Study on Therapeutic Regimen for Threatened Abortion with Low Estrogen / 广州中医药大学学报

ABSTRACT

Objective To study the relationship between estradiol (E2) and embryonic development, and to explore the optimal therapeutic regimen for threatened abortion with low estrogen. Methods One hundred and sixty threatened abortion patients 14 days after frozen embryo transfer (FET) with E2 in the range of 100-200 pg/mL were randomized into Chinese medicine group 1, Chinese medicine group 2, Chinese and western medicine group, and control group, 40 cases in each group. Chinese medicine group 1 was treated orally with Shoutai Sijun Decoction, Chinese medicine group 2 was treated orally with Shoutai Sijun Decoction combined with Placenta Hominis Granules, Chinese and western medicine group was treated orally with Shoutai Sijun Decoction combined with Femonstone white tablets, and the control group was treated orally with Femonstone white tablets. Pregnancy rate and the changes in E2 level before and after treatment in the 4 groups were compared. The sensitivity and specificity of E2 level to the prognosis of pregnancy were also investigated. Results (1) The pregnancy rate of Chinese medicine group 1, Chinese medicine group 2, Chinese and western medicine group, and control group was 70.0％, 75.0％, 95.0％, 77.5％ respectively, and Chinese and western medicine group had the highest pregnancy rate(P<0.05).(2) E2 level in the pregnant patients of 4 groups after treatment was increased, and the difference was significant compared with that on ET day 14 (P < 0.05 or P <0.01). (3) The results of prognosis of E2 for pregnancy were as follows sensitivity was 92％, specificity was 80％, and the area of curve was 0.820 when threshold of E2 being 281 on ET day 22. Conclusion The low post-FET E2 level is correlated with disordered pregnancy, and the early monitoring of E2 and prompt intervention should be performed. Shoutai Sijun Decoction combined with Femonstone white tablets is effective on increasing E2 level rapidly and leading to a higher pregnancy rate, and the effect of Shoutai Sijun Decoction combined with Placenta Hominis Granules comes next.