目的 探讨杜仲颗粒联合烯丙雌醇片治疗先兆流产的临床疗效。方法 选取2022年5月—2023年12月上海大学附属南通医院收治的先兆流产患者115例，随机分为对照组（57例）和治疗组（58例）。对照组患者口服烯丙雌醇片，5 mg/次，2次/d。治疗组在对照组基础上口服杜仲颗粒，5 g/次，2次/d。两组患者均治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状缓解时间，性激素人绒毛膜促性腺激素β（β-HCG）、孕酮（P）和雌二醇（E₂）水平，子宫动脉血流参数指标动脉阻力指数（RI）、搏动指数（PI）、S/D水平及保胎成功率。结果 治疗后，治疗组总有效率明显高于对照组（91.37% vs 77.19%，P＜0.05）。治疗后，治疗组阴道出血、下腹坠胀、腰酸腹痛、头晕耳鸣等症状缓解时间均短于对照组（P＜0.05）。治疗后，两组患者性激素β-HCG、E₂和P水平均升高（P＜0.05），且治疗组各项性激素指标高于对照组（P＜0.05）。治疗后，两组患者RI、PI、S/D显著降低（P＜0.05），且治疗组子宫动脉血流参数均低于对照组（P＜0.05）。治疗后，治疗组保胎成功率为89.66%，明显高于对照组的71.93%（P＜0.05）。结论 杜仲颗粒联合烯丙雌醇片治疗先兆流产有良好效果，缩短症状消退时间，提升性激素水平，降低子宫动脉血流阻力，提高保胎成功率。

Objective To explore the clinical effect of Duzhong Granules combined with allylestrenol in treatment of threatened abortion. Methods Patients (115 cases) with threatened abortion in Affiliated Nantong Hospital of Shanghai University from May 2022 to December 2023 were randomly divided into control (57 cases) and treatment (58 cases) group. Patients in the control group were po administered with Allylestrenol Tablets, 5 mg/time, twice daily. Patients in the treatment group were po administered with Duzhong Granules on the basis of the control group, 5 g/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, and the symptom relief time, serum sex hormone β-HCG, E₂ and P levels, uterine artery blood flow parameter indicators RI, PI and S/D levels, and the success rate of pregnancy preservation in two groups before and after treatment were compared. Results After treatment, the clinical total effective rate in the treatment group was significantly higher than that in the control group (91.37% vs 77.19%, P < 0.05). After treatment, the relief time for symptoms such as vaginal bleeding, lower abdominal distension, waist soreness, abdominal pain, dizziness and tinnitus in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the levels of sex hormone β-HCG, E₂ and P were increased in two groups (P < 0.05), and all sex hormone indicators in the treatment group were higher than those in the control group (P < 0.05). After treatment, RI, PI, and S/D in two groups were significantly reduced (P < 0.05), and the uterine arterial blood flow parameters in the treatment group were lower than those in the control group (P < 0.05). After treatment, the success rate of abortion protection in the treatment group was 89.66%, which was significantly higher than 71.93% in the control group (P < 0.05). Conclusion The clinical efficacy of Duzhong Granules combined with Allylestrenol Tablets in treatment of threatened miscarriage is significant, which can alleviate the symptoms of premature miscarriage, improve sex hormone levels, reduce uterine artery blood flow resistance, increase the success rate of fetal preservation.

R984

江苏省卫生健康委科研课题（ZD2022018）