[1]韩永梅,孟鑫婉,刘新煜,等.补肾活血方对抗磷脂抗体阳性反复种植失败患者妊娠结局的影响[J].陕西中医,2025,46(1):42-46.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.008]
 HAN Yongmei,MENG Xinwan,LIU Xinyu,et al.Effect of Bushen Huoxue formula on pregnancy outcome in patients with antiphospholipid antibody-positive recurrent implantation failure[J].,2025,46(1):42-46.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.008]
点击复制

补肾活血方对抗磷脂抗体阳性反复种植失败患者妊娠结局的影响
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年1期
页码:
42-46
栏目:
临床研究
出版日期:
2025-01-05

文章信息/Info

Title:
Effect of Bushen Huoxue formula on pregnancy outcome in patients with antiphospholipid antibody-positive recurrent implantation failure
作者:
韩永梅孟鑫婉刘新煜何鑫雨谢俊丹
(河南中医药大学中西医结合学院,河南 郑州 450000)
Author(s):
HAN YongmeiMENG XinwanLIU XinyuHE XinyuXIE Jundan
(College of Integrative Medicine,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)
关键词:
妊娠结局 补肾活血方 抗磷脂抗体阳性 反复种植失败 冻融胚胎移植 阿司匹林 子宫内膜容受性分子标志物指标
Keywords:
Pregnancy outcome Bushen Huoxue formula Antiphospholipid antibody positivity Recurrent implantation failure Frozen-thawed embryo transfer Aspirin Endometrial tolerance molecular markers indexes
分类号:
R 714
DOI:
DOI:10.3969/j.issn.1000-7369.2025.01.008
文献标志码:
A
摘要:
目的:观察补肾活血方对抗磷脂抗体阳性反复种植失败(RIF)患者妊娠结局的影响。方法:选取188例抗磷脂抗体阳性RIF患者,按随机数字表法分为补肾活血方组和对照组,两组各94例。两组均给予冻融胚胎移植方案治疗,对照组同时口服拜阿司匹林治疗,治疗组在对照组基础上给予补肾活血方治疗。比较两组子宫内膜容受性超声检测指标、子宫内膜容受性分子标志物指标、中医证候积分及临床疗效、安全性。结果:两组基线时子宫内膜厚度及血流参数比较,无统计学差异(P>0.05)。两组胚胎移植前1天子宫内膜厚度及子宫内膜收缩期峰值速度/舒张末期流速(S/D)较基线时升高,子宫内膜搏动指数(PI)、阻力指数(RI)较基线时下降(P<0.05)。治疗组胚胎移植前1天子宫内膜厚度及子宫内膜S/D高于对照组,子宫内膜PI、RI低于对照组(P<0.05)。治疗组种植窗期整合素β3低于对照组,整合素β1、同源框基因11(HoxA11)高于对照组(P<0.05)。两组治疗后中医证候积分较治疗前降低,治疗组更低(P<0.05)。治疗组临床妊娠率62.22%、活产率55.56%高于对照组,胚胎种植率40.27%,流产率10.71%,与对照组比较,无统计学差异(P>0.05)。结论:补肾活血方可改善抗磷脂抗体阳性RIF患者子宫内膜容受性,提高临床妊娠率,降低早期流产率。
Abstract:
Objective:To observe the effect of Bushen Huoxue formula on pregnancy outcome in patients with antiphospholipid antibody-positive recurrent implantation failure(RIF).Methods:188 cases of antiphospholipid antibody-positive RIF patients were selected and divided into the treatment group and the control group according to the method of random number table,with 94 cases in each of the two groups.Both groups were treated with freeze-thawed embryo transfer protocol,the control group was treated with oral aspirin,and the treatment group was treated with Bushen Huoxue formula on the basis of the control group.The two groups were compared in terms of endometrial tolerance ultrasonography indexes,endometrial tolerance molecular markers indexes,Chinese medicine evidence points,clinical efficacy and safety.Results:There was no significant difference in endometrial thickness and blood flow parameters between the two groups at baseline(P>0.05).In both groups,the endometrial thickness and the peak systolic velocity/end-diastolic velocity(S/D)of the endometrium one day before embryo transfer were increased compared with those at baseline,while the pulsatility index(PI)and resistance index(RI)of the endometrium were decreased compared with those at baseline(P<0.05).The endometrial thickness and the endometrial S/D in the treatment group one day before embryo transfer were higher than those in the control group,and the endometrial PI and RI were lower than those in the control group(P<0.05).The integrin β3 in the implantation window period in the treatment group was lower than that in the control group,while the integrin β1 and homeobox gene 11(HoxA11)were higher than those in the control group(P<0.05).The scores of traditional Chinese medicine syndromes in both groups after treatment were lower than those before treatment,and the scores in the treatment group were even lower(P<0.05).The clinical pregnancy rate and live birth rate of the treatment group were 62.22% and 55.56% higher than those of the control group. The embryo implantation rate was 40.27%, and the miscarriage rate was 10.71%. There was no statistically significant difference compared with the control group(P>0.05).Conclusion:Bushen Huoxue formula can improve endometrial tolerance in antiphospholipid antibody-positive RIF patients,increase the clinical pregnancy rate,and reduce the early miscarriage rate.

参考文献/References:

[1] 肖会,朱雯,杨帆,等.抗核抗体阳性及干预治疗与反复种植失败辅助生殖结局相关性研究[J].安徽医科大学学报,2024,59(6):947-951.
[2] 潘程程,李静,梁琦,等.小剂量阿司匹林联合强的松对冻融周期反复种植失败患者的临床观察[J].中国性科学,2020,29(3):81-85.
[3] 纪淑玲,卢素杰,郜洁,等.基于《黄帝内经》神机理论试析女性生殖生理[J].辽宁中医杂志,2021,48(9):82-85.
[4] 谢幸.妇产科学[M].9版.北京:人民卫生出版社,2018:344.
[5] 马宝璋.中医妇科学[M].北京:中国中医药出版社,2012:106-121.
[6] 国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:177-189.
[7] 楚婷,余婷,王芳,等.反复种植失败的竞争性内源核糖核酸调控网络构建及其临床验证[J].中华医学杂志,2024,104(32):3050-3058.
[8] 高云,何巧花,于岚,等.自身免疫性疾病对辅助生殖技术成功率影响的现状分析[J].医药论坛杂志,2021,42(2):17-19,22.
[9] 刘芬,姜天凤,吴丽敏,等.中药周期疗法联合阿司匹林与强的松对反复种植失败患者在FET周期中临床结局的影响[J].天津中医药大学学报,2021,40(4):477-482.
[10] 裴丽敏,杜武勋,李晓凤.中医气化理论探讨[J].陕西中医,2021,42(11):1586-1590.
[11] 韩永梅,吕宣宣.补肾活血方对抗磷脂抗体阳性复发性流产患者外周血microRNA-423-5p表达的影响及疗效分析[J].中国现代医学杂志,2023,33(2):48-53.
[12] 韩永梅,卫爱武.补肾活血方联合低分子肝素钠治疗肾虚血瘀型抗磷脂抗体阳性复发性流产[J].中医学报,2019,34(5):1077-1081.
[13] 陈曦,赵林涛,李雅娟,等.菟丝子盐炙前后对肾阳虚模型大鼠精子活力的影响[J].特产研究,2024,46(2):30-35.
[14] 金籽杉,杨浩宇,顾成娟.桑寄生的临床应用及其用量探究[J].长春中医药大学学报,2022,38(1):22-25.
[15] 李芮,刘健,靳楠,等.基于网络药理学探讨当归补血汤治疗再生障碍性贫血作用机制[J].陕西中医,2022,43(3):384-389.
[16] 梁婷,杨静雅,梁沁,等.输卵管积水性不孕症患者子宫内膜形态及容受性评估IVF-ET妊娠结局的临床研究[J].天津医药,2023,51(1):81-85.
[17] BUSNELLI A,RESCHINI M,CARDELLICCHIO E V,et al.How common is real repeated implantation failure? An indirect estimate of the prevalence[J].Reproductive Biomedicine Online,2020,40(1):91-97.
[18] 李宇彬,黄孙兴,杨景迪,等.子宫内膜血流异常是胚胎反复种植失败的相对独立风险因素[J].中华生殖与避孕杂志,2022,42(11):1182-1186.
[19] 方小婷,王国华,张宝颐,等.基于国家专利治疗女性不孕症的数据挖掘研究[J].中国性科学,2023,32(4):71-75.
[20] 梅静,秦文敏,房亚丽,等.奚嘉教授治疗不孕症经前期用药特色分析[J].山西中医药大学学报,2023,24(4):456-459,463.
[21] PENG J,LI X,ZHANG Y,et al.Par3/Integrin β1 regulates embryo adhesion via changing endometrial luminal epithelium polarity[J].Biology of Reproduction,2021,104(6):1288-1298.
[22] 韩海英,郭秀伟,张培彤.川芎对肺癌干细胞原发性肿瘤相关黏附分子影响的实验研究[J].陕西医学杂志,2024,53(4):435-438,448.
[23] 吴琼丽,白剑,邓颂.血清整合素β3、LIF水平对多囊卵巢综合征病情及合并不孕的评估价值[J].分子诊断与治疗杂志,2022,14(3):369-372,378.
[24] 陈平,周贇,龚蓉谊.HOXA11和CD10在子宫内膜异位症相关卵巢癌中的表达及其临床意义[J].临床和实验医学杂志,2023,22(13):1402-1406.
[25] 庄媛,黄莺,李延辉,等.沉默HOXA11-AS靶向miR-766-3p对ox-LDL诱导的血管内皮细胞损伤的影响[J].医学分子生物学杂志,2023,20(1):7-13.

相似文献/References:

[1]马新想,崔海玲,张富青.滋肾育胎丸对不孕症患者卵巢储备功能及妊娠结局的影响*[J].陕西中医,2019,(2):198.
 MA Xinxiang,CUI Hailing,ZHANG Fuqing..Effect of Zishen Yutai pill on ovarian reserve function and pregnancy outcome in infertile patients[J].,2019,(1):198.
[2]张广霞,张 芳,张孝平,等.中药穴位贴敷联合硬膜外麻醉镇痛对瘢痕子宫再次妊娠经阴分娩产妇妊娠结局影响*[J].陕西中医,2019,(12):1725.
 ZHANG Guangxia,ZHANG Fang,ZHANG Xiaoping,et al.Effect of acupoint placement of traditional Chinese medicine combined with epidural anesthesia on outcomes of women under vaginal birth after cesarean section[J].,2019,(1):1725.
[3]闫晓彤,朱 婷,章晓乐,等.补肾活血方联合补佳乐对宫腔粘连大鼠YAP1/TGF-β1信号通路的影响[J].陕西中医,2022,(8):987.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.001]
 YAN Xiaotong,ZHU Ting,ZHANG Xiaole,et al.Effect of Bushen Huoxue decoction combined with Progynova on YAP1/TGF-β1 pathway in intrauterine adhesions rats[J].,2022,(1):987.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.001]

备注/Memo

备注/Memo:
基金项目:河南省科技攻关项目(232102311216); 河南省中医药科学研究专项课题(2024ZY3026)
更新日期/Last Update: 2025-01-09