本文選題：加味壽胎丸 + 黃體酮　； 參考：《南京中醫(yī)藥大學(xué)學(xué)報》2017年05期

【摘要】：目的探討NK細(xì)胞活性變化在不明原因復(fù)發(fā)性流產(chǎn)(URSA)發(fā)病中的機(jī)制;加味壽胎丸聯(lián)合黃體酮通過調(diào)節(jié)NK細(xì)胞受體表達(dá)變化誘導(dǎo)母胎免疫耐受治療URSA的作用機(jī)制。方法選取加味壽胎丸聯(lián)合黃體酮治療腎虛型URSA成功患者20例,并選取同期URSA妊娠丟失組及健康早孕(HEP)組各15例,以流式細(xì)胞術(shù)檢測各組外周血NKG2D、NKG2A的表達(dá),并比較URSA妊娠組治療后與健康早孕組血E2、P、β-HCG水平。結(jié)果 URSA妊娠丟失組pNK細(xì)胞NKG2D呈高表達(dá)及NKG2A呈低表達(dá),與HEP組比較有顯著統(tǒng)計學(xué)意義(P0.01)。URSA妊娠組治療后pNK細(xì)胞NKG2D表達(dá)水平明顯低于治療前,與HEP組比較有統(tǒng)計學(xué)意義(P0.05),與URSA妊娠丟失組比較有顯著統(tǒng)計學(xué)意義(P0.01);NKG2A表達(dá)水平明顯高于治療前(P0.01),與HEP組比較無統(tǒng)計學(xué)意義,與URSA妊娠丟失組比較有顯著統(tǒng)計學(xué)意義(P0.01)。經(jīng)加味壽胎丸聯(lián)合黃體酮治療后,URSA妊娠組血清E2、P、β-HCG水平與HEP組分別比較,差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論NK細(xì)胞受體NKG2D、NKG2A的表達(dá)參與了URSA的發(fā)病;加味壽胎丸聯(lián)合黃體酮能通過下調(diào)URSA患者NKG2D的表達(dá)水平,上調(diào)NKG2A的表達(dá)水平介導(dǎo)母胎免疫耐受治療URSA;固腎安胎法是治療腎虛型URSA的有效方法,加味壽胎丸是治療腎虛型URSA的有效方劑。
[Abstract]:Objective to investigate the mechanism of the change of NK cell activity in the pathogenesis of unexplained recurrent abortion (Ursa) and the mechanism of Jiawei Shoufei pill combined with progesterone in inducing maternal and fetal immune tolerance to URSA by regulating the expression of NK cell receptor.Methods A total of 20 successful URSA patients with kidney deficiency were treated with modified Shou-Feiwan combined with progesterone, 15 with URSA pregnancy loss and 15 with healthy early pregnancy. Flow cytometry was used to detect the expression of NKG2-DnkG2A in peripheral blood of each group.The serum levels of E2P, 尾-HCG in URSA pregnancy group were compared with those in healthy early pregnancy group.Results the expression of NKG2D and NKG2A in pNK cells in URSA pregnancy loss group was higher than that in HEP group. Compared with HEP group, the NKG2D expression level of pNK cells in HEP group was significantly lower than that in HEP group.Compared with the HEP group, the expression level of NKG2A was significantly higher in the URSA pregnancy loss group than in the HEP group, but not in the HEP group, and was significantly higher than that in the URSA pregnancy loss group.The serum levels of E2P and 尾 -HCG in Ursa pregnancy group were not significantly different from those in HEP group after treatment with modified Shoufeiwan combined with progesterone.Conclusion the expression of NK cell receptor NKG2D- NKG2A is involved in the pathogenesis of URSA, and Jiawei Shouti pills combined with progesterone can down-regulate the expression of NKG2D in patients with URSA.Upregulation of NKG2A expression mediates maternal and fetal immune tolerance in the treatment of Ursa, the method of strengthening the kidney and the fetus is an effective method for the treatment of kidney deficiency type URSA, and Jiawei Shou-fetus pill is an effective prescription for the treatment of kidney deficiency type URSA.
【作者單位】： 山東中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院;山東中醫(yī)藥大學(xué)附屬醫(yī)院;山東省醫(yī)學(xué)科學(xué)院基礎(chǔ)醫(yī)學(xué)研究所;
【基金】：山東省醫(yī)藥衛(wèi)生科技發(fā)展計劃(2015WS0134)
【分類號】：R714.21

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