目的 探討孕康口服液聯(lián)合鹽酸利托君對(duì)先兆流產(chǎn)患者的臨床癥狀、血清PIBF及抑制素A的影響。方法 選擇延安大學(xué)附屬醫(yī)院于2017年3月-2019年3月收治的142例先兆流產(chǎn)患者作為研究對(duì)象，采用信封法將患者隨機(jī)分為觀察組和對(duì)照組，每組各71例。對(duì)照組患者靜脈滴注鹽酸利托君注射液，在5%葡萄糖溶液500 mL中加入100 mg鹽酸利托君注射液，起始速度5滴/min，根據(jù)患者宮縮情況調(diào)節(jié)滴注速度，最大速度為35滴/min，持續(xù)滴注12 h。停止滴注前30 min口服鹽酸利托君片，第1天12片/d，每2 h服用1次，1片/次；第2天6片/d，每4 h服用1次，1片/次；第3~10天4片/d，每6 h服用1次，1片/次。且每日服用總劑量不超過12片（120 mg）。觀察組在對(duì)照組治療基礎(chǔ)上口服孕康口服液，1瓶/次，3次/d。觀察兩組患者臨床癥狀消失時(shí)間、妊娠延長(zhǎng)時(shí)間；比較兩組孕酮、人絨毛膜促性腺激素（HCG）、孕酮誘導(dǎo)封閉因子（PIBF）、血清抑制素A水平以及不良反應(yīng)發(fā)生情況。結(jié)果 治療后，觀察組腹痛、腰痛、宮縮消失時(shí)間和陰道出血停止時(shí)間明顯縮短，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），且觀察組患者的妊娠延長(zhǎng)時(shí)間相比對(duì)照組更長(zhǎng)（P<0.05）。治療后，兩組患者的血清孕酮、HCG、PIBF及抑制素A水平均明顯升高，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組各激素水平及PIBF水平比對(duì)照組改善更明顯（P<0.05）。治療過程中，觀察組不良反應(yīng)發(fā)生率與對(duì)照組相比，差異不具有統(tǒng)計(jì)學(xué)意義。結(jié)論 孕康口服液聯(lián)合鹽酸利托君治療先兆流產(chǎn)臨床效果顯著，可顯著升高孕婦孕酮、HCG、PIBF及抑制素A水平，縮短患者臨床癥狀消失時(shí)間和延長(zhǎng)患者妊娠時(shí)間，且不良反應(yīng)發(fā)生率低，適合在臨床推廣應(yīng)用。

Objective To investigate the therapeutic effect of Yunkang Oral Liquid combined with ritodrine hydrochloride on patients with threatened abortion and its effect on serum PIBF and inhibin A. Methods Patients (142 cases) with threatened abortion admitted to Yan'an University Affiliated Hospital from March 2017 to March 2019 were selected as subjects. Patients were randomly divided into observation group and control group by envelope method, with 71 cases in each group. In the control group, Ritodrine Hydrochloride injection was injected intravenously, and 100 mg of Ritodrine Hydrochloride injection was added into 500 mL of 5% glucose solution. The initial rate was 5 drops/min, and the infusion rate was adjusted according to the patients' contractions. The maximum rate was 35 drops/min, and the infusion continued for 12 h. Ritodrine Hydrochloride Tablets were taken orally 30 min before the infusion was stopped, 12 tablets/d on the first day, once every 2 h, 1 tablet/time; on the second day, 6 tablets/d, once every 4 h, 1 tablet/time; Day 3 to 10, 4 tablets/d, once every 6 h, 1 tablet/time. The total daily dose should not exceed 12 tablets (120 mg). Patients in the observation group were po administered with Yunkang Oral Liquid on the basis of control group, 1 bottle/time, three times daily. The disappearance time of clinical symptoms and prolonged pregnancy time in two groups was observed, and the level of progesterone, HCG, serum PIBF, serum inhibin A, and adverse reactions between two groups were compared. Results After treatment, the disappearance time of abdominal pain, backache, uterine contractions, and vaginal bleeding in the observation group were significantly shorter than those in the control group, the difference is statistically significant (P<0.05). The prolonged pregnancy time in the observation group was significantly longer than that in the control group (P<0.05). After treatment, serum progesterone, HCG, PIBF, and inhibin A levels in two groups were significantly increased, the difference is statistically significant (P<0.05). And the improvement level of each hormone level and PIBF level in the observation group was better than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group. Conclusion Yunkang Oral Liquid combined with ritodrine hydrochloride has significant curative effect in treatment of threatened abortion. It can significantly increase the level of progesterone, HCG, PIBF and inhibin A, shorten the disappearance of clinical symptoms and prolong the pregnancy time of patients, and the incidence of adverse reactions is low, it is suitable for clinical application.

R984

陜西省衛(wèi)生計(jì)生科研基金項(xiàng)目（2016D076）