Page 105 - 《中国药房》2023年7期

固肾安胎丸联合达肝素钠治疗ACA阳性复发性流产的临床观察
Δ

＊
张 丽 ，董冰莹，袁小丽（三二〇一医院妇科，陕西 汉中 723000）
中图分类号 R984 文献标志码 A 文章编号 1001-0408（2023）07-0863-05
DOI 10.6039/j.issn.1001-0408.2023.07.18

摘 要 目的 探讨固肾安胎丸联合达肝素钠对抗心磷脂抗体（ACA）阳性复发性流产患者的临床疗效。方法 将ACA阳性复发
性流产患者203例随机分为对照组（n＝101）和联合治疗组（n＝102）。对照组患者在基础治疗的基础上采用达肝素钠治疗，联合
治疗组患者在对照组治疗的基础上加用固肾安胎丸治疗。收集患者血清样本，采用酶联免疫吸附试验法检测2组患者血清白细
胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、环氧化酶2（COX-2）、β人绒毛膜促性腺激素（β-HCG）、ACA 水平并计算抗体转阴率，观
察患者的临床疗效，同时记录不良反应发生情况。结果 治疗后，联合治疗组患者的妊娠成功率和抗体转阴率均显著高于对照组
（P＜0.05），流产率显著低于对照组（P＜0.05）；2 组患者血清 IL-6、TNF-α、ACA 水平均较治疗前显著下降（P＜0.05），COX-2、β-
HCG水平均较治疗前显著升高（P＜0.05），且联合治疗组患者上述指标水平变化更显著（P＜0.05）。2组患者不良反应发生率比
较，差异无统计学意义（P＞0.05）。结论 固肾安胎丸可通过上调ACA阳性复发性流产患者血清COX-2水平、下调IL-6水平来维
持β-HCG的高表达，降低ACA水平，改善免疫微环境，从而提高妊娠成功率。
关键词 复发性流产：固肾安胎丸；达肝素钠；抗心磷脂抗体；临床疗效

Clinical observation of Gushen antai pill combined with heparin sodium in the treatment of anticardiolipin
antibody-positive recurrent abortion
ZHANG Li，DONG Bingying，YUAN Xiaoli（Dept. of Gynaecology， No. 3201 Hospital， Shaanxi Hanzhong
723000， China）

ABSTRACT OBJECTIVE To investigate the clinical efficacy of Gushen antai pills combined with heparin sodium in the
treatment of antiphospholipin antibody （ACA）-positive recurrent abortion. METHODS A total of 203 ACA-positive recurrent
abortion patients were randomly divided into control group （n＝101） and combination treatment group （n＝102）. Control group
was additionally treated with heparin sodium on basis of basic treatment， and combination treatment group was additionally treated
with Gushen antai pills on the basis of control group. Serum samples were collected from patients， the levels of interleukin 6 （IL-
6）， tumor necrosis factor α （TNF-α）， cyclooxygenase 2 （COX-2）， β-human chorionic gonadotropin （β-HCG） and ACA were
detected by enzyme-linked immunosorbent assay. The antibody-negative conversion rate was calculated， the clinical efficacy of the
patient was observed， and the occurrence of adverse drug reactions was recorded. RESULTS After treatment， the pregnancy
success rate and antibody-negative conversion rate of combination treatment group were significantly higher than those in the control
group （P＜0.05）， and the abortion rate was significantly lower than that in the control group （P＜0.05）. Compared with before
treatment， serum levels of IL-6， TNF-α and ACA in 2 groups were decreased significantly （P＜0.05）， while the levels of COX-2
and β -HCG were increased significantly （P＜0.05）； the changes of above indexes in combination treatment group were more
significant（P＜0.05）. There was no statistical significance in the incidence of adverse drug reactions between 2 groups（P＞0.05）.
CONCLUSIONS Gushen antai pills can maintain high expression of β -HCG， reduce the level of ACA and improve immune
microenvironment in patients with ACA-positive recurrent abortion by increasing the serum level of COX-2 and decreasing the
serum level of IL-6， so as to increase the success rate of pregnancy.
KEYWORDS recurrent abortion； Gushen antai pill； heparin sodium； anticardiolipin antibody； clinical efficacy

复发性流产常继发于多种疾病，有报道称其与遗 起的一组反复动脉或静脉血栓、自然流产、ACA 阳性等
[1]
传、激素和子宫等因素有关 。目前，抗心磷脂抗体（an‐ 临床问题的总称，其中产科并发症如胎儿死亡、早产、先
[2]
ticardiolipin antibody，ACA）已被确认为复发性流产的重 兆子痫和反复性流产是APS的特征性表现 。在自身免
要因素之一，两者之间的关联已得到广泛认证 。抗磷 疫因素中，ACA引发的APS在复发性流产女性中的患病率
[1]
[3]
脂综合征（antiphospholipid syndrome，APS）是由ACA引 高达40% ，目前的治疗方案以免疫抑制和抗凝为主。
固肾安胎丸由制何首乌、地黄、肉苁蓉（制）、续断、
Δ 基金项目 陕西省科技发展计划项目（No.2021B00200）
桑寄生、钩藤、菟丝子、白术（炒）、黄芩、白芍制成，具有
＊第一作者 副主任医师，硕士。研究方向：妇科肿瘤、生殖医学。
E-mail：zhanglillian3201@126.com 滋阴补肾、固冲安胎的功效，适用于早期先兆流产的治

中国药房 2023年第34卷第7期 China Pharmacy 2023 Vol. 34 No. 7 · 863 ·