热敏灸联合西药孕前干预肾虚血瘀型复发性流产血栓前状态疗效观察

孙利利; 孙自学; 李鹏超

doi:10.13703/j.0255-2930.20240617-0001

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热敏灸联合西药孕前干预肾虚血瘀型复发性流产血栓前状态疗效观察

临床研究 | 更新时间：2025-09-12

- 热敏灸联合西药孕前干预肾虚血瘀型复发性流产血栓前状态疗效观察
- Efficacy of heat-sensitive moxibustion combined with western medication for preconception intervention in prethrombotic state of recurrent spontaneous abortion with kidney deficiency and blood stasis
- 中国针灸 2025年45卷第9期页码：1253-1258
- 作者机构：
  
  河南省中医院/河南中医药大学第二附属医院男科与生殖诊疗中心，郑州　450002
- 作者简介：
  
  ✉孙自学，主任医师、二级教授。E-mail：hnszyyszyxk@foxmail.com
- 基金信息：
  
  国家区域中医（专科）诊疗中心建设项目(国中医药办医政函〔2017〕39号);国家中医药管理局高水平中医药重点学科建设项目(国中医药人教函〔2023〕85号);河南省中原英才计划-中原名医项目(ZYMY201809);河南省生殖障碍疾病中医药防治工程研究中心项目(豫发改高技〔2023〕484号);河南省中医药传承和创新人才工程青苗人才项目(豫卫中医函〔2021〕16号)
- DOI：10.13703/j.0255-2930.20240617-0001
  中图分类号：
- 收稿：2024-06-17，
  
  网络首发：2025-07-16，
  
  纸质出版：2025-09-12
- 稿件说明：
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孙利利, 孙自学, 李鹏超. 热敏灸联合西药孕前干预肾虚血瘀型复发性流产血栓前状态疗效观察[J]. 中国针灸, 2025,45(9):1253-1258.

SUN Lili, SUN Zixue, LI Pengchao. Efficacy of heat-sensitive moxibustion combined with western medication for preconception intervention in prethrombotic state of recurrent spontaneous abortion with kidney deficiency and blood stasis[J]. Chinese Acupuncture & Moxibustion, 2025, 45(9): 1253-1258.
孙利利, 孙自学, 李鹏超. 热敏灸联合西药孕前干预肾虚血瘀型复发性流产血栓前状态疗效观察[J]. 中国针灸, 2025,45(9):1253-1258. DOI： 10.13703/j.0255-2930.20240617-0001.

SUN Lili, SUN Zixue, LI Pengchao. Efficacy of heat-sensitive moxibustion combined with western medication for preconception intervention in prethrombotic state of recurrent spontaneous abortion with kidney deficiency and blood stasis[J]. Chinese Acupuncture & Moxibustion, 2025, 45(9): 1253-1258. DOI： 10.13703/j.0255-2930.20240617-0001.

摘要

目的

观察热敏灸联合西药孕前干预肾虚血瘀型复发性流产（RSA）血栓前状态的临床疗效。

方法

将100例肾虚血瘀型RSA血栓前状态患者随机分为综合组（50例，剔除5例）和药物组（50例，剔除5例）。药物组给予口服阿司匹林肠溶片，每次75 mg，每日1次；在药物组治疗基础上，综合组予热敏灸治疗，即在关元、神阙及双侧三阴交、足三里、气海、太溪、子宫、卵巢、血海、阴陵泉穴区探寻热敏化腧穴并施灸，每次约40 min，隔日1次。两组均连续治疗3个月经周期。治疗结束后随访3个月，在医生指导下受孕，记录两组患者12周妊娠成功率；分别于治疗前后观察两组患者中医临床症状评分，并检测凝血-纤溶指标[活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、血小板计数（PLT）、D-二聚体（D-D）、纤维蛋白原（FIB）、蛋白S（PS）、蛋白C（PC）、抗凝血酶Ⅲ（AT-Ⅲ）]。

结果

综合组患者12周妊娠成功率为80.0%（32/40），高于药物组的54.3%（19/35，

0.05）。治疗后，两组患者中医临床症状评分较治疗前降低（

0.05），且综合组低于药物组（

0.05）。治疗后，两组患者APTT、PT较治疗前延长（

0.05），PLT、FIB、D-D水平较治疗前降低（

0.05），AT-Ⅲ、PS、PC活性较治疗前升高（

0.05）；综合组患者APTT长于药物组（

0.05），PLT、FIB、D-D水平低于药物组（

0.05），AT-Ⅲ、PS和PC活性高于药物组（

0.05）。

结论

热敏灸联合西药可有效干预肾虚血瘀型RSA患者血栓前状态，改善临床症状，提高妊娠成功率，其作用机制可能与调节患者血液高凝状态有关。

Abstract

Objective

To observe the clinical efficacy of heat-sensitive moxibustion combined with western medication for preconception intervention in prethrombotic state of recurrent spontaneous abortion (RSA) with kidney deficiency and blood stasis.

Methods

A total of 100 RSA patients of prethrombotic state with kidney deficiency and blood stasis were randomized into a combination group (50 cases

5 cases were eliminated) and a medication group (50 cases

5 cases were eliminated). In the medication group

the aspirin enteric-coated tablet was given orally at a dose of 75 mg a time

once daily. On the basis of the treatment in the medication group

in the combination group

heat-sensitive moxibustion was applied at the heat-sensitive points selected among the areas of Guanyuan (CV4)

Shenque (CV8)

and bilateral Sanyinjiao (SP6)

Zusanli (ST36)

Qihai (CV6)

Taixi (KI3)

Zigong (EX-CA1)

Luanchao (Extra)

Xuehai (SP10)

and Yinlingquan (SP9)

about 40 min a time

once every two days. Both groups were treated for 3 menstrual cycles continuously. Pregnancy success rate of 12 weeks was recorded in the two groups in follow-up of 3 months after treatment completion

during which conception was tried under the guidance of doctor. The TCM symptom score was observed and the coagulation-fibrinolysis indexes (activated partial thromboplastin time [APTT]

prothrombin time [PT]

platelet count [PLT]

D-dimer [D-D]

fibrinogen [FIB]

protein S [PS]

protein C [PC] and antithrombin Ⅲ [AT-Ⅲ]) were detected before and after treatment in the two groups.

Results

The pregnancy success rate of 12 weeks was 80.0% (32/40) in the combination group

which was higher than 54.3% (19/35) in the medication group (

0.05). After treatment

the TCM symptom scores were decreased compared with those before treatment in the two groups (

0.05)

and the TCM symptom score in the combination group was lower than that in the medication group (

0.05). Compared before treatment

the APTT and PT was prolonged (

0.05)

the levels of PLT

FIB and D-D were reduced (

0.05)

the activity of AT-Ⅲ

PS and PC was increased (

0.05) after treatment in the two groups. After treatment

in the combination group

the APTT was longer (

0.05)

the levels of PLT

FIB and D-D were lower (

0.05)

the activity of AT-Ⅲ

PS and PC was higher (

0.05) than those in the medication group.

Conclusion

Heat-sensitive moxibustion combined with western medication can effectively improve the prethrombotic state and TCM clinical symptoms in RSA patients with kidney deficiency and blood stasis

enhance pregnancy success rate

its mechanism may be related to ameliorating hypercoagulability.

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