| Objective:To investigate the clinical effect of Jiawei Shoutai Wan combined with dydrogesterone on early recurrent spontaneous abortion caused by unexplained abortion;animal experiment aims to explore the mechanism of Shoutai Wan for reinforcing kidney and fetus protection through studying the expression of aquaporins in uterine decidual tissue of recurrent spontaneous abortion mice and the effect of Shoutai Wan on these aquaporins.Methods:(1)Clinical study--60 cases of kidney deficiency early unexplained recurrent spontaneous abortion in the Hebei Provincial Hospital of TCM from January 2017 to November 2018 were selected and divided into two groups according to the random number table,and each group had 30 cases.The control group was given dydrogesterone tablet 10 mg three times in a day;the experimental group was given Jiawei Shoutai Wan on the basis of the control group,and both were taken until 12 weeks of pregnancy.At 12 weeks of gestation,the early pregnancy success rate,clinical efficacy of TCM syndromes,the scores of TCM symptoms before and after treatment,and the serum ?-HCG 6,8,10,12 weeks of pregnancy of this two groups were compared.(2)Animal experiment-Established a normal pregnant group(10 rats)and a recurrent spontaneous abortion model(40 rats).According to the order of pregnancy,the spontaneous abortion group were randomly divided into model group(10 rats),Shoutai Wan low dose group(10 rats,3 g·kg· d),Shoutai Wan medium dose group(10 rats,6 g·kg · d),and Shoutai Wan high dose group(10rats,12 g·kg · d).Since the first day of gestation,the normal pregnant group and the model group were gavaged the same amount of normal saline,and the other three groups were given the suspension of Shoutai Wan until the 14 thday of gestation.The expression of aquaporin 1,2,5,and 8 in the decidual tissue of each group was detected by immunohistochemical analysis and observed the effect of Shoutai Wan on the AQPs.Results:(1)(1)there was no significant difference between the two groups in the age,duration,gestational age,previous mean abortion time,TCM symptom scores and serum ?-HCG levels at 6 weeks before treatment(P>0.05),which was comparable before treatment.(2)After treatment,the scores of TCM syndromes in the two groups were significantly decreased(P<0.05).The experimental group was statistically superior to the control group in the reduction of the score,the effect of TCM and the sucess rate of early pregnancy(P<0.05).(3)After treatment,serum ?-HCG increased in different degrees,and the experimental group was statistically superior to the control group(P<0.05).(2)(1)AQP1,AQP2,AQP5 and AQP8 were expressed in the decidual tissue of pregnant mice.AQP1,AQP2,AQP5 and AQP8 were respectively expressed in the cytoplasm and membrane of decidua vascular endothelial cells,cytoplasm and membrane of decidua cells,cytoplasm and membrane of decidua cells,nucleus of decidua cells,cytoplasm and membrane of decidua cells;(2)AQP1,AQP2,AQP5,AQP8 on the decidual tissue of the model group were statistically decreased compared with the normal group(P<0.01);(3)The high-dose group of Shoutai Wan could significantly increase the expression of AQP1,AQP2,AQP5 and AQP8 in the decidual tissue of recurrent spontaneous abortion mice,and these increases were statistically significant(P<0.01);(4)In the medium –dose and low-dose groups of Shoutai Wan,the expression of AQP5 and AQP8 in the decidual tissue of recurrent spontaneous abortion mice was significantly increased,and the expression of AQP1 was also increased in the middle dose group.These increases were statistically significant(P<0.01);(5)The expression of AQP5 and AQP8 in the high-dose group of Shoutai Wan were statistically higher than that in the medium –dose and low-dose groups of Shoutai Wan(P< 0.01).Conclusions:Jiawei Shoutai Wan combined with dydrogesterone cansignificantly improve the symptoms and pregnancy rate of early URSA;AQP1,AQP2,AQP5,AQP8 are all expressed in the decidua of RSA model mice,and Shoutai Wan had an effect on the aquaporin expression,which may be one of the mechanisms of Shoutai Wan for reinforcing kidney and fetus protection. |
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