安子调冲汤联合低分子肝素钙治疗肾虚血瘀型复发性流产合并抗磷脂综合征的临床效果

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摘要目的观察安子调冲汤联合低分子肝素钙治疗肾虚血瘀型复发性流产合并抗磷脂综合征的临床效果及安全性。方法收集2017年3月至2019年12月南方医科大学附属深圳妇幼保健院收治的138例肾虚血瘀型复发性流产合并抗磷脂综合征患者的临床资料。根据治疗方法分为观察组（安子调冲汤联合低分子肝素钙治疗）和对照组（低分子肝素钙治疗），每组69例，疗程为7周。记录并比较两组妊娠结局、临床疗效、中医症候改善情况、抗磷脂抗体转阴率、凝血-纤溶指标以及不良反应发生情况。结果观察组孕早期、孕晚期安胎成功率高于对照组，差异有统计学意义（P < 0.05）。观察组总有效率高于对照组，差异有统计学意义（P < 0.05）。治疗后，两组中医证候积分低于同组治疗前，且观察组低于对照组，差异有统计学意义（P < 0.05）。观察组抗磷脂抗体总转阴率高于对照组，差异有统计学意义（P < 0.05）。治疗后，两组血浆凝血酶原时间、活化部分凝血活酶时间水平高于同组治疗前，且观察组高于对照组，差异有统计学意义（P < 0.05）；纤维蛋白原、D-二聚体水平低于同组治疗前，且观察组低于对照组，差异有统计学意义（P < 0.05）。观察组不良反应总发生率低于对照组，差异有统计学意义（P < 0.05）。结论安子调冲汤联合低分子肝素钙治疗肾虚血瘀型复发性流产合并抗磷脂综合征患者效果显著，可提高安胎成功率和临床疗效，降低中医症候积分，增加抗磷脂抗体转阴率，改善凝血-纤溶指标。

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	马飞1 罗颂平2 郜洁2 刘昱磊1 何珊3 宁艳1▲

关键词 ：安子调冲汤, 低分子肝素钙, 复发性流产, 抗磷脂综合征, 肾虚血瘀

Abstract：Objective To observe the clinical efficacy and safety of Anzi Tiaochong Decoction combined with Low Molecular Weight Heparin Calcium in the treatment of kidney deficiency and blood stasis type recurrent spontaneous abortion with antiphospholipid syndrome. Methods The clinical data of 138 patients with kidney deficiency and blood stasis type recurrent spontaneous abortion with antiphospholipid syndrome admitted to Affiliated Shenzhen Maternity ＆ Child Healthcare Hospital, Southern Medical University from March 2017 to December 2019 were selected. According to the treatment method, they were divided into observation group (Anzi Tiaochong Decoction combined with Low Molecular Weight Heparin Calcium treatment) and control group (Low Molecular Weight Heparin Calcium treatment), with 69 cases in each group. The course of treatment was seven weeks. Pregnancy outcome, clinical efficacy, improvement of traditional Chinese medicine symptom, negative conversion rate of antiphospholipid antibody, coagulation-fibrinolysis indexes and the occurrence of adverse reactions were recorded and compared between two groups. Results The success rate of abortion in the first and third trimester in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). After treatment, the traditional Chinese medicine syndrome scores of two groups were lower than those before treatment, and observation group was lower than control group, and the differences were statistically significant (P < 0.05). The total negative conversion rate of antiphospholipid antibody in observation group was higher than that in control group, and the difference was statistically significant (P < 0.05). After treatment, plasma prothrombin time and activated partial thrombin time in two groups were higher than those before treatment, and observation group was higher than control group, and the differences were statistically significant (P < 0.05); the levels of fibrinogen and D-dimer were lower than those before treatment, and observation group was lower than control group, and the differences were statistically significant (P < 0.05). The total incidence of adverse reactions in observation group was lower than that in control group, and the difference was statistically significant (P < 0.05). Conclusion Anzi Tiaochong Decoction combined with Low Molecular Weight Heparin Calcium has a significant effect on the treatment of kidney deficiency and blood stasis type recurrent spontaneous abortion with antiphospholipid syndrome, which can improve the success rate of abortion and clinical efficacy, reduce the traditional Chinese medicine syndrome score, increase the negative conversion rate of antiphospholipid antibody, and improve the indexes of coagulation-fibrinolysis.

Key words： Anzi Tiaochong Decoction Low Molecular Weight Heparin Calcium Recurrent spontaneous abortion Antiphospholipid syndrome Kidney deficiency and blood stasis

基金资助:广东省基础与应用基础研究基金项目（2019A15 15110579）；
广东省中医药局科研项目（20201292）；
广东省深圳市“医疗卫生三名工程”项目（SZSM201612046）；
广东省名中医传承工作室建设项目（粤中医办函﹝2019﹞5号）。

通讯作者: ▲通讯作者

引用本文:

马飞1 罗颂平2 郜洁2 刘昱磊1 何珊3 宁艳1▲. 安子调冲汤联合低分子肝素钙治疗肾虚血瘀型复发性流产合并抗磷脂综合征的临床效果[J]. 中国医药导报, 2021, 18(27): 88-92,109.
MA Fei1 LUO Songping2 GAO Jie2 LIU Yulei1 HE Shan3 NING Yan1▲. Clinical effect of Anzi Tiaochong Decoction combined with Low Molecular Weight Heparin Calcium in the treatment of kidney deficiency and blood stasis type recurrent spontaneous abortion with antiphospholipid antibody syndrome. 中国医药导报, 2021, 18(27): 88-92,109.

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