【摘要】 目的 探讨针药联合对复发性流产患者血栓前状态子宫内膜容受性及妊娠结局的影响。方法 将36例复发性流产血栓前状态患者随机分为A、B组，每组各18例。A组采用阿司匹林肠溶片治疗，50mg/次，1次/每天，空腹口服。B组采用阿司匹林肠溶片+补肾活血方+针灸治疗。连续治疗3周，分别于治疗前及治疗结束后，检测血栓指标：血浆D2、蛋白C、蛋白S活性%;子宫内膜容受性指标：子宫动脉搏动指数(PI)、子宫动脉血流阻力指数(RI)及收缩压最大血流速度/舒张末期最大血流速度(S/D)、子宫内膜厚度、子宫内膜类型A型%;比较两组临床疗效并追踪妊娠结局。结果 从妊娠率及妊娠结局来看：B组流产率低于A组，并在足月产率、活产率、妊娠率上均高于A组。从血栓前状态指标看：3个周期治疗结束后，B组与A组比较更能有效降低D2并提高PS活性%,差异均具有统计学意义(P<0.05)。从子宫内膜容受性情况看：3个周期治疗结束后，B组较A组能有效的降低PI、RI及S/D,提高子宫内膜厚度、内膜类型A型%(P<0.01,P<0.05),有统计学意义。结论 针药联合治疗复发性流产患者，通过干预血栓前状态及子宫内膜容受性，从而改善患者妊娠结局，提高了妊娠率、足月产率、活产率，降低了流产率、早产率。更多还原

【Abstract】 Objective To investigate the effect of combination of acupuncture and medicine on endometrial receptivity and pregnancy outcome in patients with prethrombotic recurrent miscarriage. Methods Thirty six patients with recurrent miscarriage were randomly divided into Group A and Group B, each group have 18 cases. Group A was given Aspirin enteric-coated tablets, 50mg/time, once a day, taken orally on an empty stomach. Group B were given Aspirin enteric-coated tablets + Bushen Huoxue formula + acupuncture treatment. After 3 weeks of continuous treatment, D-dimer(D2), protein c(PC) and protein s(PS) activity% were detected before and after treatment;Endometrial Receptivity Index: Uterine Artery pulsation index(PI), uterine artery resistance index(RI) and systolic/diastolic(S/D), endometrial thickness and type A were compared between the two groups. Results(1) In terms of pregnancy rate and pregnancy outcome, group B had a lower miscarriage rate than group A. The full-term delivery rates, live birth rate, and pregnancy rate of group B was higher than group A.(2)After three cycles of treatment, group B was more effective in reducing D2 and increasing PS activity% compared with group A. The difference was statistically significant(P<0.05), and both groups were able to increase PC activity%, but the difference was not statistically significant(P>0.05); compared with groups A and B after treatment, group B had lower plasma D2(P<0.05) and higher PS activity% than group A(P<0.05). PS activity % increased compared to group A(P<0.05).(3) In terms of endometrial tolerance, at the end of 3 cycles of treatment, group B could effectively reduce PI, RI and S/D and increase endometrial thickness and endometrial type A %(P<0.01, P<0.05) compared with group A, which was statistically significant. Conclusion The combination of acupuncture and medicine in the treatment of patients with RSA improved pregnancy outcome by intervening in the PTS and endometrial tolerance, thereby improving the pregnancy rate, full-term delivery rate, and live birth rate, and reducing the miscarriage rate and preterm delivery rate.更多还原