目的 觀察坤泰膠囊聯(lián)合潑尼松治療人工流產(chǎn)后免疫性不孕癥患者的療效。方法 選擇2018年1月—2020年1月于滄州市人民醫(yī)院就診的人工流產(chǎn)后繼發(fā)不孕癥患者100例作為研究對(duì)象，將患者按照治療方法分為對(duì)照組和觀察組，每組50例。對(duì)照組患者口服潑尼松片，5～10 mg/次，3次/d。觀察組在對(duì)照組的基礎(chǔ)上口服坤泰膠囊治療，2.0 g/次，3次/d。每4周作為1個(gè)療程，治療6個(gè)療程。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的抗精子抗體（AsAb）、抗子宮內(nèi)膜抗體（EmAb）及抗卵巢抗體（AoAb）、抗心磷脂抗體（AcAb）、抗弓形蟲抗體（ToxAb）的轉(zhuǎn)陰率及血清中上述抗體的水平；促卵泡生成素（FSH）、雌二醇（E₂）和黃體生成素（LH）水平；白細(xì)胞介素-2（IL-2）、白細(xì)胞介素6（IL-6）、β-內(nèi)啡肽（β-EP）、腦啡肽（ENK）水平及妊娠結(jié)局。結(jié)果 治療后，對(duì)照組總有效率為66.0%，觀察組總有效率為84.0%，兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組AsAb、EmAb、AcAb、AoAb、ToxAb轉(zhuǎn)陰率顯著高于對(duì)照組（P<0.05）。治療后，兩組患者血清AsAb、EmAb、AcAb、AoAb、ToxAb水平均顯著降低（P<0.05），且觀察組治療后血清AsAb、EmAb、AcAb、AoAb、ToxAb水平較對(duì)照組治療后顯著降低（P<0.05）。治療后，兩組患者的血清FSH水平較治療前顯著更低，LH和E₂水平較治療前顯著升高（P<0.05），且觀察組的血清FSH水平較對(duì)照組治療后顯著更低，血清LH和E₂水平較對(duì)照組治療后顯著升高（P<0.05）。治療后，兩組患者的血清IL-2、IL-6、ENK、β-EK水平均顯著降低（P<0.05）；且治療后，觀察組上述指標(biāo)水平顯著低于對(duì)照組（P<0.05）。兩組患者經(jīng)過觀察1年，觀察組妊娠率為52.0%，顯著高于對(duì)照組的26.0%，兩組妊娠率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 坤泰膠囊聯(lián)合潑尼松治療人工流產(chǎn)后免疫性不孕癥患者可以使患者體內(nèi)的免疫抗體轉(zhuǎn)陰率顯著升高，顯著降低患者血清免疫抗體水平，改善性激素水平、降低細(xì)胞因子水平，促進(jìn)生殖內(nèi)分泌功能的恢復(fù)，提高患者妊娠率。

Objective To observe the effects of Kuntai Capsules combined with prednisone in treatment of immune infertility after induced abortion. Methods A total of 100 patients with immune infertility after induced abortion treated in Cangzhou People's Hospital from January 2018 to January 2020 were selected as the research subjects, and the patients were divided into control group and observation group according to treatment methods, with 50 patients in each group. Patients in the control group were po administered with Prednisone Acetate Tablets, 5 — 10 mg/time, three times daily. Patients in the observation group were po administered with Kuntai Capsules, 2.0 g/time, three times daily. Six courses of treatment were performed as one course every 4 weeks. The clinical efficacy and pregnancy outcome of two groups was observed, and the negative rates of AsAb, EmAb, AoAb, AcAb and ToxAb, and the serum levels of the above antibodies, and the levels of FSH, E₂, LH, IL-2, IL-6, β-EP, ENK were compared before and after treatment between two groups. Results After treatment, the total effective rate of the control group was 66.0%, and the total effective rate of the observation group was 84.0%, and the difference between two groups was statistically significant (P < 0.05). After treatment, the negative conversion rates of AsAb, EmAb, AcAb, AoAb, and ToxAb in the observation group were significantly higher than those in the control group (P < 0.05). After treatment, the serum levels of AsAb, EmAb, AcAb, AoAb, and ToxAb in two groups were significantly decreased (P < 0.05), and the serum levels of AsAb, EmAb, AcAb, AoAb, and ToxAb in the observation group were significantly decreased compared with the control group after treatment (P < 0.05). After treatment, serum FSH levels in two groups were significantly decreased, while serum LH and E₂ levels were significantly increased (P < 0.05). And serum FSH levels in observation group were significantly lower than those in the control group, while serum LH and E 2 levels were significantly higher than those in the control group (P < 0.05). After treatment, the levels of serum IL-2, IL-6, ENK, and β-EK in two groups were significantly decreased (P < 0.05). After treatment, the above indexes in observation group were significantly lower than those in control group (P < 0.05). After observation for 1 year, the pregnancy rate of the observation group was 52.0%, which was significantly higher than that of the control group 26.0%, and the difference of pregnancy rate between two groups was statistically significant (P < 0.05). Conclusion Kuntai Capsules combined with prednisone in treatment of patients with immune infertility after induced abortion can significantly increase the negative rate of immune antibodies in patients, significantly reduce the level of serum immune antibodies, improve the level of sex hormones, reduce the level of cytokines, promote the recovery of reproductive endocrine function, and improve the pregnancy rate of patients

R979.1

滄州市科學(xué)技術(shù)研究與發(fā)展指導(dǎo)計(jì)劃項(xiàng)目（162302075）