補腎健脾法治療原因不明復(fù)發(fā)性流產(chǎn)初步機理研究.pdf

1、提要目的：運用補腎健脾中藥以補腎健脾，益氣養(yǎng)血之法治療原因不明復(fù)發(fā)性流產(chǎn)，通過對臨床療效進(jìn)行觀察，探討補腎健脾中藥對原因不明復(fù)發(fā)性流產(chǎn)患者外周血CD4CD25調(diào)節(jié)性T細(xì)胞的影響并探討其作用機制，從而為本病尋找有效方便的治療方法。方法：按隨機數(shù)字表法，將初選合格病例共120例，分為三組，分別為中藥組40例，免疫治療組40例，空白組40例。中藥組治以自擬補腎健脾中藥方劑，日一劑，每21天為一個療程，治療周期為三個療程，期滿安排其自然受孕；免

2、疫組采用主動免疫療法，每21天為一個療程，每療程行一次主動免疫治療，共三個療程，期滿安排其自然受孕；空白組孕前不行任何治療，僅給予患者生活指導(dǎo)兩個月，囑其放松心情、注意休息。三組均在確定妊娠后給予黃體酮HCG常規(guī)保胎治療至孕三個月。對比治療前后三組外周血CD4CD25調(diào)節(jié)性T細(xì)胞含量、妊娠成功率、流產(chǎn)率、封閉抗體轉(zhuǎn)陽率以及中醫(yī)癥狀積分，分析三組妊娠結(jié)局與封閉抗體的相關(guān)性比較以及治療前后不同妊娠結(jié)局的CD4CD25調(diào)節(jié)性T細(xì)胞含量的比較。

3、結(jié)果：三組不孕年齡、流產(chǎn)次數(shù)、流產(chǎn)孕周經(jīng)統(tǒng)計學(xué)處理，差異無統(tǒng)計學(xué)意義（P0.05），具有可比性。三組患者治療前各項指標(biāo)無明顯差異，治療后中藥組與免疫組CD4CD25調(diào)節(jié)性T細(xì)胞占T淋巴細(xì)胞百分比、占外周血白細(xì)胞百分比較空白組提高，且較兩組治療前均有提高，差異均有顯著意義（P0.05）.Therewasnostatisticaldifferenceamongthethreegroupsbefetreatment.Butthepercent

4、ageofCD4CD25regulatyTcellsinperipheralbloodweresignificantlyincreasedinTCMgroupimmunotherapygroupaftertreatmentcomparedwiththecontrolgroupalsosignificantlyincreasedcomparedwiththatbefetreatment（P0.05）。TheTCMsymptomsceinT

5、CMgroupwassignificantlydecreasedcomparedwiththeothertwogroupsthatbefetreatment（P0.05）.ThesuccessfulpregnantratestheantiHLAⅠⅡantibodiespositiveratesinTCMgroupimmunotherapygroupweresignificantlyincreasedcomparedwiththecont

6、rolgroup（P0.05）.ThepercentageofCD4＋CD25regulatyTcellsinsuccessfulpregnantwomenwassignificantlyhigherthanthatinpregnantlosswomen(P0.05).AndtherewasapositivecrelationbetweensuccessfulpregnantratestheantiHLAⅠⅡantibodiesposi

7、tiverates（P0.05）.Conclusions:TraditionalChinesemedicinenourishingkidneystrengthingspleencanimprovethespleenkidneydeficiencysyndromeenhancethepercentageofCD4＋CD25regulatyTcellsinperipheralbloodtheantiHLAⅠⅡantibodiespositi

8、verateaccdinglycanincreaseimmunefunctionpregnancyratesthendecreaseabtionrate.ItisaneffectivetherapyfpatientswithURSAhastheadvantagesofeasyoperationpractical.Therefeitdeservedtobewidelyused.Keywdsnourishingkidneystrengthi