Department of Gynecology and Obstetrics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Department of Gynecology and Obstetrics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Explore (NY). 2023 Jan-Feb;19(1):52-57. doi: 10.1016/j.explore.2022.03.009. Epub 2022 Mar 26.
The present study aims to analyze the clinical effect of the Qing Yi Tiao Mian (QYTM) formula on unexplained recurrent spontaneous abortion (URSA) during early pregnancy and the immune balance of T lymphocytes.
With their consent, 45 patients with URSA in weeks 4-9 of pregnancy were separated into three groups, i.e., the conventional fetal protection (n = 15), prednisone treatment (n = 10), and QYTM formula treatment (n = 20) groups. These patients received treatment once they had been diagnosed with an intrauterine pregnancy. The conventional fetal protection group was given progesterone (20 ∼ 40 mg daily injection) for four weeks. The prednisone treatment group was given progesterone (20 ∼ 40 mg daily injection) + prednisone (5 mg/d) for four weeks. The QYTM formula treatment group was given progesterone (20 ∼ 40 mg daily injection) + QYTM formula (one dose per day) for four weeks. In addition, women who had previously had a normal pregnancy were enrolled as a control group (n = 18). The success rate of the pregnancy in the first trimester was observed in each group, and the proportion of T lymphocytes in the peripheral blood before and after treatment was recorded.
Among the 20 patients with URSA in the QYTM formula treatment group, 19 remained pregnant. Thus, the success rate during early pregnancy was 95%, which was significantly higher than the conventional fetal protection (53.33%) and prednisone treatment (70%) groups. The CD8+ T and natural killer (NK) cells population in the URSA groups was higher compared with the control group (P < 0.01). The QYTM formula treatment significantly decreased the ratio of CD8+ T lymphocytes (P < 0.01) and NK cells (P < 0.01).
The QYTM formula significantly decreased the spontaneous abortion rate in patients with URSA during early pregnancy. The mechanism may be closely related to the inhibition of the killer lymphocytes' proliferation by CD8+ T lymphocytes and NK cells.
本研究旨在分析青一调免（QYTM）配方对早孕不明原因复发性自然流产（URSA）的临床疗效及 T 淋巴细胞免疫平衡的影响。
45 例孕 4 ～ 9 周 URSA 患者，均知情同意，按就诊顺序随机分为常规保胎组（n=15）、泼尼松组（n=10）、QYTM 配方组（n=20）。确诊宫内妊娠后即开始治疗，常规保胎组予黄体酮 20 ～ 40 mg 每日肌内注射保胎 4 周；泼尼松组予黄体酮 20 ～ 40 mg 每日肌内注射保胎的同时加用泼尼松 5 mg/d 口服 4 周；QYTM 配方组予黄体酮 20 ～ 40 mg 每日肌内注射保胎的同时加用 QYTM 配方（每日 1 剂）口服 4 周。另选择同期正常妊娠的妇女 18 例作为正常妊娠对照组。观察各组患者的保胎成功率，记录各组患者治疗前后外周血 T 淋巴细胞亚群比例。
QYTM 配方治疗组 20 例 URSA 患者中，19 例继续妊娠，保胎成功率为 95%，明显高于常规保胎组（53.33%）和泼尼松组（70%），差异均有统计学意义（P<0.05）。URSA 组患者外周血 CD8+T 细胞、自然杀伤（NK）细胞比例明显高于正常妊娠对照组（P<0.01），经 QYTM 配方治疗后 CD8+T 细胞、NK 细胞比例明显降低（P<0.01）。
QYTM 配方可显著降低 URSA 患者早孕流产率，其机制可能与 CD8+T 细胞、NK 细胞抑制杀伤性淋巴细胞的增殖有关。
