The Clinical Study Of The Effect Of Prescription On "Jia Wei Shou Tai Wan And Si Jun Zi Tang" On Cytokines TNF-α, IL10 And Nitric Oxide(NO) On Spontaneous Abortion Patients

Objective:To study the changes in the peripheral blood levels of cytokines Th1/Th2(TNF-α/IL-10)and NO in patients who have suffered a spontaneous abortion.Clinically,we measured the peripheral blood levels of estradiol (E₂),Progesterone(P),human chorionic gonadotropin(β-HCG)and Tumor necrosis factor(TNF-α),Interleukin-10(IL-10),Nitric oxide-NO of threatened abortion (spontaneous abortion)patients before and after the administration of Jiawei Shoutaiwan and Sijunzitang decoctions and thus to understand at the immunological level the calming the fetus effect attributed in TCM to the above two herbal formulae.Methods:To conduct the screening of the medical case records strictly abiding to the diagnostic data.30 cases of early spontaneous abortion patients whom according to TCM pattern identification suffer from Spleen and Kidney deficiency syndrome,have been selected.The control group consists of 15 healthy early pregnant women.The peripheral blood level of E₂,P,β-HCG and TNF-α,IL-10,NO is measured and studied comparatively in both groups in order to investigate the relationship of Th1/Th2 level changes and spontaneous abortion.By comparing the cytokine level before and after two weeks of daily Jiawei Shoutaiwan and Sijunzitang decoction administration,we are able to understand better the 'nourishing Kidney,healing the Spleen' recipe mechanism of action in Spleen Kidney deficiency type of spontaneous abortionResult:In comparison of control group,in the intervention group E₂,P,β-HCG,IL-10 levels were significantly decreased(P＜0.01),TNF-αwere increased and TNF-α/IL-10 were significantly increased(P＜0.01)before the Jiawei Shoutaiwan and Sijunzitang decoction treatment.With regard to NO,no significant difference has been recorded amongst the two groups.The frequency of spontaneous abortion has positive correlation with TNF-αlevel(P＜0.05) while NO,IL-10,TNF-α/IL-10 levels didn't show any strong correlation. Autoimmune antibody-positive and negative patient groups had no significant differences in TNF-α,IL-10,NO level(P＞0.05).Patients with spontaneous abortion had positive correlation between blood serum P and IL-10 level,when P decreased IL-10 had decreased,too(P＜0.05),but there are no significant correlation between pre-treatment NO level and TNF-α,IL-10,TNF-α/IL-10 (P＞0.05).After two weeks of Jiawei Shoutaiwan and Sijunzitang decoction treatment, 28 out of the 30 studied cases have been successfully treated:2 cases were prolonged previous duration of miscarriage.The overall efficiency of treatment was 93.3%.In the intervention group,post-treatment E₂,P,β-HCG levels had significant differences comparing to pre-treatment level(P＜0.01). As a result of the treatment,IL-10 increased,TNF-αdecreased,Th1/Th2(TNF-α/IL-10)decreased,which has significant difference(P＜0.01).NO level decreased with a significant statistical value(P＜0.05).Conclusion:In the early spontaneous abortion patients group peripheral blood,increased TNF-α,decreased IL-10 and Th1/Th2 abnormal regulation is the main factor.TNF-α/IL-10(Th1/Th2)abnormal regulation has clinical significance in spontaneous abortion.A higher than normal NO level can promote Th1 reaction through inhibition of Th2 factors and have a certain effect on pregnancy.'Kidney nourishing,Spleen healing' TCM recipe of Jiawei Shoutaiwan and Sijunzitang decoction can increase blood level of IL-10, decrease TNF-αlevels and by decreasing TNF-α/IL-10 ratio it can help to reach normal balance.At the same time,during the pregnancy,by secreting E₂,P,β-HCG can inhibit too much the Th1 reaction,decrease the high content of NO level,regulate the Th1/Th2 balance and regulate the immune imbalance of the whole body,thus helping to maintain the pregnancy.