世界中医药

目的：探讨滋肾育胎丸联合盐酸屈他维林片治疗绒毛膜下血肿（SCH）的临床效果，并观察治疗前后调节性T细胞/辅助性T细胞17（Treg/Th17）表达情况。方法：选取2023年1月至2023年12月新疆医科大学第一附属医院收治的早期先兆流产合并SCH，并伴有下腹痛和阴道流血的97例患者作为研究对象，采用随机数字表法随机分为观察组（n=47）和对照组（n=50）。对照组单纯给予屈他维林治疗；观察组在对照组的基础上加用滋肾育胎丸进行治疗。比较2组患者的一般临床资料、临床治疗有效率、止血止痛相关指标、治疗前后绒毛膜下血肿超声检测结果及治疗前后外周血Treg/Th17表达水平。结果：2组治疗后的绒毛膜下血肿面积/孕囊面积均低于治疗前（P<0.01），且观察组低于对照组（P<0.01）。观察组止血控制时间短于对照组（P<0.01）；观察组临床治疗有效率高于对照组（P<0.05）。治疗后2组患者TGF-β水平高于治疗前，且IL-17水平低于治疗前（P<0.01）；治疗后观察组TGF-β水平高于对照组，而IL-17水平低于对照组（P<0.01）。结论：滋肾育胎丸联合盐酸屈他维林片在早孕期SCH患者中的临床应用效果显著，提高临床治疗有效率，促进T细胞向Treg转化。

English Summary:

To investigate the clinical effect of Zishen Yutai Pills combined with drotaverine hydrochloride tablets in the treatment of subchorionic haematoma(SCH) and to observe the expression levels of regulatory T cells(Treg) and T helper 17 cells(Th17) before and after treatment.Methods:From January 2023 to December 2023，97 patients with early threatened abortion combined with SCH，accompanied by lower abdominal pain and vaginal bleeding，were enrolled from the First Affiliated Hospital of Xinjiang Medical University.The patients were randomly divided into an observation group(n=47) and a control group(n=50) using a random number table method.The control group received drotaverine hydrochloride treatment alone，while the observation group received Zishen Yutai Pills in addition to drotaverine hydrochloride.The general clinical data，clinical treatment efficacy，hemostasis and pain relief indicators，ultrasound detection results of SCH，and peripheral blood Treg/Th17 expression levels before and after treatment were compared between the two groups.Results:After treatment，the SCH area to gestational sac area ratio was lower in both groups compared to those before treatment(P<0.01)，and the observation group was lower than the control group(P<0.01).The hemostasis control time was shorter in the observation group than in the control group(P<0.01).The clinical treatment efficacy rate was higher in the observation group than in the control group(P<0.05).After treatment，TGF-β levels were higher and IL-17 levels were lower in both groups compared to those before treatment(P<0.01).The observation group had higher TGF-β levels and lower IL-17 levels than the control group after treatment(P<0.01).Conclusion:Zishen Yutai Pills combined with drotaverine hydrochloride tablets have a significant clinical effect in patients with early pregnancy SCH，which can improve the clinical treatment efficacy and promote the conversion of T cells to Treg cells.

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