- Prethrombotic state /
- Jiawei Shoutai Pills /
- Coagulation fibrinolysis

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表 1 3组多囊卵巢综合征合并复发性流产患者中医症候评分比较[M(P₂₅, P₇₅)，分]

Table 1. Comparison of traditional Chinese medicine syndrome scores in 3 groups of patients with polycystic ovary syndrome complicated with recurrent abortion[M(P₂₅, P₇₅), points]

组别	例数	治疗前	治疗后
A组	50	16.50(7.25，21.75)	10.00(3.75，11.25)^a
B组	50	17.00(7.00，21.00)	11.21(4.60，12.18)^a
C组	50	18.00(9.00，27.00)	4.00(1.46，8.00)^abc
H值		0.769	20.195
P值		0.361	< 0.001
注：与同组治疗前比较，^aP < 0.05；与治疗后A组比较，^bP < 0.05；与治疗后B组比较，^cP < 0.05。

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表 2 3组多囊卵巢综合征合并复发性流产患者内分泌指标比较[M(P₂₅, P₇₅)]

Table 2. Comparison of endocrine indexes in 3 groups of patients with polycystic ovary syndrome complicated with recurrent abortion[M(P₂₅, P₇₅)]

组别	例数	血清β-HCG(mIU/mL)		P(ng/mL)		E₂(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	50	27 343.00(16 973.25，110 919.75)	129 744.00(66 712.75，200 138.25)^a	21.68(10.60，31.80)	26.02(10.26，30.78)^a	562.00(360.75，2 882.25)	1 220.00(755.50，3 766.50)^a
B组	50	26 448.50(10 351.75，121 055.25)	115 064.50(66 700.00，200 100.00)^a	19.18(10.35，31.05)	21.84(10.51，31.52)^a	533.00(360.75，2 882.25)	1 843.50(867.00，3 201.00)^a
C组	50	24 417.00(11 450.00，124 350.00)	186 767.50(67 200.00，201 600.00)^abc	19.51(10.12，30.35)	33.10(10.67，32.01)^abc	563.50(312.25，2 136.75)	2 002.00(853.75，3 761.25)^abc
H值		0.166	11.871	0.360	7.628	0.162	8.241
P值		0.753	< 0.001	0.645	< 0.001	0.875	< 0.001
注：与同组治疗前比较，^aP < 0.05；与治疗后A组比较，^bP < 0.05；与治疗后B组比较，^cP < 0.05。

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表 3 3组多囊卵巢综合征合并复发性流产患者凝血-纤溶指标比较

Table 3. Comparison of coagulation and fibrinolysis indexes in 3 groups of patients with polycystic ovary syndrome complicated with recurrent abortion

组别	例数	APTT(x±s，s)		FIB[M(P₂₅, P₇₅)，mg/dL]		DD[M(P₂₅, P₇₅)，ng/mL]		ATⅢ(x±s，%)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	50	29.80±3.24	30.74±1.75	403.50(120.00, 360.00)	386.50(113.5, 340.5)^b	99.00(78.00, 374.00)	90.00(60.75, 272.25)^b	82.71±3.49	85.40±3.45^b
B组	50	29.74±3.17	30.82±1.80	403.50(120.00, 360.00)	384.50(111.10, 332.80)^b	100.00(73.75, 383.47)	90.00(51.00, 273.00)^b	82.63±3.30	85.65±3.11^b
C组	50	29.73±3.25	31.80±2.68^bcd	405.50(129.50, 358.50)	365.00(86.50, 309.50)^bcd	99.50(52.25, 327.75)	86.00(36.00, 168.00)^bcd	82.75±3.39	87.16±3.52^bcd
统计量		0.007^a	3.875^a	0.081^e	3.901^e	0.080^e	3.346^e	0.016^a	4.004^a
P值		0.993	0.023	0.922	0.013	0.942	0.041	0.984	0.020
注：^a为F值，^e为H值；与同组治疗前比较，^bP < 0.05；与治疗后A组比较，^cP < 0.05；与治疗后B组比较，^dP < 0.05。

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表 4 3组多囊卵巢综合征合并复发性流产患者抗心磷脂抗体比较[例(%)]

Table 4. Comparison of anti-cardiolipin antibodies in 3 groups of patients with polycystic ovary syndrome complicated with recurrent abortion[cases(%)]

组别	例数	治疗前	治疗后
A组	50	30(60.0)	14(28.0)^a
B组	50	31(62.0)	14(28.0)^a
C组	50	30(60.0)	5(10.0)^abc
χ²值		0.056	6.294
P值		0.972	0.043
注：与同组治疗前比较，^aP < 0.05；与治疗后A组比较，^bP < 0.05；与治疗后B组比较，^cP < 0.05。

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