养血安胎颗粒对复发性流产血栓前状态的中西结合干预模式的建立

目的通过对复发性流产患者血栓前状态的相关血栓标志物进行筛查,验证中医瘀血型辨证与其相关性,建立养血安胎颗粒对其规范化的治疗模式。方法将1497例自然流产患者按流产次数分为1次、2次、3次及以上,分别检测抗凝血酶Ⅲ(AT-Ⅲ)、纤溶酶原(PLG)、交联纤维蛋白降解产物(DD)、纤溶酶原降解产物(FDP)、纤溶酶原活化物抑制因子-1(PAI-1)、组织型纤溶酶原激活物(t-PA)、蛋白C(PC)、蛋白S(PS)等血栓标志物。对入选289例复发性流产患者按照随机、对照原则分为中药治疗组(127例)和西药治疗组(162例),观察养血安胎颗粒和阿司匹林对复发性流产血栓前状态的疗效。结果 AT-Ⅲ、PAI-1对不良妊娠结局的影响具有统计学差异(P0.05),随着流产次数的增加特征性明显(P0.05);阿司匹林对AT-Ⅲ的影响具有统计学意义(P0.05);养血安胎颗粒对PAI-1的影响具有统计学意义(P0.01);各指标两组间治疗前后效果比较差异均无统计学意义(P0.05)。结论养血安胎颗粒通过养血活血、健脾补肾,调节止血—凝血—抗凝系统,改善复发性流产血栓前状态。

Intervention of Integrated Chinese and Western Medicine on Prethrombotic State in Recurrent Spontaneous Abortion with Yangxue Antai Granules

Objective To verify the correlation between blood stagnation in TCM and thrombotic markers by screening the relevant thrombotic markers in the patients of prethrombotic state（PTS）of recurrent spontaneous abortion（RSA）so as to establish the standard therapeutic mode with Yangxue Antai Granules. Methods One thousand nine hundred and ninety seven patients of spontaneous abortion were divided into groups according to the frequency of spontaneous abortion,such as 1 time,twice,three times or over 3 times. The thrombotic markers such as AT - III,PLG,DD,FDP,PAT - 1,t - PA,PC and PS were detected. The en-rolled 289 cases of RSA were randomized into a Chinese medicine group（127 cases）and a western medicine group（162 cases）. The effect on PTS of RSA was observed in the treatment with Yangxue Antai Granules and Aspirins. Results The impacts of AT - III and PAI - 1on adverse pregnant outcome were different signifi-cantly（P ﹤ 0. 05）. The characteristics were getting obvious with the increased frequency of abortion（ P ﹤0. 05）. The impact of Aspirins was significant on AT - III（P ﹤ 0. 05）. The impacts of Yangxue Antai Gran-ules and Aspirins were significant on PAI - 1 statistically（P ﹤ 0. 01）. The differences in every marker before and after treatment were not significant in comparison of the two groups（P ﹥ 0. 05）. Conclusion Yangxue Antai Granules regulate the system of stopping bleeding,coagulation and anticoagulation and improve in PTS of RSA by nourishing blood,activating blood circulation,strengthening the spleen and tonifying the kidney.