| Objective: This article discusses the general clinical data,endocrine,immune,prethrombotic state and chromosomal abnormalities of patients with embryo abortion,and analyzes the related risk factors of embryo abortion.And it puts forward a new understanding of the differentiation and typing of embryo abortion,which provides objective basis for the etiology and pathology of this disease and TCM differentiation and typing,in order to improve the clinical efficacy.Methods:Part 1: We collected 139 early pregnant women who went to the reproductive endocrinology clinic of Hunan second people's hospital from December 2016 to December 2017 for pregnancy examination.According to the pregnancy outcome,they were divided into two groups:88 women with embryo termination(the termination group)and 51 women with normal pregnancy(the normal group).By combining the results of HCG(monitor HCG every other day for three times,mark them as HCG1?HCG2?HCG3,the specific values are marked as HCG2/HCG1 and HCG3/HCG2)?P?E2?TSH?CA125?ACA?ANA?EmAb?AoAb?PLT and plasma D-dimer measured by patients and cases,we summarized,compared and analyzed the risk factors related to the onset of embryo abortion.In the result of the single factor analysis,the variableof P<0.05 includes: HCG2/HCG1?HCG3/HCG2?E2?TSH?PLT and plasma D-dimer,bring the variable of P<0.05 to the multi-factor logistic for regression analysis.Based on the intention of 88 cases of embryo-stopping patients,uterus villous tissu of 57 cases of embryo-stopping patients were analyzed for villous chromosome karyotype by using the long term culture of villous cell and the chromosome G-banding technique to prepare chromosome specimens,there are 4 examples failed in cultivation due to the serious maternal blood pollution or the serious DNA degradation among the 57 examples of the embryo damage patients,the rest 53 examples are successful in cultivation,and the relationship between the 53 cases of embryo-stopping patients and the age of the patients was analyzed,so as to provide the genetic correct examination and genetics consultation for the embryo to stop the embryo-stopping patients.In the results of single factor analysis,the variables with P<0.05 were selected to be included in multivariate logistic regression analysis.Part 2: 88 cases of embryo abortion were classified according to TCM syndrome differentiation standard.They were divided into four syndrome types : kidney deficiency and liver depression syndrome,kidney deficiency and blood stasis syndrome,spleen and kidney deficiency syndrome and kidney deficiency and blood heat syndrome in advance.Through statistics and analysis,this paper summarized the performance characteristics of TCM syndromes of embryo abortion patients,and put forward the new characteristics of embryo abortion in TCM syndromedifferentiation and classification.Results:Part 1: The E2 level of the patients in the termination group was lower than that of the normal group,and the difference was statistically significant(p< 0.05);The HCG ratio in the termination group was lower than that in the normal group,and the difference was statistically significant(p< 0.05);TSH level,plasma D-dimer and platelet count in the termination group were higher than those in the normal group,and the difference was statistically significant(p<0.05);The positive rates of ACA,ANA,EmAb and AoAb in the termination group were significantly higher than those in the normal group,and the difference was statistically significant(p< 0.05).there was no significant difference in P level between the two groups(p> 0.05);the CA 125 level of the patients in the termination roup and the normal group was higher than that of the normal level,but the difference was not statistically significant(p >0.05);Multivariate logistic regression analysis showed that E2 and TSH were the independent influencing factors of the Diapause group,in which E2 was the protective factor(P=0.024,OR=0.997,95%CI:0.995-1.000)and TSH was the risk factor(P=0.035,OR=1.567,95%CI:1.031-2.0383).In53 cases of successfully cultured villi,there were 24 abnormal chromosome,29 normal cases,and chromosome karyotype abnormality was 45.28%.the amount of the villus chromosome deviants in the advanced age group(the age period ?35)is 14,the abnormal rate is66.67%;that in the low age group(the age period <35)is 10,theabnormal rate is 31.25%,the comparison of the two groups of the abnormal rate has the statistics difference(P<0.05),the abnormal rate of the villus chromosome in the advanced group is higher than that in the low age group.Part 2: 88 cases of embryo abortion were mainly characterized by kidney deficiency and liver depression,followed by kidney deficiency and blood stasis> spleen and kidney deficiency > kidney deficiency and blood heat;The frequency analysis of symptoms showed that the frequency of soreness and weakness of waist and knees,breast distention and pain,tinnitus,vaginal bleeding,emotional depression,frequent urination,vexation and insomnia,impatience and irritability,palpitation and dry mouth and bitter taste were the highest;tongue image is mainly pale,followed by pale purple tongue and red tongue;the tongue coating is thin and white with yellow fur,pulse condition is dominated by pulse string,followed by pulse number,fine and astringent pulse,weak pulse,heavy and fine pulse,fine pulse and moist pulse.Conclusion:1.Estrogen should be regarded as a new indicator to predict the early pregnancy outcome,and should be detected as early as possible.Estrogen plays an important role in the process of pregnancy occurrence and maintenance;Hypothyroidism in pregnancy related to infertility are important risk factors leading to the onset of fetal arrest.Therefore,prenatal and prenatal examination should be paid early attention to and intervention should be made as soon as possible.More and more evidenceand clinical practice have confirmed that embryo-stopping is closely related to embryo chromosome abnormality,which occupies more than half of the proportion;The pregnant woman aged more than 35 is an important high-risk factor for chromosomal abnormalities in embryos.2.Through the distribution of symptoms,this study found that the TCM symptoms of embryo abortion were closely related to kidney,liver and spleen,and the clinical manifestations of kidney system were more than those of liver system,and the clinical manifestations of liver system were more than those of spleen system.This study discusses the TCM syndromes of embryo abortion patients,and finds that kidney deficiency is the main disease,which is mainly divided into kidney deficiency and liver depression,kidney deficiency and blood stasis,kidney deficiency and blood heat,spleen and kidney deficiency,liver depression and qi stagnation throughout the disease,and qi deficiency,blood deficiency,dampness and heat are mixed together. |
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