内科

目的探讨补肾健脾汤辅助治疗脾肾虚亏型反复自然流产（RSA）患者的临床效果。方法选取2018年6月至2019年6月我院收治的脾肾虚亏型RSA患者68例为研究对象，采用随机数字法分为对照组和观察组，每组34例。对照组患者给予阿司匹林和泼尼松治疗，观察组患者在对照组治疗的基础上联合补肾健脾汤治疗，疗程3个月。治疗后随访患者至分娩，比较两组患者的妊娠结局和正常分娩率；比较两组患者妊娠满12周时的封闭抗体阳性率；比较两组患者治疗前、妊娠12周时的血清孕酮（P）、催乳素（PRL）水平。结果观察组患者的正常分娩率（94.12%）显著高于对照组（73.53%），差异有统计学意义（P＜0.05）；妊娠满12周时，观察组患者的封闭抗体阳性率（91.18%）明显高于对照组（66.67%），差异有统计学意义（P＜0.05）。治疗前，两组患者的血清P、PRL水平比较，差异无统计学意义（P＞0.05）；妊娠12周时，两组患者的P、PRL水平均显著增高，观察组患者的水平明显高于对照组，差异有统计学意义（P＜0.05）。结论补肾健脾汤辅助治疗能显著提高脾肾虚亏型反复自然流产患者的封闭抗体阳性率，促进孕酮及催乳素分泌，改善患者的妊娠结局，提高患者的正常分娩率。

ObjectiveTo investigate the clinical effects of Bushen Jianpi decoction in the adjuvant treatment of recurrent spontaneous abortion (RSA) of deficiency of spleen and kidney. MethodsA total of 68 RSA patients with deficiency of spleen and kidney admitted to our hospital were selected as the research subjects, and they were divided into control group and observation group according to the random number method, with 34 cases in each group. The patients in the control group were administrated aspirin and prednisone, based on which the patients in the observation group were combinedly administrated Bushen Jianpi decoction, for a 3-month treatment course. The patients were followed up to delivery after treatment, and the pregnancy outcome and normal delivery rate were compared between the two groups. The positive rates of blocking antibody at 12 weeks after pregnancy were compared between the two groups. The levels of serum progesterone (P) and prolactin (PRL) before treatment and at 12 weeks after pregnancy were compared between the two groups. ResultsThe normal delivery rate in the observation group (94.12%) was significantly higher than that in the control group (73.53%), with a statistically significant difference (P＜0.05). At 12 weeks of pregnancy, the positive rate of blocking antibody in the observation group (91.18%) was significantly higher than that in the control group (66.67%), with a statistically significant difference (P＜0.05). Before treatment, there were no statistically significant differences in the levels of serum P and PRL between the two groups (P＞0.05). At 12 weeks of pregnancy, the levels of P and PRL in the two groups significantly increased, and the levels in the observation group were significantly higher than those in the control group, with statistically significant differences (P＜0.05). ConclusionBushen Jianpi decoction in the adjuvant treatment of RSA patients with deficiency of spleen and kidney can significantly increase the positive rate of blocking antibody, promote the secretion of progesterone and PRL, improve the pregnancy outcome, and increase the normal delivery rate in patients.