滋肾益胎颗粒联合西药对习惯性流产患者抗苗勒管激素水平及妊娠情况的影响

目的:观察滋肾益胎颗粒联合西药对习惯性流产患者抗苗勒管激素(AMH)水平及妊娠情况的影响。方法:将88例脾肾两虚型习惯性流产患者按照随机数字表法分为观察组、对照组各44例,2组均采用注射用绒促性素、黄体酮注射液治疗,观察组加用滋肾益胎颗粒治疗。持续治疗至妊娠3个月,月经期停用。治疗前及治疗3个月后评定中医证候积分、检测抗苗勒管激素(AMH)水平,对比2组的临床疗效、不良反应发生情况及妊娠情况。结果:治疗后,观察组临床疗效总有效率90.91%,对照组总有效率63.64%,2组比较,差异有统计学意义(P<0.01)。2组中医证候积分均有所降低,与治疗前相比,差异均有统计学意义(P<0.01);观察组中医证候积分低于对照组,差异有统计学意义(P<0.01)。2组AMH浓度均有所上升,与治疗前相比,差异均有统计学意义(P<0.01);观察组AMH浓度高于对照组,差异有统计学意义(P<0.01)。经随访可知,观察组妊娠成功率90.91%,对照组妊娠成功率63.64%,2组比较,差异有统计学意义(P<0.01)。观察组顺产率高于对照组(P<0.05)。2组围产期不良反应发生率比较,差异无统计学意义(P>0.05)。结论:针对脾肾两虚型习惯性流产患者采用滋肾益胎颗粒联合西药治疗,临床效果显著,可有效改善患者的临床症状,调节AMH浓度,提高妊娠率。

Effect of Zishen Yitai Granules Combined with Western Medicine on Level of Anti- Mullerian Hormone and Pregnancy in Patients with Habitual Abortion

Objective:To observe the effect of Zishen Yitai granules combined with western medicine on level of antimullerian hormone(AMH)and pregnancy in patients with habitual abortion.Methods:A total of 88 cases of patients with habitual abortion of spleen-kidney deficiency type were divided into the observation group and the control group according to the random number table method,44 cases in each group.Both groups were given the injection of chorionic gonadotrophin and progesterone injection,and the observation group was additionally given Zishen Yitai granules.Both groups were continuously treated for three months until pregnancy,and the treatment was discontinued in menstrual period.Before treatment and after three-month treatment,Chinese medicine syndrome scores were evaluated;the level of AMH was detected;the clinical effect,the incidence of adverse reactions,and the pregnancy were compared between the two groups.Results:After treatment,the total effective rate of clinical effect was 90.91%in the observation group,and 63.64%in the control group,the difference being significant(P<0.01).In the two groups,Chinese medicine syndrome scores were decreased when compared with those before treatment,differences being significant(P<0.01);the scores in the observation group were lower than those in the control group,the difference being significant(P<0.01).In the two groups,AMH concentration was increased when compared with that before treatment,differences being significant(P<0.01);the concentration in the observation group was higher than that in the control group,the difference being significant(P<0.01).According to information from the follow-up,the success rate of pregnancy was 90.91%in the observation group,and 63.64%in the control group,the difference being significant(P<0.01).The rate of spontaneous delivery in the observation group was higher than that in the control group(P<0.05). There was no significant difference being found in the comparison ofthe incidence of adverse reactions in perinatal period between the two groups(P>0.05). Conclusion:The therapy of ZishenYitai granules combined with western medicine has significant clinical effect in the treatment of patients with habitual abortionof spleen-kidney deficiency type,which can effectively improve their clinical symptoms,regulate AMH concentration,andimprove pregnancy rate.