补肾活血方治疗肾虚血瘀证不明原因复发性自然流产的疗效观察及对血清FTO、METTL3的影响OA
Observing the effect of Bushen Huoxue Formula(补肾活血方)in the treatment of URSA with kidney deficiency and blood stasis syndrome and its influence on serum FTO and METTL3
目的 探讨补肾活血方治疗不明原因复发性自然流产(URSA)的临床疗效及对血清N6-甲基腺苷RNA去甲基酶(FTO)与甲基化转移酶3(METTL3)的调节机制.方法 选取有/无URSA病史的肾虚血瘀证早期先兆流产患者及无不良孕产史的正常孕妇各30例.观察时间为4周,URSA组、先兆流产组予以补肾活血方中药汤剂联合地屈孕酮片治疗;正常妊娠组给予常规孕检.观察三组人员保胎前后疗效性指标和中医证候积分的变化,每周监测一次血清β-绒毛膜促性腺激素(β-hCG)、孕酮(P)、雌二醇(E2)水平,并于孕6、8、10周分别行超声检查,评估胎儿发育情况.采用ELISA法检测各组人员血清FTO、METTL3的表达水平,探讨其与早期妊娠失败的相关性.结果 补肾活血方联合地屈孕酮片治疗能改善血清β-hCG、P、E2水平,促进胚芽长度及胎囊直径增长.治疗后URSA组与先兆流产组的中医证候积分均下降,且综合疗效总有效率分别为93.75%、90.91%.与正常妊娠组比较,肾虚血瘀证URSA和先兆流产患者血清FTO表达降低、METTL3表达升高,而治疗后两组中的FTO、METTL3水平均有所上调.结论 补肾活血方在治疗肾虚血瘀证URSA上疗效显著,可有效改善肾虚血瘀证URSA及先兆流产患者妊娠结局,提高孕12周妊娠成功率,其可能通过改善肾虚血瘀证URSA患者血清中FTO、METTL3表达,促进胚胎发育.
Objective To investigate the clinical efficacy of Bushen Huoxue Formula(补肾活血方,BSHXF)in treating unexplained recurrent spontaneous abortion(URSA)with kidney deficiency and blood stasis syndrome,and to explore its regulatory effects on serum N6-methyladenosine RNA demethylase(FTO)and methyltransferase-like 3(METTL3).Methods Thirty patients with threatened abor-tion and kidney deficiency-blood stasis syndrome(with URSA history),thirty patients with the same syndrome(without URSA his-tory),and thirty normal pregnant women without adverse pregnancy history were enrolled.The observation period was 4 weeks.The URSA and threatened abortion groups received BSHXF combined with dydrogesterone tablets,while the normal pregnancy group received routine prenatal care only.Efficacy indices and TCM syndrome scores were evaluated before and after treatment.Serum β-human chorionic gonadotropin(β-hCG),progesterone(P),and estradiol(E2)levels were monitored weekly.Fetal development was assessed via ultrasound at 6,8,and 10 weeks of gestation.Serum levels of FTO and METTL3 were measured using ELISA to investigate their correlation with early pregnancy failure.Results BSHXF combined with dydrogesterone significantly improved serum β-hCG,P,and E2 levels,and promoted the growth of embryonic bud length and average gestational sac diameter.The TCM syndrome scores were significantly decreased in both the URSA and threatened abortion groups after treatment,with overall effective rates of 93.75%and 90.91%,respectively.Compared with the normal pregnancy group,patients with URSA and threatened abortion showed lower serum FTO and higher METTL3 expression at baseline.Following treatment,both FTO and METTL3 levels in these groups were upregulated.Conclusion BHF demonstrates significant efficacy in treating URSA with kidney deficiency and blood stasis syndrome,effectively improving pregnancy outcomes and increasing the 12-week pregnancy success rate.Its therapeutic mechanism may involve modulating the expression of serum FTO and METTL3 to promote embryonic development.
冯晓玲;李广慧;王清仪;任佳杰
黑龙江中医药大学附属第一医院,黑龙江 哈尔滨 150040黑龙江中医药大学研究生院,黑龙江 哈尔滨 150040上海中医药大学附属岳阳中西医结合医院,上海 200080黑龙江中医药大学研究生院,黑龙江 哈尔滨 150040
医药卫生
不明原因复发性流产先兆流产甲基化酶去甲基化酶补肾活血方
Unexplained recurrent spontaneous abortionThreatened abortionMethyltransferaseDemethylaseBushen Huoxue Formula(补肾活血方)
《时珍国医国药》 2026 (8)
1483-1489,7
国家自然科学基金(8217442182205163)黑龙江省自然科学基金(2022ZX06C19)中医药循证能力提升项目(国中医药科技中药便函[2023]24号)
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