补肾养血安胎汤治疗先兆流产合并甲状腺功能减退疗效及对妊娠激素水平、甲状腺功能的影响

目的:探讨补肾养血安胎汤治疗肾阳虚型先兆流产合并甲状腺功能减退疗效及对妊娠激素水平、甲状腺功能的影响。方法:选择2016年2月至2017年6月在河北省中医院接受治疗的肾阳虚型先兆流产合并甲状腺功能减退患者144例为研究对象,按入院顺序对其做编号,并利用随机数字表分成观察组和对照组,各72例。对照组给予优甲乐治疗,观察组在此基础上加用补肾养血安胎汤治疗。治疗2周后对两组疗效进行评估,并比较治疗前后两组妊娠激素水平及甲状腺功能相关指标等变化情况。结果:治疗2周后,观察组总有效率为90.28%(65/72),与对照组的69.44%(50/72)比较明显上升(P0.05)。观察组治疗后总三碘甲状腺激素(TT_3),总四碘甲状腺激素(TT_4)水平均明显高于治疗前(P0.05),游离三碘甲状腺激素(FT_3),促甲状腺激素(TSH)水平均明显低于治疗前(P0.05);与本组治疗前比较,对照组治疗后游离四碘甲状腺激素(FT_4)水平明显升高(P0.05),FT_3,TSH水平均明显下降(P0.05);且与对照组治疗后对比,观察组同期TT_3水平明显升高(P0.05),TSH水平明显降低(P0.05)。与本组治疗前比较,治疗后两组血清雌二醇(E_2),孕酮(P),人绒毛膜促性腺激素(HCG)水平均明显升高(P0.05);观察组治疗后E_2,P,HCG水平均明显高于对照组(P0.05)。与本组治疗前对比,两组治疗后血清白细胞介素-2(IL-2)水平明显降低(P0.05),白细胞介素-10(IL-10)水平明显上升(P0.05);且与对照组治疗后比较,观察组血清IL-10水平更高(P0.05)。结论:对于肾阳虚型先兆流产合并甲状腺功能减退患者采用补肾养血安胎汤治疗能有效促进临床症状的缓解,并能有效改善妊娠激素水平,促进甲状腺功能的恢复,疗效确切。

Efficacy of Bushen Yangxue Antaitang on Patients with Threatened Abortion Combined with Hypothyroidism and Its Effect on Pregnant Hormone Level and Thyroid Function

Objective: To investigate the clinical efficacy of Bushen Yangxue Antaitang on patients with threatened abortion combined with hypothyroidism of kidney-Yang deficiency type and its effect on their pregnant hormone level and thyroid function.Method: Totally 144 patients with threatened abortion combined with hypothyroidism of kidney-Yang deficiency type admitted in our hospital from February 2016 to June 2017 were selected as the subjects of this study, numbered according to the admission sequence and divided into two groups on the basis of random number table, with 72 cases in each group. The control group was treated with Euthyrox, while observation group was given Bushen Yangxue Antaitang in addition to the therapy of control group. The clinical efficacy of two groups was evaluated after 2 weeks of treatment, in order to compare the changes of pregnant hormone and thyroid function-related indexes before and after treatment between the two groups.Result: After 2 weeks of treatment, the overall effective rate of observation group was 90.28% (65/72), which was much higher than 69.44% (50/72) of control group (P<0.05). After treatment, observation group had significantly higher total T₃(TT₃), total T₄(TT₄) levels and lower free T₃(FT₃), thyroid stimulating hormone(TSH) levels compared with those before treatment (P<0.05). After treatment, control group had much higher TT₄ level and lower free T₃(FT₃), TSH levels compared with those before treatment (P<0.05). Compared with those of control group in the same period after treatment, the TT₃ level of observation group was significantly higher (P<0.05), and TSH level of observation group was much lower (P<0.05). The estradiol(E₂), progesterone(P)and human chorionic gonadotrophin(HCG) levels of both groups were remarkably higher than those before treatment (P<0.05); after treatment, observation group had much higher levels in E₂, P and HCG than control group (P<0.05). The serum interleukin(IL)-2 of the two groups after treatment decreased, while IL-10 level of two groups increased significantly compared with those before treatment (P<0.05). The observation group had a much higher IL-10 level than control group in the same period after treatment (P<0.05).Conclusion: Bushen Yangxue Antaitang is effective in treating threatened abortion combined with hypothyroidism of kidney-Yang deficiency type by alleviating clinical symptoms, improving patients'' pregnant hormone level and promoting the recovery of their thyroid function.