种子转阴汤治疗不孕女性血清抗精子抗体阳性的临床研究

目的 :探讨种子转阴汤治疗不孕女性血清抗精子抗体阳性的治疗机制。方法 :将 6 0例不孕女性血清As Ab(+)患者随机分为中药组 (40例 ,口服种子转阴汤 )及西药组 (2 0例 ,口服泼尼松 ) ,观察治疗前后临床症状改善、免疫指标 (外周血 As Ab;体液免疫 Ig A、Ig M、Ig G;T细胞亚群 CD3、CD4、CD8、CD4 / CD8;RC3b R)的变化 ,检测妊娠结果。结果 :患者存在免疫功能紊乱 ,表现为 CD4、CD4 / CD8、Ig M、Ig G升高 ,CD8、RC3b R降低。治疗前两组在临床表现、免疫指标方面均无显著性差异 (P>0 .0 5 ) ;治疗后 ,两组在降低 CD4、CD4 / CD8、Ig M、Ig G方面无显著性差异 (P>0 .0 5 ) ,但中药组能显著升高 RC3b R、CD8(P<0 .0 5 ) ,而西药组 RC3b R显著降低 (P<0 .0 5 ) ;两组总有效率无显著性差异 (P>0 .0 5 ) ,但在改善临床症状、妊娠率、复发率、流产率方面有显著性差异 (P<0 .0 5 )。结论 :种子转阴汤能双向调节患者体内存在的免疫功能紊乱 ,改善临床症状 ,可通过多个环节提高孕育率。

CLINICAL STUDY ON TREATMENT OF FEMALE INFERTILITY WITH POSITIVE SERUM AsAb BY ZHONGZI HUANYIN DECOCTION

Objective To explore the menchanism of treating female infertility with positive serum antisperm antibody (AsAb) by Zhongzi Zhuanyin decoction(ZZD).Methods:Sixty patients were divided randomly into TCM group (40 cases,treated with ZZD) and control group(20 cases,treated with Prednisone).The improvements of clinical symptoms,immunologic indexes (humoral immunity funciton:AsAb,IgG,IgA,IgM;tlymphocytes subpopulations:CD3,CD4,CD8,CD4/CD8 and erythrocyte immunity function RC 3bR of peripheral blood)and the pregnant outcome were determined.Results:Patients were associated with immunlogic disturbances:elevated CD4,CD4/CD8,IgM,IgG,and descended CD8,RC 3bR.There were no significant differences in clinical symptoms and immunologic indexes between the two groups before treatment.After treatment,there were no significant differences in reducing CD4,CD4/CD8,IgM,IgG between the two groups(P>0.05),but in TCM group the CD8 and RC 3 bR(P<0.05)increased to normol level while in thecontrol group RC 3 bR reduced (P<0.05).There were no significant differences in total effective rates between the two groups,but there were significance in relief of clinical symptoms,pregnant rate,recurrent rate and abortion rate(P<0.05).Conclusions:ZZD could modulate the immunologic disturbance in female inferility with positive serum AsAb bidirectionly,improve the clinical symptoms and signs obviously and enhance pregnant rate multi-effectively.