目的 观察乐孕宁颗粒联合醋酸阿托西班注射液班治疗晚期先兆流产的临床疗效。方法 选取2020年3月—2021年12月邯郸市妇幼保健收治100例晚期先兆流产患者，采用随机数字表法将患者分为对照组和治疗组，每组各50例。对照组给予醋酸阿托西班注射液，初始剂量6.75 mg，缓慢静脉注射，时间＞1 min；紧接着醋酸阿托西班注射液7.5 mg/mL溶入0.9%氯化钠注射液405 mL，持续静脉滴注3 h，24 mL/h；然后持续静脉滴注45 h，8 mL/h。治疗组在对照组基础上口服乐孕宁颗粒，5 g/次，3次/d，持续治疗14 d。比较两组临床疗效、症状评分、子宫动脉血流动力学、血清细胞因子。结果 治疗组的总有效率94.00%较对照组的总有效率80.00%更高，组间比较差异显著（P＜0.05）。治疗后，两组腰酸痛、下腹坠痛、阴道出血评分均下降（P＜0.05），且治疗组的腰酸痛、下腹坠痛、阴道出血评分较对照组低（P＜0.05）。治疗后，两组搏动指数（PI）、阻力指数（RI）均下降（P＜0.05），且治疗组PI、RI较对照组低（P＜0.05）。治疗后，两组血清γ-干扰素（IFN-γ）、肿瘤坏死因子-α（TNF-α）水平下降，血清白细胞介素-10（IL-10）水平升高（P＜0.05），且治疗组血清IFN-γ、TNF-α水平较对照组低，血清IL-10水平较对照组高（P＜0.05）。结论 乐孕宁颗粒联合醋酸阿托西班注射液治疗晚期先兆流产的效果确切，能减轻临床体征，改善子宫胎盘灌注，调节血清细胞因子水平。

Objective To observe the clinical curative effect of Leyunning Granules combined with Atosiban Acetate Injection in treatment of late threatened abortion. Methods A total of 100 patients with late threatened abortion in Handan Maternal and Child Health Hospital from March 2020 to December 2021 were selected and divided into random number table method, with 50 cases in each group. Patients of the control group was treated with Atosiban Acetate Injection, the initial dose was 6.75 mg, and the time of slow intravenous injection was > 1 min, then Atosiban Acetate Injection 7.5 mg/mL was dissolved into 0.9% sodium chloride injection 405 mL, and continued intravenous infusion for 3 h, 24 mL/h, then the intravenous infusion was continued for 45 h, 8 mL/h. Patients in the treatment group was po administered with Leyunning Granules on the basis of the control group, 5 g/ time, 3 times daily, and continued treatment for 14 d. The clinical efficacy, symptom score, uterine arterial hemodynamics, and serum cytokines were compared between two groups. Results The total effective rate ( 94.00%) in the treatment group was higher than 80.00% in the control group, with significant difference between two groups (P < 0.05). After treatment, the scores of lumbar soreness, lower abdominal pain, and vaginal bleeding were decreased in both groups (P < 0.05), and the scores of lumbar soreness, lower abdominal pain, and vaginal bleeding in the treatment group were lower than those in the control group (P < 0.05). After treatment, PI and RI in both groups were significantly decreased (P < 0.05), and PI and RI in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of IFN-γ and TNF-α were decreased, but the levels of IL-10 were increased (P < 0.05). And the levels of IFN-γ and TNF-α in the treatment group were lower than those in the control group, but the levels of IL-10 in the treatment group were higher than those in the control group (P < 0.05). Conclusion Leyunning Granules combined with Atosiban Acetate Injection has good effect and safety in treatment of late threatened abortion. It can effectively relieve symptoms of patients, improve uterine placental perfusion status, and reduce inflammatory response.

R984

河北省医学科学研究课题计划(20231932)