目的 探討安胎丸聯(lián)合黃體酮軟膠囊治療早期先兆流產(chǎn)的臨床效果。方法 選取2019年7月—2021年7月南開大學(xué)附屬醫(yī)院收治的98例早期先兆流產(chǎn)患者，使用隨機(jī)數(shù)字表法分成對(duì)照組和治療組，每組各49例。對(duì)照組口服黃體酮軟膠囊，0.2 g/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服安胎丸，1丸/次，2次/d。所有患者均連續(xù)治療14 d。觀察兩組臨床療效，統(tǒng)計(jì)兩組典型臨床癥狀消失時(shí)間。比較治療前后兩組子宮螺旋動(dòng)脈血流參數(shù)[阻力指數(shù)（RI）、搏動(dòng)指數(shù)（PI）]及血清生殖激素[孕酮（P）、人絨毛膜促性腺激素β亞基（β-hCG）]、輔助性T細(xì)胞（Th）1/Th2細(xì)胞因子[腫瘤壞死因子（TNF）-α、白細(xì)胞介素（IL）-10]水平。結(jié)果 治療組保胎有效率是93.9%，較對(duì)照組（79.6%）顯著提高（P＜0.05）。治療組陰道出血停止時(shí)間、腹痛消失時(shí)間、腰痛消失時(shí)間均顯著短于對(duì)照組（P＜0.05）。與治療前對(duì)比，兩組治療后子宮螺旋動(dòng)脈RI、PI均顯著降低（P＜0.05）；且均以治療組的下降更顯著（P＜0.05）。治療后，兩組血清P、β-HCG水平均較治療前顯著升高（P＜0.05）；且均以治療組的改善更顯著（P＜0.05）。與治療前相比，兩組治療后血清TNF-α水平均顯著下降，血清IL-10水平均顯著上升（P＜0.05）；且治療后，治療組血清TNF-α水平低于對(duì)照組，血清IL-10水平高于對(duì)照組（P＜0.05）。結(jié)論 安胎丸聯(lián)合黃體酮對(duì)早期先兆流產(chǎn)患者具有確切的臨床療效，是緩解患者癥狀的安全有效方案，并能進(jìn)一步改善子宮血流狀態(tài)、提高體內(nèi)生殖激素水平及糾正Th1/Th2細(xì)胞因子的失衡狀態(tài)。

Objective To explore the clinical effect of Antai Pills combined with progesterone in treatment of early threatened abortion. Methods A total of 98 patients with early threatened abortion admitted to The Affiliated Hospital of Nankai University from July 2019 to July 2021 were selected and divided into control group and treatment group by random number table method, with 49 cases in each group. Patients in the control group were po administered with Progesterone Soft Capsules, 0.2 g/time, once daily. Patients in the treatment group were po administered with Antai Pills on the basis of the control group, 1 pill/time, twice daily. Patients in two groups were treated for 14 d. The efficacy of the two groups was observed, and the disappearance time of the typical clinical manifestations of the two groups was counted. The blood flow parameters of the uterine spiral arteries [resistance index (RI), pulsatility index (PI)] and serum reproductive hormones [progesterone (P), human chorionic gonadotropin β subunit (β-hCG)], Pregnancy-associated plasma protein-A (PAPP-A), helper T cells (Th)1/Th2 cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-10], progesterone induction block Factor (PIBF) level before and after treatment were compared. Results The effective rate of foetus preservation in treatment group was 93.9%, significantly higher than 79.6% in control group (P < 0.05). The stop time of vaginal bleeding, the disappear time of abdominal pain and the disappear time of back pain in two groups were significantly shorter than those in the control group (P < 0.05). Compared with before treatment, the uterine spiral artery RI and PI in two groups was significantly decreased after treatment (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). After treatment, the levels of serum P and β-HCG in two groups were significantly increased compared with before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). Compared with before treatment, serum TNF-α level was significantly decreased, but serum IL-10 level was significantly increased in two groups after treatment (P < 0.05). After treatment, the serum TNF-α level in the treatment group was lower than that in the control group, but the serum IL-10 level was higher than that in the control group (P < 0.05). Conclusion Antai Pills combined with progesterone has a definite clinical effect on patients with early threatened abortion. It is a safe and effective solution to relieve the symptoms of patients, and can further improve the uterine blood flow, increase the level of pregnancy maintenance related factors in the body, and correct Th1/Th2 cytokines state of imbalance.

R984

天津市衛(wèi)生和計(jì)劃生育委員會(huì)科研基金項(xiàng)目(2017kz183)