| Objective: To observe the clinical efficacy of the method of nourishing the kidney and nourishing blood in the treatment of recurrent spontaneous abortionwith positive anticardiolipin antibodies,and preliminarily explore its mechanism of action.Methods:Select from January 2019 to April 2020 in Guangxi University of traditional Chinese Medicine affiliated Renai Hospital gynecological outpatient in accordance with kidney deficiency and blood stasis type confirmed pregnancy anticardiolipin antibody positive recurrent spontaneous abortion patients,Sixty cases were included in the study.It was divided into treatment group(Bushen Yangxue recipe combined with low molecular weight heparin sodium aspirin),control group(low molecular weight heparin sodium aspirin),Treatment until 12 weeks of gestation,The changes of anticardiolipin antibody(ACA)conversion rate,coagulation index(APTT、PT、TT、FIB、D-D),platelet count(PLT),TCM symptoms,uterine artery blood flow(PI、RI)and blood HCG、P、E2 were observed after treatment.Results:(1)Laboratory indicators:(1)Coagulation indicators: Both groups can prolong APTT,PT,TT time and reduce DD and FIB levels after treatment.There are significant differences in DD between the two groups after treatment(P<0.05).The treatment was better than the control group;the two groups had no significant difference in APTT,PT,TT,FIB(P>0.05).(2)Platelet count: There was no significant difference in platelet count between the two groups after treatment(P>0.05).(3)HCG,P,E2 changes: the two groups of HCG,P,E2 levels can increase with the growth of gestational weeks,for HCG: there is no significant difference between the two groups of blood HCG at 6 weeks of gestation(P> 0.05);at 8 o’clock in pregnancy There were significant differences between gestational weeks and 10 weeks(P<0.01),and the treatment was better than the control group.For P: There was no significant difference in blood P between the two groups at 6 weeks,8weeks,and 10 weeks of gestation(P>0.05).For E2: There was no significant difference between the two groups of blood E2 at 6 weeks,8 weeks,and 10 weeks of gestation(P>0.05).(4)ACA negative conversion rate: the negative conversion rate of the treatment group was 83.33%;the negative conversion rate of the control group was 60.00%.There was a significant difference between the two groups(P<0.05),and the treatment group was better than the control group.(5)The rate of negative conversion with other antibodies: There was no significant difference between the two groups after treatment(P>0.05).(2)Uterine artery blood flow(PI,RI): Both groups can reduce the levels of PI and RI after treatment.There are significant differences in PI and RI between the two groups(P<0.05),and the treatment is better than the control group.(3)Vaginal hemostasis time: There is a significant difference in vaginal hemostasis time between the two groups after treatment(P<0.01),indicating that the two groups are better than the control group in terms of vaginal hemostasis time.(4)Clinical efficacy of traditional Chinese medicine:(1)After treatment,the total effective rate of the treatment group was 93.33%,and the total effective rate of the control group was 70.00%.There was a significant difference between the two groups after treatment(P<0.01),and the treatment was better than the control group.(2)Total scores of TCM syndromes: After treatment,the total scores of TCM syndromes were significantly different between the two groups(P<0.01),and the treatment was better than the control group.(3)Single Chinese medical effect:significant difference in waist pain,lower abdomen pain or swelling,sore knees,frequent nocturia,dry mouth and throat,yellow urine,constipation,the treatment group is better than Control group: There were no significant differences in dizziness,tinnitus,upset,less sleep sound,heat in the hands,feet,heart,tongue and pulse(P>0.05).(4)Comprehensive clinical efficacy:After treatment,the total effective rate of the treatment group was 76.67%,and the total effective rate of the control group was 63.33%.There was a significant difference between the two groups after treatment(P<0.05),and the treatment was better than the control group.(5)Pregnancy outcome: The treatment group had an early abortion rate of 23.33%,a late abortion rate of20.00%,and a pregnancy success rate of 56.67%.The control group had an early abortion rate of 36.67%,a late abortion rate of 26.67%,and a pregnancy success rate of 36.67%,all of which were not significant.Difference(P>0.05).(6)Follow-up delivery outcomes: in the treatment group,the rate of pre-term cesarean section was 11.76%,the rate of pre-term cesarean section was17.65%,the rate of term cesarean section was 23.53%,and the rate of full-term cesarean section was 47.06%.The delivery rate was 27.27%,the pre-term normal delivery rate was 9.09%,the term cesarean section rate was36.36%,and the term normal delivery rate was 27.27%.There was no significant difference(P>0.05).Conclusion(s):The method of invigorating the kidney and nourishing blood combined with western medicine has a good effect on the treatment of anticardiolipin antibody positive recurrent spontaneous abortion.It can improve the patient’s clinical symptoms,Improve the growth of serum HCG,P,E2,maintain the normal level of coagulation indicators and platelets,improve the uterine artery blood perfusion,reduce the abortion rate,and effectively increase the pregnancy rate. |
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