[关键词]
[摘要]
目的 观察坤泰胶囊联合泼尼松治疗人工流产后免疫性不孕症患者的疗效。方法 选择2018年1月—2020年1月于沧州市人民医院就诊的人工流产后继发不孕症患者100例作为研究对象,将患者按照治疗方法分为对照组和观察组,每组50例。对照组患者口服泼尼松片,5~10 mg/次,3次/d。观察组在对照组的基础上口服坤泰胶囊治疗,2.0 g/次,3次/d。每4周作为1个疗程,治疗6个疗程。观察两组患者的临床疗效,同时比较两组治疗前后的抗精子抗体(AsAb)、抗子宫内膜抗体(EmAb)及抗卵巢抗体(AoAb)、抗心磷脂抗体(AcAb)、抗弓形虫抗体(ToxAb)的转阴率及血清中上述抗体的水平;促卵泡生成素(FSH)、雌二醇(E2)和黄体生成素(LH)水平;白细胞介素-2(IL-2)、白细胞介素6(IL-6)、β-内啡肽(β-EP)、脑啡肽(ENK)水平及妊娠结局。结果 治疗后,对照组总有效率为66.0%,观察组总有效率为84.0%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,观察组AsAb、EmAb、AcAb、AoAb、ToxAb转阴率显著高于对照组(P<0.05)。治疗后,两组患者血清AsAb、EmAb、AcAb、AoAb、ToxAb水平均显著降低(P<0.05),且观察组治疗后血清AsAb、EmAb、AcAb、AoAb、ToxAb水平较对照组治疗后显著降低(P<0.05)。治疗后,两组患者的血清FSH水平较治疗前显著更低,LH和E2水平较治疗前显著升高(P<0.05),且观察组的血清FSH水平较对照组治疗后显著更低,血清LH和E2水平较对照组治疗后显著升高(P<0.05)。治疗后,两组患者的血清IL-2、IL-6、ENK、β-EK水平均显著降低(P<0.05);且治疗后,观察组上述指标水平显著低于对照组(P<0.05)。两组患者经过观察1年,观察组妊娠率为52.0%,显著高于对照组的26.0%,两组妊娠率比较差异有统计学意义(P<0.05)。结论 坤泰胶囊联合泼尼松治疗人工流产后免疫性不孕症患者可以使患者体内的免疫抗体转阴率显著升高,显著降低患者血清免疫抗体水平,改善性激素水平、降低细胞因子水平,促进生殖内分泌功能的恢复,提高患者妊娠率。
[Key word]
[Abstract]
Objective To observe the effects of Kuntai Capsules combined with prednisone in treatment of immune infertility after induced abortion. Methods A total of 100 patients with immune infertility after induced abortion treated in Cangzhou People's Hospital from January 2018 to January 2020 were selected as the research subjects, and the patients were divided into control group and observation group according to treatment methods, with 50 patients in each group. Patients in the control group were po administered with Prednisone Acetate Tablets, 5 — 10 mg/time, three times daily. Patients in the observation group were po administered with Kuntai Capsules, 2.0 g/time, three times daily. Six courses of treatment were performed as one course every 4 weeks. The clinical efficacy and pregnancy outcome of two groups was observed, and the negative rates of AsAb, EmAb, AoAb, AcAb and ToxAb, and the serum levels of the above antibodies, and the levels of FSH, E2, LH, IL-2, IL-6, β-EP, ENK were compared before and after treatment between two groups. Results After treatment, the total effective rate of the control group was 66.0%, and the total effective rate of the observation group was 84.0%, and the difference between two groups was statistically significant (P < 0.05). After treatment, the negative conversion rates of AsAb, EmAb, AcAb, AoAb, and ToxAb in the observation group were significantly higher than those in the control group (P < 0.05). After treatment, the serum levels of AsAb, EmAb, AcAb, AoAb, and ToxAb in two groups were significantly decreased (P < 0.05), and the serum levels of AsAb, EmAb, AcAb, AoAb, and ToxAb in the observation group were significantly decreased compared with the control group after treatment (P < 0.05). After treatment, serum FSH levels in two groups were significantly decreased, while serum LH and E2 levels were significantly increased (P < 0.05). And serum FSH levels in observation group were significantly lower than those in the control group, while serum LH and E 2 levels were significantly higher than those in the control group (P < 0.05). After treatment, the levels of serum IL-2, IL-6, ENK, and β-EK in two groups were significantly decreased (P < 0.05). After treatment, the above indexes in observation group were significantly lower than those in control group (P < 0.05). After observation for 1 year, the pregnancy rate of the observation group was 52.0%, which was significantly higher than that of the control group 26.0%, and the difference of pregnancy rate between two groups was statistically significant (P < 0.05). Conclusion Kuntai Capsules combined with prednisone in treatment of patients with immune infertility after induced abortion can significantly increase the negative rate of immune antibodies in patients, significantly reduce the level of serum immune antibodies, improve the level of sex hormones, reduce the level of cytokines, promote the recovery of reproductive endocrine function, and improve the pregnancy rate of patients
[中图分类号]
R979.1
[基金项目]
沧州市科学技术研究与发展指导计划项目(162302075)