目的 探討安胎益母丸聯(lián)合地屈孕酮片治療早期先兆流產(chǎn)的臨床療效。方法 選取2021年4月—2023年4月在青島市城陽區(qū)人民醫(yī)院進(jìn)行保胎治療并定期產(chǎn)檢的早期先兆流產(chǎn)孕婦99例，根據(jù)治療方案分成對(duì)照組（49例）和治療組（50例）。對(duì)照組口服地屈孕酮片，首次劑量為40 mg，后續(xù)3次/d，10 mg/次；治療組在對(duì)照組的基礎(chǔ)上口服安胎益母丸，1丸/次，2次/d。兩組孕婦均進(jìn)行2周治療。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候評(píng)分，血清同型半胱氨酸（Hcy）、妊娠相關(guān)血漿蛋白A（PAPP-A）、α-黑色素細(xì)胞刺激素（α-MSH）和糖類抗原125（CA125）水平，及血清Th1/Th2細(xì)胞因子水平。結(jié)果 治療后，對(duì)照組和治療組臨床總有效率分別為79.59%和94.00%，組間比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組患者中醫(yī)證候評(píng)分均明顯降低（P＜0.05），且治療組中醫(yī)證候評(píng)分降低更明顯（P＜0.05）。治療后，兩組血清Hcy、α-MSH和CA125水平均明顯降低，而PAPP-A水平則明顯升高（P＜0.05），且治療組各指標(biāo)改善更明顯（P＜0.05）。治療后，兩組血清Th1細(xì)胞因子腫瘤壞死因子-α（THF-α）和白細(xì)胞介素-2（IL-2）均明顯降低，而Th2細(xì)胞因子白細(xì)胞介素-4（IL-4）和白細(xì)胞介素-10（IL-10）則明顯升高（P＜0.05），且治療組改善更為明顯（P＜0.05）。結(jié)論 安胎益母丸聯(lián)合地屈孕酮治療早期先兆流產(chǎn)療效顯著，不僅能夠顯著改善孕婦不適癥狀和促進(jìn)血清學(xué)指標(biāo)的恢復(fù)，同時(shí)還能夠改善免疫功能失衡狀態(tài)。

Objective To investigate the clinical effectiveness of Antai Yimu Pills combined with Dydrogesterone Tablets in treatment of early threatened miscarriage. Methods Patients (99 cases) with early threatened miscarriage in Qingdao Chengyang People's Hospital from April 2021 to April 2023 were divided into control (49 cases) and treatment (50 cases) group based on different treatments. Patients in the control group were po administered with Dydrogesterone Tablets, the first dose was 40 mg, followed by three times daily for with 10 mg/time. Patients in the treatment group were po administered with Antai Yimu Pills on the basis of the control group, 1 pill/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluations were evaluated, the TCM syndrome scores, the levels of serum Hcy, PAPP-A, α-MSH and CA125, and the serum Th1/Th2 cytokine levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the control group and the treatment group was 79.59% and 94.00% respectively, and the difference between two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome scores in two groups were significantly decreased (P < 0.05), and the TCM syndrome scores in the treatment group were decreased more significantly (P< 0.05). After treatment, the levels of serum Hcy,α-MSH and CA125 were significantly decreased, while the level of PAPP-A was significantly increased in two groups, the improvement of all indexes in the treatment group was more obvious (P < 0.05). After treatment, serum Th1 cytokines THF-α and IL-2 were significantly decreased, while Th2 cytokines IL-4 and IL-10 were significantly increased in two groups, and the improvement in the treatment group was more obvious (P < 0.05). Conclusion Antai Yimu Pills combined with ditroprogesterone is effective in treatment of early threatened abortion, which can not only significantly improve the symptoms of pregnant women and promote the recovery of serological indexes, but also improve the imbalance of immune function.

R984

青島市醫(yī)藥衛(wèi)生科研指導(dǎo)項(xiàng)目（2022-WJZD239）