|
| 基于Ang/Tie信号通路探讨健脾固胎方对胎儿生长受限分娩时间及妊娠结局的影响 |
|
| 投稿时间：2026-04-13 修订日期：2026-06-18 |
| DOI： |
| 中文关键词: 胎儿生长受限 脾肾不足证 血管生成素 血管生成素受体酪氨酸激酶1 |
| 英文关键词:Fetal growth restriction Spleen-Kidney Deficiency pattern Angiopoietin Angiopoietin receptor tyrosine kinase 1 |
| 基金项目:浙江省中医药科技计划项目，编号：2022ZA106 |
|
| 摘要点击次数: 9 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的:探讨健脾固胎方联合常规西医治疗对脾肾不足型胎儿生长受限(FGR)孕妇分娩时间、妊娠结局的影响,及对血管生成素(Ang)/ 血管生成素受体酪氨酸激酶1(Tie)信号通路的调控作用,为临床治疗提供依据。方法:选取2022年1月-2024年6月本院收治的90例脾肾不足型FGR孕妇,按随机数字表法分为对照组和观察组,各45例。研究过程中对照组脱落4例,最终纳入41例。观察组脱落5例,最终纳入40例。对照组给予常规西医治疗,观察组在对照组基础上联合健脾固胎方治疗,每日1剂煎服,连续治疗3周。观察两组临床疗效、妊娠结局(分娩孕周、新生儿体重等)、胎儿生长指标[头围(HC)、腹围(AC)子宫高度(FH)和双顶径(BPD)增长幅度]、胎盘血流动力学(脐动脉S/D比值、胎儿大脑中动脉血流指数(MCA-PI)]、Ang/Tie信号通路相关指标[血管紧张素Ⅰ(Ang-Ⅰ)、血管紧张素Ⅱ(Ang-Ⅱ)、Tie2]及中医证候积分、不良反应。结果:观察组总有效率(92.50%)高于对照组(73.17%)(P＜0.05)；相较于对照组,观察组分娩孕周更长、新生儿体重和HC、AC、FH、BPD增长幅度更高,Apgar 评分与产后出血发生率更低,组间差异具有统计学意义(P＜0.05)；治疗后两组脐动脉S/D比值、胎儿MCA-PI均降低,且观察组低于对照组(P＜0.05)；治疗后两组血清Ang-Ⅰ、Ang-Ⅱ、Tie2水平均升高,且观察组高于对照组(P＜0.05)；治疗后两组中医证候各项评分及总分均降低,且观察组低于对照组(P＜0.05)；两组不良反应发生率低且无严重不良反应。结论:健脾固胎方联合常规西医治疗脾肾不足型FGR,可通过调控Ang/Tie信号通路改善胎盘血流灌注及胎儿生长发育,优化妊娠结局,减轻中医证候,安全性良好。 |
| 英文摘要: |
| Objective:To explore the efficacy of Jianpi Gutai Recipe combined with conventional Western medicine on delivery timing, pregnancy outcomes in pregnant women with fetal growth restriction (FGR) of Spleen-Kidney Deficiency pattern, and its regulatory mechanism on angiopoietin (Ang)/angiopoietin receptor tyrosine kinase 1 (Tie) signaling pathway, so as to provide clinical evidence for the treatment of FGR. Methods:A total of 90 pregnant women with spleen-kidney deficiency type FGR who were admitted to our hospital from January 2022 to June 2024 were selected and divided into the control group and the observation group according to the random number table method, with 45 cases in each group. During the study, 4 cases in the control group dropped out, and finally 41 cases were included. 5 cases in the observation group dropped out, and finally 40 cases were included. Standard Western medical therapy was applied to the control group, while the observation group was additionally administered with Jianpi Gutai Recipe (one decoction daily) for 3 consecutive weeks on the basis of the control treatment. The clinical efficacy, pregnancy outcomes (gestational week at delivery, neonatal birth weight, etc.), fetal growth parameters (increments of head circumference (HC), abdominal circumference (AC), fundal height (FH) and biparietal diameter (BPD)), placental hemodynamics (umbilical artery S/D ratio, fetal middle cerebral artery pulsatility index (MCA-PI)), serum levels of Ang/Tie pathway-related factors (Ang-Ⅰ, Ang-Ⅱ, Tie2), traditional Chinese medicine (TCM) syndrome scores and adverse reactions were compared between the two groups. Results:A statistically significant elevation in total effective rate was found in the observation group (92.50%) compared with the control group (73.17%)(P<0.05). The observation group presented longer gestational age at delivery, higher neonatal birth weight, higher Apgar scores and lower incidence of postpartum hemorrhage relative to the control group (P<0.05). The increments of fetal HC, AC, FH and BPD in the observation group were all significantly greater than those in the control group (P<0.05). After treatment, both groups showed decreased umbilical artery S/D ratio、 MCA-PI and scores of TCM syndromes , as well as elevated serum levels of Ang-Ⅰ, Ang-Ⅱ and Tie2, with more significant changes in the observation group (P<0.05). Conclusion:Jianpi Gutai Recipe combined with conventional Western medicine can improve placental blood perfusion and fetal growth and development by regulating the Ang/Tie signaling pathway, optimize pregnancy outcomes and alleviate TCM syndromes in FGR patients with Spleen-Kidney Deficiency pattern, with favorable clinical safety. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
