目的 探討保胎靈膠囊聯(lián)合烯丙雌醇治療習(xí)慣性流產(chǎn)的臨床效果。方法 選取2015年3月—2019年3月鄭州市第六人民醫(yī)院收治的80例習(xí)慣性流產(chǎn)患者，隨機分成對照組（n=40）和治療組（n=40）。對照組口服烯丙雌醇片，2片/次，1次/d。治療組在對照組基礎(chǔ)上口服保胎靈膠囊，3粒/次，3次/d。兩組均于確定妊娠后開始服藥，連服12周。觀察兩組的臨床療效和典型表現(xiàn)的消失時間，比較兩組血清生殖激素、外周血T淋巴細胞亞群的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別是75.0%、92.5%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療組典型表現(xiàn)（如腰酸、下腹墜脹、腹痛、陰道流血等）的消失時間顯著短于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組雌二醇（E₂）、人絨毛膜促性腺激素β（β-HCG）、孕酮（P）水平均顯著高于治療前（P<0.05）；治療后，治療組E₂、β-HCG、P水平高于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。與治療前相比，兩組治療后卵巢及子宮動脈的搏動、阻力指數(shù)（PI和RI）均顯著降低（P<0.05）；且治療后，治療組以上盆腔血流動力學(xué)參數(shù)值均顯著低于對照組同期（P<0.05）。治療后，兩組外周血CD4⁺、CD4⁺/CD8⁺較治療前均顯著下降（P<0.05）；治療后，治療組CD4⁺、CD4⁺/CD8⁺顯著低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 保胎靈膠囊聯(lián)合烯丙雌醇治療習(xí)慣性流產(chǎn)有較好的臨床療效，能有效緩解患者的臨床癥狀，升高體內(nèi)生殖激素水平，改善卵巢及子宮動脈血流的高阻狀態(tài)，糾正T淋巴細胞亞群的免疫失衡，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Baotailing Capsules combined with allylestrenol in treatment of habitual abortion. Methods 80 Patients with habitual abortion admitted to Zhengzhou Sixth People's Hospital from March 2015 to March 2019 were selected and randomly divided into control group (n=40) and treatment group (n=40). Patients in the control group were po administered with Allylestrenol Tablets, 2 tablets/time, once daily. Patients in the treatment group were po administered with Baotailing Capsules on the basis of the control group, 3 grains/time, three times daily. Both groups began taking the drugs after confirmed pregnancy for 12 weeks. The clinical efficacy and typical disappearance time of the two groups were observed, and the changes of serum reproductive hormones and peripheral blood T lymphocyte subsets in the two groups were compared. Results After treatment, the total effective rates of the control group and the treatment group were 75.0% and 92.5%, respectively, and there were differences between two groups (P<0.05). The disappearance time of typical manifestations (such as lumbar acid, abdominal distension, abdominal pain, vaginal bleeding) in the treatment group was significantly shorter than that in the control group, and there were differences between two groups (P<0.05). The levels of E₂, β-HCG and P in the two groups were significantly higher than those before treatment (P<0.05). After treatment, E₂, β-HCG and P in the treatment group were higher than those in the control group, and the difference between the two groups was statistically significant (P<0.05). Compared with before treatment, pulsation and resistance index (PI and RI) of ovarian and uterine arteries were significantly reduced after treatment in both groups (P<0.05). After treatment, pelvic hemodynamic parameters in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, CD4⁺ and CD4⁺/CD8⁺ in peripheral blood of both groups decreased significantly compared with that before treatment (P<0.05). After treatment, CD4⁺ and CD4⁺/CD8⁺ in the treatment group were significantly lower than those in the control group, and the difference between the two groups was statistically significant (P<0.05). Conclusion Baotailing Capsules combined with allylestrenol has good clinical effect in treatment of habitual abortion, and can effectively relieve the clinical symptoms of patients, and can increase the level of reproductive hormones in the body, and also can improve the high resistance state of ovarian and uterine artery blood flow, and correct the immune imbalance of T lymphocyte subgroup, which has a certain clinical application value.

R984