目的 觀察樂孕寧顆粒聯(lián)合醋酸阿托西班注射液班治療晚期先兆流產(chǎn)的臨床療效。方法 選取2020年3月—2021年12月邯鄲市婦幼保健收治100例晚期先兆流產(chǎn)患者，采用隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各50例。對(duì)照組給予醋酸阿托西班注射液，初始劑量6.75 mg，緩慢靜脈注射，時(shí)間＞1 min；緊接著醋酸阿托西班注射液7.5 mg/mL溶入0.9%氯化鈉注射液405 mL，持續(xù)靜脈滴注3 h，24 mL/h；然后持續(xù)靜脈滴注45 h，8 mL/h。治療組在對(duì)照組基礎(chǔ)上口服樂孕寧顆粒，5 g/次，3次/d，持續(xù)治療14 d。比較兩組臨床療效、癥狀評(píng)分、子宮動(dòng)脈血流動(dòng)力學(xué)、血清細(xì)胞因子。結(jié)果 治療組的總有效率94.00%較對(duì)照組的總有效率80.00%更高，組間比較差異顯著（P＜0.05）。治療后，兩組腰酸痛、下腹墜痛、陰道出血評(píng)分均下降（P＜0.05），且治療組的腰酸痛、下腹墜痛、陰道出血評(píng)分較對(duì)照組低（P＜0.05）。治療后，兩組搏動(dòng)指數(shù)（PI）、阻力指數(shù)（RI）均下降（P＜0.05），且治療組PI、RI較對(duì)照組低（P＜0.05）。治療后，兩組血清γ-干擾素（IFN-γ）、腫瘤壞死因子-α（TNF-α）水平下降，血清白細(xì)胞介素-10（IL-10）水平升高（P＜0.05），且治療組血清IFN-γ、TNF-α水平較對(duì)照組低，血清IL-10水平較對(duì)照組高（P＜0.05）。結(jié)論 樂孕寧顆粒聯(lián)合醋酸阿托西班注射液治療晚期先兆流產(chǎn)的效果確切，能減輕臨床體征，改善子宮胎盤灌注，調(diào)節(jié)血清細(xì)胞因子水平。

Objective To observe the clinical curative effect of Leyunning Granules combined with Atosiban Acetate Injection in treatment of late threatened abortion. Methods A total of 100 patients with late threatened abortion in Handan Maternal and Child Health Hospital from March 2020 to December 2021 were selected and divided into random number table method, with 50 cases in each group. Patients of the control group was treated with Atosiban Acetate Injection, the initial dose was 6.75 mg, and the time of slow intravenous injection was > 1 min, then Atosiban Acetate Injection 7.5 mg/mL was dissolved into 0.9% sodium chloride injection 405 mL, and continued intravenous infusion for 3 h, 24 mL/h, then the intravenous infusion was continued for 45 h, 8 mL/h. Patients in the treatment group was po administered with Leyunning Granules on the basis of the control group, 5 g/ time, 3 times daily, and continued treatment for 14 d. The clinical efficacy, symptom score, uterine arterial hemodynamics, and serum cytokines were compared between two groups. Results The total effective rate ( 94.00%) in the treatment group was higher than 80.00% in the control group, with significant difference between two groups (P < 0.05). After treatment, the scores of lumbar soreness, lower abdominal pain, and vaginal bleeding were decreased in both groups (P < 0.05), and the scores of lumbar soreness, lower abdominal pain, and vaginal bleeding in the treatment group were lower than those in the control group (P < 0.05). After treatment, PI and RI in both groups were significantly decreased (P < 0.05), and PI and RI in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of IFN-γ and TNF-α were decreased, but the levels of IL-10 were increased (P < 0.05). And the levels of IFN-γ and TNF-α in the treatment group were lower than those in the control group, but the levels of IL-10 in the treatment group were higher than those in the control group (P < 0.05). Conclusion Leyunning Granules combined with Atosiban Acetate Injection has good effect and safety in treatment of late threatened abortion. It can effectively relieve symptoms of patients, improve uterine placental perfusion status, and reduce inflammatory response.

R984

河北省醫(yī)學(xué)科學(xué)研究課題計(jì)劃(20231932)