| Objective: To investigate the clinical efficacy of Shoutai Pill combined with Dang Gui San in combination with western medicine low molecular heparin in the treatment of recurrent spontaneous abortion of kidney deficiency and blood stasis type associated with antiphospholipid syndrome,a common disease of pregnancy,through a clinical observation,to provide some experience and basis for clinical treatment of this disease.Methods: Sixty-eight patients with APS-related recurrent spontaneous abortion who required abortion and with TCM evidence of kidney deficiency and blood stasis type,collected from October 2019 to December 2021 in the gynecological department of Huayuanshan District,Hubei Provincial Hospital of Traditional Chinese Medicine,were randomly divided into an observation group（n=34）and a control group（n=34）.The control group was treated with subcutaneous injection of low-molecular-weight heparin calcium,on this base,the observation group was given the traditional Chinese medicine Shoutai Pill and Dang Gui San.Both groups were treated until 12 weeks of gestation.Differences in TCM syndrome score,the efficacy of TCM syndrome,antiphospholipid antibody negative rate,serum progesterone and HCG levels,coagulation function,thromboelastography,gestational sac diameter and germ length,uterine artery hemodynamic index,incidence of uterine effusion and its absorption time,the outcome of pregnancy preservation,and the comprehensive clinical efficacy were compared between the two groups.Result:1.68 patients were included in this study,all of whom met the diagnosis and inclusion criteria.During the treatment,1 patient dropped out and 1 patient was removed from the observation group,and 2 cases were shed in the control group.32 cases in each of the observation and control groups were finally entered for clinical observation.2.The age,number of miscarriages,and maximum number of weeks of miscarriage were not significantly different between the two groups（P>0.05）and were comparable.3.After treatment,the TCM syndrome scores in both groups decreased significantly compared with those before treatment（P<0.001）,and the observation group was significantly lower than the control group（P<0.001）.4.The total efficacy rates of the TCM symptoms in the observation and control groups were 87.5% and 65.63%,respectively,and the observation group was superior to the control group（P<0.05）.5.The conversion rates of antiphospholipid antibodies in the observation and control groups were 18.75% and 15.63%,respectively,which were not significant（P<0.05）,and the efficacy was general.6.Serum progesterone and β-HCG values increased with gestational age in both groups（P<0.05）.There was no significant difference in serum progesterone and β-HCG levels between the two groups at 6 weeks of gestation（P > 0.05）.However,at 8 and 10 days of gestation,progesterone andβ-HCG levels in the observation group were significantly higher than those in the control group（P < 0.01）.7.Coagulation index: After treatment,compared with the control group,the observation group could better prolong the time of PT and APTT,and reduce the levels of FIB,MPAG,and DD（P<0.05）,while the two groups had no significant increase in the activity of ATⅢ.difference（P>0.05）.8.Thromboelastography: after treatment,R value,MA value,and α angle improved in the control group compared with before（P<0.05）,while K value did not change significantly（P>0.05）.In the observation group,all four parameters improved significantly（P<0.05）compared with before treatment,and the effect was better than that in the control group（P<0.05）.9.During the treatment,the diameter of the gestational sac and the length of the germ in the observation group were greater than those in the control group at the same period（P<0.05）.10.After treatment,the uterine artery RI and PI values of the two groups were significantly lower than before（P<0.05）,and the observation group was lower than the control group（P<0.05）.11.During the treatment,compared with the control group,the incidence of uterine effusion in the observation group was lower（P<0.05）,and the absorption time was shorter（P<0.05）.12.The success rates of fetal preservation in the observation group and control group were 93.75% and 75.00%,respectively,with better results in the observation group（P<0.05）.13.The total clinical comprehensive efficacy rates of the observation group and control group were 90.63% and 68.75%,respectively,and the observation group was higher than the control group（P<0.05）.Conclusion:Shoutai Pill combined with Dang Gui San combined with low molecular weight heparin in the treatment of APS-related recurrent spontaneous abortion of kidney deficiency and blood stasis type has not been sufficiently demonstrated to promote the conversion of serum antiphospholipid antibodies to negative significantly,but it can improve coagulation indicators,reduce uterine artery blood flow resistance during pregnancy,thereby improving blood hypercoagulability,which is beneficial for embryos.Provide sufficient blood supply;at the same time,it can increase the level of progesterone in early pregnancy,promote the growth of trophoblasts,gestational sac,and germ,reduce the occurrence of uterine effusion and promote its absorption,which is beneficial to the development of embryos;it can also improve clinical symptoms better,promote successful miscarriage protection and improve pregnancy outcomes and overall efficacy. |
PDF Full Text Request