关键词:

复发性流产, 抗心磷脂抗体, 凝血-纤溶平衡, 安奠化瘀组方, 中西医结合

Abstract:

Objective　To explore the effect of the Andian Huayu formula combined with western medicine on the balance of coagulation-fibrinolysis in patients with recurrent spontaneous abortion positive for anticardiolipin antibody. Methods　Sixty patients with positive anticardiolipin antibody and recurrent spontaneous abortion who visited Guangdong Women and Children Hospital from January 2021 to December 2023 were selected as the research subjects. Using the random number table method, the patients were divided into the western medicine group (30 cases) and the treatment group (30 cases). The age of the western medicine group was (30.90±3.43) years; the number of spontaneous abortions was (2.82±0.94) times. The age of the treatment group was (31.10±3.19) years, and the number of spontaneous abortions was (2.73±0.82) times. At the same time, 20 non-pregnant women of childbearing age without a history of spontaneous abortion were selected as the normal control group, with an average age of (30.37±4.24) years. The western medicine group was treated with oral western medicine. The treatment group was treated in addition with the Anding Huayu formula. Both the treatment group and the western medicine group started the treatment at least 3 months before pregnancy. After 3 months, they were instructed to have sexual intercourse for conception preparation. The treatment with both traditional Chinese medicine and western medicine was stopped when the pregnancy reached 12 weeks. The antibody clearance rate, the rate of threatened miscarriage and the pregnancy success rate were compared between the western medicine group and the treatment group. The coagulation and fibrinolysis system indicators before and after treatment in the three groups were compared [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), antithrombin Ⅲ (AT-Ⅲ), D-dimer (D-D), fibrinogen (Fbg)]. The normal control group only compared the data before treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　There was no statistically significant difference in the antibody clearance rate between the western medicine group and the treatment group (P>0.05). The rate of threatened miscarriage in the treatment group was lower than that in the western medicine group, and the pregnancy success rate was higher in the treatment group than in the western medicine group [16.67% (5/30) vs. 40.00% (12/30); 63.33% (19/30) vs. 36.67% (11/30)] (both P<0.05). Before treatment, the levels of D-D and Fbg in both the western medicine group and the treatment group were higher than those in the normal control group [(0.35±0.15) mg/L, (0.37±0.16) mg/L vs. (0.20±0.09) mg/L; (3.23±0.84) g/L, (3.08±0.68) g/L vs. (2.38±0.50) g/L] (all P<0.05); there were no statistically significant differences in the levels of APTT, PT, TT, and AT-Ⅲ among the western medicine group, the treatment group, and the normal control group (all P>0.05); there were no statistically significant differences in the levels of APTT, PT, TT, AT-Ⅲ, D-D, and Fbg between the western medicine group and the treatment group (all P>0.05). In the western medicine group, there were 12 patients whose pregnancies lasted until 12 weeks. In the treatment group, there were 19 patients whose pregnancies lasted until 12 weeks. After treatment, the levels of D-D and Fbg in the treatment group were lower than those in the western medicine group [(0.18±0.11) mg/L vs. (0.27±0.11) mg/L; (2.50±0.65) g/L vs. (2.98±0.55) g/L] (both P<0.05); there were no statistically significant differences in APTT, PT, TT, and AT-Ⅲ levels between the western medicine group and the treatment group (all P>0.05). Conclusions　The combined use of traditional Chinese medicine and western medicine can more effectively maintain the coagulation-fibrinolysis balance in patients with recurrent spontaneous abortion, improve the pre-thrombotic state, thereby increasing the pregnancy rate and improving the pregnancy outcome. It is worthy of clinical promotion.

Key words:

Recurrent spontaneous abortion, Anticardiolipin antibody, Coagulation-fibrinolysis balance, Andian Huayu , formula, Integration traditional Chinese and western medicine