The Clinical Efficacy Of Bao Tai Ling And Dydrogesterone Tablets Treatment Of Unexplained Recurrent Spontaneous Abortion

BackgroundRecurrent spontaneous abortion is defined as 2 or more consecutive pregnancy losses before 20 weeks of gestation(with the same partner)[1-5]and both maternal and fetal factors may contribute to underlying causes[6]The cases that the cause of 40%-60%of recurrent spontaneous abortion(RSA)cannot be determined is defined as unexplained recurrent spontaneous abortion(URSA).According to statistics,5%of women may experience spontaneous abortion twice and 1%may suffer 3 times or even more[7-10]Recent studies suggest it is related to immunity imbalance.T lymphocyte plays a vital role in immune system and Th17/Treg imbalance could be the pathogenic mechanism for recurrent spontaneous abortion[11-13].In practice,Dydrogesterone could increase pregnancy rates[14][15]in a relatively safe way[16].Furthermore,traditional Chinese medicine has been applied for the treatment of recurring spontaneous abortion for thousands of years[17]and recent clinical research shows that traditional Chinese medicine could increase pregnancy rate and live birth rate in various ways[18-20].ObjectiveThe present study was designed to investigate the clinical efficacy of bao tai ling and Dydrogesterone Tablets treatment of unexplained recurrent spontaneous abortion on pregnancy outcome.And ultimately,providing basis for the prevention and treatment of unexplained recurrent spontaneous abortion and insights into pathogenesis.MethodsA total of 120 consecutive patients were randomly divided into 3 groups,and one was treated with Dydrogesterone Tablets and bao tai ling while the other two were treated with Dydrogesterone alone and bao tai ling alone respectively.Another 40 outpatients were chose for comparative purposes.Above treatment was applied in early pregnancy.SPSS 17.0 software was applied to perform the statistical analysis.Measurement data are described as Average ± Standard Variances(x±s)and tested by t testing;Ranked data are tested by rank sum test;Enumeration data was described in frequency and tested by Chi-square with inspection level ?=0.05?Results1.Baseline characteristics of patients in various Study groups:The baseline characteristics(age,BMI,Hb)of the participants who completed the study were similar among the 4 groups(P>0.05).2.Comparison of pregnancy outcomes among various study groups:compared with the control group,the miscarriages rate in the 3URSA groups were significantly higher;while compared with the single-medicine treatment groups,the miscarriages rate in the combination treatment group was lower(P<0.05).No significant variances has been identified within single-medicine treatment groups(P>0.05)and no significant variances was noted either in the gestational ages when giving birth among other 4 groups(P>0.05).3.Comparison of INF-??TNF-??IL-4?IL-10?IL-17A level:The differences of INF-??TNF-??IL-4?IL-10?IL-17A levels in the 3 URSA groups were not statistically significant before treatment but statistically significant after treatment,while compared with the single-medicine treatment groups,The differences of INF-??TNF-??IL-4?IL-10?IL-17A levels in the combination treatment group was statistically significant.And in the 2 single-medicine treatment groups,these cytokine levels before and after treatment were no statistically significant differences.4.Harmful and undesired side-effects and/or toxic effects after treatment were not observed in both treatment group.ConclusionDydrogesterone Tablets and Bao tai ling can significantly improve the clinical effect in patients with URSA;It's mechanism of action is possibly related to the fact that it could increase the level of IL-4?IL-10 and decrease the level of INF-??TNF-? to maintain immunologic tolerance.Treatments with Dydrogesterone Tablets and bao tai ling together are better than applied alone.