本文選題：免疫性復發(fā)性流產(chǎn)　切入點：消抗靈Ⅰ號　出處：《黑龍江中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:探討Th17細胞在復發(fā)性流產(chǎn)(recurrent miscarriage,RM)發(fā)生過程中的作用及臨床驗方對其具有的潛在調(diào)節(jié)作用,揭示免疫性RM的發(fā)生機制。為中藥治療自身抗體陽性RM患者提供新靶點和理論依據(jù)。為治療提供有效免疫性RM中藥產(chǎn)品。并對其臨床療效進行驗證。方法:采用自身治療前后對照法,收集所有的病例自2015年08月-2016年08月期間,就診于黑龍江中醫(yī)藥大學附屬第一醫(yī)院婦科門診的30例篩選符合納入條件的自身抗體陽性RM患者。納入的患者自身四項抗體(抗心磷脂抗體、抗精子抗體、抗卵巢抗體、抗子宮內(nèi)膜抗體)中至少有一項陽性的30例患者設(shè)為疾病組,留取符合標準患者外周血,檢測Th17細胞亞群比例,應用消抗靈Ⅰ號治療,療后30天如抗體轉(zhuǎn)陰,再次留取患者靜脈血檢測Th17細胞比例,此后不再繼續(xù)采血;如果抗體未轉(zhuǎn)陰,間隔15天采血至抗體轉(zhuǎn)陰。如果90天抗體仍未轉(zhuǎn)陰,為治療無效。觀察對比疾病組的治療前后中醫(yī)癥候積分等,以判定中藥對于中醫(yī)證候的臨床療效。健康志愿者為我院年齡匹配的正常女性30名作為對照。采用酶連免疫法檢測抗體,應用流式細胞術(shù)檢測Th17細胞的數(shù)量。結(jié)果:1、疾病組治療前靜脈血中Th17相關(guān)細胞因子CD4+IL-17A+比例表達水平高于健康組(P0.01),有統(tǒng)計學意義。2、疾病組自身治療前后相比,CD4+IL-17A+細胞因子比例表達水平明顯下降(P0.01),有顯著差異及統(tǒng)計學意義。3、疾病組治療后與健康組相比,外周靜脈血中Th17相關(guān)細胞CD4+IL-17A+細胞因子比例表達水平無明顯差異(P0.05)。4、疾病組治療前后Th17相關(guān)細胞因子CD4+IL-17A+比例下降情況與不孕四項轉(zhuǎn)陰情況存在明顯的正相關(guān)性(r=0.863,P＜0.01)。5、經(jīng)規(guī)律用藥后,疾病組治療前的臨床伴隨癥狀治療后得到明顯改善,中醫(yī)癥候積分明顯下降。結(jié)論:研究中發(fā)現(xiàn)免疫性復發(fā)性流產(chǎn)(RM)患者外周靜脈血中Th17細胞相關(guān)亞群比例顯著高于健康組,說明Th17細胞在自身抗體陽性RM患者中具有的潛在調(diào)節(jié)作用。中藥消抗靈Ⅰ號對治療自身免疫性復發(fā)性流產(chǎn)患者外周血中Th17細胞比例下降有明顯效果并對臨床伴隨癥狀有明顯改善,是已病防變治療滑胎脾腎兩虛型的有效方劑。
[Abstract]:Objective: to investigate the role of Th17 cells in the pathogenesis of recurrent miscarriage and the potential regulatory effects of clinical prescriptions. To reveal the pathogenesis of immune RM, to provide new targets and theoretical basis for the treatment of autoantibody positive RM patients with Chinese medicine, and to provide effective immunological RM traditional medicine products for treatment, and to verify its clinical efficacy. Before and after self-treatment, Collecting all cases from August 2015 to August 2016, Thirty patients in gynecological outpatient clinic of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine were screened for autoantibody positive RM patients who met the criteria of inclusion. The four autoantibodies (anti-cardiolipin antibody, anti-sperm antibody, anti-ovarian antibody) were included. 30 patients with at least one positive anti-endometrial antibody were selected as disease group. Peripheral blood samples were collected from patients who met the criteria. The proportion of Th17 cell subsets was detected. The patients were treated with Xiaokangling 鈪，

本文編號：1668967