| Purpose:To observe the changes of NK cells in peripheral blood of patients with early threatened abortion of blood heat type,and to compare the changes of NK cells in peripheral blood before and after treatment between traditional Chinese medicine group(Ramie root mixture)and western medicine group(Diqu progesterone tablet),combined with the levels of serum estradiol,progesterone,β-HCG and total effective rate,to explore the regulatory effect and clinical effect of Ramie root mixture on peripheral blood NK cells.Methods:The patients who met the inclusion and exclusion criteria were enrolled in the gynecology,obstetrics clinic and inpatient department of Xiamen traditional Chinese Medicine Hospital,Xiamen Huli Maternal and Child Health Hospital,Jiangtou,Weshan,Jinshan and Gaoqi Community Health Service Center of Xiamen traditional Chinese Medicine Hospital from January 2020 to December 2020.There were 240 patients in traditional Chinese medicine group,western medicine group and normal control group(each n=80).The traditional Chinese medicine group and the western medicine group were given 3courses of treatment respectively.The values of NK cells,estradiol,progesterone,β-HCG and TCM syndrome scores in peripheral blood were observed before and after treatment,and the outcome of fetal preservation was followed up.In the normal control group,the corresponding indexes were detected at 6-8 weeks and 11-12 weeks of pregnancy,and statistical analysis was carried out to explore the changes of NK cells in peripheral blood of patients with early threatened abortion of blood-heat type and the regulatory effect and clinical effect of Ramie root mixture on NK cells in peripheral blood.Results:1.According to the inclusion and exclusion criteria of this experiment,a total of 240 patients with early threatened abortion and normal pregnancy were collected,11 cases fell off in the course of the experiment,and 229 cases were finally completed.there were 76 cases in the traditional Chinese medicine group,77 cases in the western medicine group and 76 cases in the normal control group.2.Changes of NK cells in peripheral blood of patients with early threatened abortion of blood-heat type:(1)comparison of general data: there was no significant difference in age,gestational weeks of the first and second time between the threatened abortion group and the normal control group(all P>0.05),but there was comparability between the two groups.(2)there was significant difference in NK cells in peripheral blood between normal control group and threatened abortion group before treatment(P<0.05),and binary Logistic regression analysis showed that NK cells in peripheral blood were positively correlated with the occurrence of threatened abortion(P<0.05),and the occurrence ratio was 1.057.The ROC curve of peripheral blood NK cells was used to predict the occurrence of threatened abortion,and it was found that peripheral blood NK cells had a certain value in predicting the occurrence of early threatened abortion of blood-heat type(AUG>0.5,P<0.05).The best predictive value of peripheral blood NK cells calculated by Yoden index was 18.50%,the sensitivity was 45.8%,and the specificity was 82.9%.(3)there was no significant difference in the number of NK cells in peripheral blood between 6-8 weeks and 11-12 weeks of gestation in the normal control group(P>0.05).3.The clinical efficacy of Ramie root mixture and the effect of peripheral blood NK cells:(1)Comparison of general data: before treatment,there was no significant difference in estradiol,progesterone,β-HCG,peripheral blood NK cells and TCM syndrome scores between the traditional Chinese medicine group and the western medicine group(all P>0.05).(2)Clinical efficacy: the total effective rate was 81.58% in the traditional Chinese medicine group and 87.01% in the western medicine group.There was no significant difference in clinical efficacy between the two groups(P>0.05).(3)TCM syndrome scores: the TCM syndrome scores of the two groups after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the difference of TCM syndrome scores between the traditional Chinese medicine group and the western medicine group before and after treatment(P>0.05),but there was no significant difference in the improvement of TCM syndrome scores between the two groups(P>0.05).(4)effect on the level of serum progesterone: the levels of estradiol,progesterone and β-HCG in the traditional Chinese medicine group and the western medicine group after treatment were significantly higher than those before treatment(P<0.05);but there was no significant difference in the estradiol and progesterone levels between the two groups after treatment(P>0.05),but the β-HCG in the western medicine group after treatment was significantly higher than that in the traditional Chinese medicine group(P<0.05).(5)the effect of NK cells in peripheral blood: the level of NK cells in peripheral blood after treatment in traditional Chinese medicine group and western medicine group was significantly lower than that before treatment(P>0.05),and there was significant difference between the two groups after treatment(P<0.05).There was no significant difference in the number of NK cells in peripheral blood between the normal group and the traditional Chinese medicine group after treatment(P>0.05),but there was significant difference between the normal group and the western medicine group(P<0.05).Conclusion:1.The occurrence of early threatened abortion of blood-heat type is positively correlated with NK cells in peripheral blood.The number of NK cells in peripheral blood can be used as a cutoff value for predicting early threatened abortion of blood-heat type.The level of NK cells in peripheral blood of normal pregnant women was relatively stable in early pregnancy.2.Ramie root mixture has the same clinical efficacy as didrone in the treatment of early threatened abortion of blood-heat type.both can improve the TCM syndrome score,effectively increase the levels of estradiol,progesterone and β-HCG,and down-regulate the level of NK cells in peripheral blood.However,the increase of β-HCG level of patients with didro-progesterone was better than that of Ramie root mixture,and the down-regulation of peripheral blood NK cells of Ramie root mixture was better than that of didro-progesterone.Ramie root mixture could make the level of NK cells in peripheral blood tend to normal pregnancy. |
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