安子合剂治疗肾虚型复发性流产的临床疗效及对白细胞介素-6的影响

发布时间：2018-03-14 06:14

本文选题：复发性流产　切入点：肾虚　出处：《南京中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过观察安子合剂治疗肾虚型复发性流产患者治疗前后临床症状、血清妊娠激素、B超胚胎发育等情况,探讨安子合剂治疗肾虚型复发性流产的临床疗效,并通过检测治疗前后血清白细胞介素-6(IL-6)水平探讨其安胎机理。方法：临床收集肾虚型复发性流产患者60例,随机分为2组：治疗组30例,给予安子合剂口服,加肌注黄体酮注射液和／或绒毛膜促性腺激素；对照组30例,肌注黄体酮注射液和／或绒毛膜促性腺激素。5周为一疗程。观察2组患者治疗前后临床症候积分、血清妊娠激素(E2、P、β-HCG)水平、IL-6浓度及B超胚胎发育情况。结果： ①症候积分两组治疗前后各症候积分比较,数值明显小于治疗前,有统计学意义(P0.05)。两组组间比较发现,治疗后两组的症状总积分亦有统计学意义(P0.05)。治疗组中医症状改善的总有效率90.00%；对照组为76.67%,治疗组显著优于对照组(P0.05)。 ②血清妊娠激素两组治疗后血清E2、P、β-HCG水平均较治疗前提高,差异有统计学意义(P0.05)；且激素水平均随孕周的增加而增长,通过折线图即可以看出治疗组上升水平优于对照组。 ③血清IL-6的浓度两组治疗后血清IL-6浓度均上升,治疗前后比较,有统计学意义(P0.05)；两组组间比较,差异亦具显著性(P0.05)。 ④B超监测胚胎发育治疗组B超成形27例,胚停3例,保胎成功率为90.00%；对照组B超成形23例,胚停7例,保胎成功率为76.67%,两组差异有统计学意义(P0.05)。 ⑤综合疗效治疗组总有效率90.00%；对照组总有效率76.67%。两组总有效率比较,治疗组明显高于对照组,差异有统计学意义(P0.05)。结论：安子合剂治疗肾虚型复发性流产临床疗效确切,能明显改善患者小腹坠痛、腰骶酸痛、阴道流血等临床症状,提高血清E2、P、β-HCG、IL-6水平,促进孕囊及胚胎的发育,其安胎的成功率达90.0%。其安胎机理一方面与改善RSA患者黄体功能,调节卵巢内分泌功能有关；另一方面亦可能与升高患者体内IL-6含量,平衡Thl/Th2比例,调节机体自身免疫反应有关。
[Abstract]:Objective: to investigate the clinical effect of Anzi mixture on the treatment of recurrent abortion of kidney deficiency type by observing the clinical symptoms, serum pregnancy hormone and embryo development of B-ultrasound before and after treatment, and to explore the clinical efficacy of Anzi mixture in the treatment of recurrent abortion of kidney deficiency type. The level of serum interleukin-6 (IL-6) was measured before and after treatment. Methods: sixty patients with recurrent abortion of kidney deficiency type were randomly divided into two groups: treatment group (n = 30), treated group (n = 30) and control group (n = 30), treated by oral administration of Anzi mixture and intramuscular injection of progesterone injection and / or chorionic gonadotropin (chorionic gonadotropin). Progesterone injection and / or chorionic gonadotropin were injected intramuscularly as a course of treatment. The clinical symptom scores, serum pregnancy hormone E2P, 尾 -HCG levels, and B ultrasound embryo development were observed in two groups before and after treatment. Results:. 1 symptom integral. The scores of symptoms before and after treatment in the two groups were significantly lower than those before treatment (P 0.05). The total score of symptoms in the two groups was also statistically significant after treatment. The total effective rate of TCM symptom improvement in the treatment group was 90.00.The control group was 76.677.The treatment group was significantly better than the control group (P 0.05). 2Serum pregnancy hormone. After treatment, the serum levels of E2P and 尾 -HCG in the two groups were higher than those before treatment, the difference was statistically significant (P 0.05), and the levels of hormones increased with the increase of gestational week, and the increase level of the treatment group was better than that of the control group. 3 concentration of serum IL-6. The serum IL-6 level increased after treatment in both groups, and there was a significant difference between the two groups before and after treatment (P 0.05), and the difference between the two groups was also significant (P 0.05). 4B Super-monitoring of embryonic Development. In the treatment group, there were 27 cases of B-ultrasound shading, 3 cases of embryo stopping, the success rate of fetal preservation was 90.000.In the control group, 23 cases of B-mode ultrasonography and 7 cases of embryo arrest, the success rate of fetal preservation was 76.67%. The difference between the two groups was statistically significant (P 0.05). 5. Comprehensive curative effect. The total effective rate of the treatment group was 90.00g and the total effective rate of the control group was 76.677.The total effective rate of the treatment group was significantly higher than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: Anzi mixture is effective in the treatment of recurrent abortion of kidney deficiency type. It can obviously improve the clinical symptoms such as lower abdominal pain, lumbosacral pain, vaginal bleeding and so on, increase the serum levels of E2P, 尾 -HCG, IL-6, and promote the development of pregnancy sac and embryo. The mechanism is related to the improvement of luteal function and the regulation of ovarian endocrine function in patients with RSA. On the other hand, it may be related to increasing the content of IL-6, balancing the proportion of Thl/Th2 and regulating the autoimmune response of the body.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.21

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