Clinical Observation Of Anzi Mixture Combined With Aspirin In Pre-pregnancy Intervention Of ACA Positive Recurrent Abortion Thrombosis

Objective:Clinical observation of Anzi Mixture combined with Aspirin in pre-pregnancy intervention of ACA positive recurrent abortion thrombosis;and by observing the changes of serum ACA,platelet aggregation rate,four coagulation items and D-dimer levels before and after treatment,the therapeutic mechanism was explored,so as to provide clinical basis for finding a new method to prevent and treat ACA-positive recurrent abortion thrombosis-prone patients.Methods:From December 2016 to March 2019,90 ACA positive patients with RSA thrombosis who met the selection criteria in the gynecological outpatient department of jiangsu provincial hospital of traditional Chinese medicine were collected and randomly divided into experimental group,control group A and control group B,with 30 patients in each group.Experimental group:oral anzi mixture combined with aspirin(the former 125ml,2 times/day,the latter 25mg,3 times/day);Control group A:oral aspirin enteric-coated tablets 25mg,3 times/day;Control group B:oral anzi mixture,125ml,2 times/day.A menstrual cycle for a course of treatment,a total of 3 courses of observation.The collected data were processed and analyzed by SPSS 25.0 statistical software,and the clinical symptom improvement,serum ACA,platelet aggregation rate,clotting four items and d-dimer level changes and clinical comprehensive efficacy of the three groups before and after treatment were compared.Results:1.Changes in the scores of TCM syndromes and the efficacy of TCM syndromes:The TCM syndrome scores of the three groups after treatment were significantly lower than those before treatment(P<0.05).The total effective rate of TCM syndromes in the three groups was 90.0%,60.0%and 86.7%,respectively.The scores and total effective rate of TCM syndromes in the experimental group and the control group B were both better than those in the control group A,and the difference was statistically significant(P<0.05).After treatment,there was no significant difference in the scores and efficacy of TCM syndromes between the experimental group and the control group B(P>0.05).2.Changes of Serum ACA levels:Serum ACA level in the three groups was significantly decreased after treatment compared with before treatment(P<0.01).After treatment,the serum ACA level of the experimental group was lower than that of the two control groups,and the difference was statistically significant(P<0.01),while there was no statistically significant difference between the control group A and the control group B(P>0.05).3.Changes of D-dimer levels:The D-dimer level in the three groups after treatment was significantly lower than that before treatment(P<0.05).After treatment,the d-dimer level of the experimental group was lower than that of the two control groups,and the difference was statistically significant(P<0.05),but there was no statistically significant difference between the control group A and the control group B(P>0.05).4.Changes of Platelet aggregation rates:The platelet aggregation rate in the three groups after treatment was significantly lower than that before treatment(P<0.05).After treatment,the platelet aggregation rate of the experimental group was lower than that of the two control groups,and the platelet aggregation rate of the control group A was lower than that of the control group B,and the differences between the groups were statistically significant(P<0.05).5.Changes of Blood coagulation function:APTT increased in the three groups after treatment(except P<0.05).PT increased in the three groups compared with that before treatment(P>0.05,remaining P<0.05 in group B).After treatment,APTT and PT increases in the experimental group and control group A were higher than those in the control group B,with statistically significant differences(P<0.05),but no statistically significant differences were found between the experimental group and control group A(P>0.05).TT increased and FIB decreased in the three groups after treatment compared with that before treatment(P<0.05),and the difference between the three groups was not statistically significant(P>0.05).6.Comprehensive clinical curative effect:The total clinical efficacy of the three groups was 83.3%,70.0%and 60.0%,respectively.After treatment,the comprehensive clinical efficacy of the experimental group was better than that of the two control groups,and the difference was statistically significant(P<0.05),while the difference between the experimental group A and the control group B was not statistically significant(P>0.05).Conclusion:The clinical efficacy of anzi mixture combined with aspirin in pre-pregnancy intervention of ACA positive RSA embolism is significant,with the total effective rate as high as 83.3%,which is significantly superior to aspirin or anzi mixture alone.The combination of the two drugs can not only improve the clinical symptoms of patients,but also reduce or turn negative the level of ACA,reduce the rate of platelet aggregation and alleviate the pre-thrombosis state.The mechanism of action of combination of anzi mixture and aspirin may be to improve the body's coagulation function and alleviate the pre-thrombotic state caused by the body's immune disorder by reducing ACA level and platelet aggregation rate.