目的 探讨嗣育保胎丸联合烯丙雌醇治疗先兆流产的临床疗效。方法 采用回顾性研究设计，选取2024年1月—2025年12月武汉市中西医结合医院妇产科收治的98例先兆流产患者为研究对象，按治疗方案分为对照组与治疗组，各49例。对照组给予烯丙雌醇片口服治疗，每次5 mg，每日3次，饭后温水送服，连续治疗2周。治疗组在对照组治疗方案的基础上口服嗣育保胎丸，每次2丸，每日3次，连续治疗2周。比较两组临床疗效、中医证候积分、子宫动脉血流参数、宫腔积血面积、血清激素与免疫调节指标、妊娠相关焦虑量表（PRAQ）评分、生育生活质量量表（FertiQoL）评分。结果 治疗后，治疗组总有效率（95.92%）显著高于对照组（81.63%，P＜0.05）。治疗后，两组阴道出血积分、腰腹疼痛积分、腰膝酸软积分、神疲乏力积分、总积分均较治疗前显著下降（P＜0.05），且治疗后治疗组阴道出血积分、腰腹疼痛积分、腰膝酸软积分、神疲乏力积分、总积分均较对照组降低（P＜0.05）。治疗后，两组阻力指数（RI）、搏动指数（PI）均较治疗前降低，宫腔积血面积均较治疗前缩小（P＜0.05），且治疗组RI、PI、宫腔积血面积与对照组比较均显著下降（P＜0.05）。治疗后，两组孕酮（P）、人绒毛膜促性腺激素β亚基（β-HCG）、可溶性人白细胞抗原-G（sHLA-G）水平均较治疗前显著升高，单核细胞趋化蛋白-1（MCP-1）水平降低（P＜0.05）；且治疗后，治疗组P、β-HCG、sHLA-G水平均显著高于对照组，而MCP-1低于对照组（P＜0.05）。治疗后，两组PRAQ评分相比于同组治疗前显著降低，而FertiQoL评分显著升高（P＜0.05）；治疗后，治疗组PRAQ评分均较对照组降低，而FertiQoL评分较对照组升高（P＜0.05）。结论 嗣育保胎丸联合烯丙雌醇可有效提升先兆流产的临床疗效，改善患者临床症状与中医证候，优化子宫血流灌注、内分泌水平与免疫耐受状态，同时缓解妊娠焦虑、提升生活质量，且安全性良好，具有临床推广价值。

Objective To investigate the clinical efficacy of Siyu Baotai Pills combined with allylestrenol in treatment of threatened miscarriage. Methods A retrospective study design was adopted. 98 Patients with threatened miscarriage who were admitted to Obstetrics Department of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine from January 2024 to December 2025 were selected as research subjects. They were divided into control group and treatment group according to treatment plan, with 49 cases in each group. The control group patients were treated with oral administration of Allylestrenol Tablets, 5 mg each time, three times daily, taken with warm water after meals, for a continuous treatment period of 2 weeks. The treatment group patients received oral administration of Siyu Baotai Pills in addition to treatment plan of control group, 2 pills each time, three times daily, for a continuous treatment period of 2 weeks. The clinical efficacy, TCM syndrome scores, uterine artery blood flow parameters, uterine cavity hematoma area, serum hormone and immune regulation indicators, pregnancy-related anxiety scale (PRAQ) score, and fertility quality of life scale (FertiQoL) score were compared between two groups. Results After treatment, the total effective rate of treatment group (95.92%) was significantly higher than that of control group (81.63%, P < 0.05). After treatment, the vaginal bleeding score, waist and abdomen pain score, waist and knee soreness score, fatigue and weakness score, and total score of both groups decreased significantly compared to those before treatment (P< 0.05), and vaginal bleeding score, waist and abdomen pain score, waist and knee soreness score, fatigue and weakness score, and total score of treatment group were all lower than those of control group after treatment (P < 0.05). After treatment, the resistance index (RI) and pulsatility index (PI) of both groups decreased compared to those before treatment, and uterine cavity hematoma area decreased compared to that before treatment (P < 0.05), and RI, PI, and uterine cavity hematoma area of treatment group were significantly lower than those of control group (P < 0.05). After treatment, the progesterone (P), human chorionic gonadotropin β subunit (β-HCG), soluble human leukocyte antigen-G (sHLA-G) levels of both groups increased significantly compared to those before treatment, and the level of monocyte chemoattractant protein-1 (MCP-1) decreased (P < 0.05). And after treatment, the P, β-HCG, sHLA-G levels of treatment group were significantly higher than those of control group, but MCP-1 was lower than that of control group (P < 0.05). After treatment, the PRAQ score of both groups was significantly lower than that before treatment in same group, but FertiQoL score was significantly higher (P < 0.05). After treatment, PRAQ score of treatment group was lower than that of control group, but FertiQoL score was higher than that of control group (P < 0.05). Conclusion Siyu Baotai Pills combined with allylestrenol can effectively improve the clinical efficacy of threatened miscarriage, improve the clinical symptoms and TCM syndromes of patients, optimize uterine blood perfusion, endocrine levels and immune tolerance status, and also can simultaneously alleviate pregnancy anxiety, improve the life quality with good safety. It also has clinical promotion value.

R984

湖北省科技计划项目（2025AFC112）