目的 探討嗣育保胎丸聯(lián)合地屈孕酮片治療早期先兆流產(chǎn)（腎虛證）的臨床療效。方法 納入南陽市中心醫(yī)院婦產(chǎn)科2024年1月—2024年12月收治的早期先兆流產(chǎn)（腎虛證）的孕婦120例，按照隨機(jī)數(shù)字表法分為對(duì)照組（60例）和治療組（60例）。對(duì)照組口服地屈孕酮片，1片/次，3次/d。治療組在對(duì)照組的基礎(chǔ)上口服嗣育保胎丸，2丸/次，3次/d。兩組患者治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)癥候評(píng)分、每周陰道流血次數(shù)、下腹部疼痛評(píng)分，血清雌激素雌二醇（E₂）水平、孕激素孕酮（Prog）水平、炎癥因子腫瘤壞死因子-α（TNF-α）和白細(xì)胞介素-10（IL-10）水平，血清凝血指標(biāo)D-二聚體和纖維蛋白原（FIB）水平。結(jié)果 治療后，治療組總有效率為93.33%，顯著高于對(duì)照組總有效率80.00%（P＜0.05）。治療后，兩組中醫(yī)癥候評(píng)分、每周陰道流血次數(shù)、下腹部VAS評(píng)分均顯著降低（P＜0.05），且與對(duì)照組相比，治療組在中醫(yī)癥候評(píng)分、每周陰道流血次數(shù)、下腹部VAS評(píng)分降低更為顯著（P＜0.05）。治療后，兩組血清E₂、Prog和IL-10水平均顯著升高，而TNF-α、D-二聚體、FIB水平均顯著降低（P＜0.05），且與對(duì)照組相比，治療組這些指標(biāo)水平改善更顯著（P＜0.05）。結(jié)論 嗣育保胎丸聯(lián)合地屈孕酮治療早期先兆流產(chǎn)（腎虛證）的臨床療效顯著，能顯著緩解孕婦陰道出血及下腹部疼痛癥狀，可能機(jī)制與調(diào)節(jié)炎癥狀態(tài)、凝血功能以及雌激素、孕激素水平有關(guān)。

Objective To explore the clinical efficacy of Siyu Baotai Pills combined with dydrogesterone in treatment of early threatened abortion (syndrome of kidney deficiency). Methods Patients (120 cases) with early threatened abortion (syndrome of kidney deficiency) in Nanyang Central Hospital from January 2024 to December 2024 were divided into control (60 cases) and treatment (60 cases) group according to random number table method. Patient in control group were po administered with Dydrogesterone Tablets, 1 tablet/time, three times daily. Patient in treatment group were po administered with Siyu Baotai Pills on the basis of the control group, 2 pills/time, three times daily. Patient in two groups were treated for 2 weeks. After treatment, the clinical evaluations were evaluated, and the TCM symptom scores, vaginal bleeding times per week and VAS scores of lower abdominal, serum E₂ and P levels, serum IL-10 and TNF-αlevels, serum D-dimer and FIB levels in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 93.33%, which was significantly higher than that in the control group (80.00%, P < 0.05). After treatment, the TCM symptom score, the vaginal bleeding times per week, and the VAS score of the lower abdomen were significantly reduced in two groups (P < 0.05). Compared with the control group, the TCM symptom score, vaginal bleeding times per week, and the VAS score of the lower abdomen were significantly reduced in the treatment group (P < 0.05). After treatment, the serum E₂, Prog and IL-10 levels were significantly increased in two groups, but the levels of TNF-α, D-dimer, and FIB were significantly decreased (P < 0.05). Compared with the control group, the level of these indicators in the treatment group improved more significantly (P < 0.05). Conclusion Siyu Baotai Pills combined with dydrogesterone has a significant clinical efficacy in treatment of early threatened abortion (syndrome of kidney deficiency), which can significantly relieve the symptoms of vaginal bleeding and lower abdominal pain in pregnant women. The possible mechanism may be related to the regulation of the inflammatory state, coagulation function, and the levels of estrogen and progesterone.

R984

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（LHGJ20200525）