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目的:探讨宫清颗粒联合米非司酮药物流产缩短流产后出血时间的可能机制。方法:将非意愿妊娠49天内要求药物流产的宫内早孕妇女120例随机分成:A组:给予宫清颗粒联合米非司酮150mg配伍米索前列醇600μg;B组:将宫清颗粒换成茜芷胶囊余同治疗组;C组:单纯口服药物流产药。应用免疫组化SP法检测自然排出绒毛及蜕膜组织中wtp53的表达,并以40例负压吸宫流产绒毛及蜕膜组织做对照(D组)。结果:wtp53在各组绒毛及蜕膜中均有表达。在A、B、C、D组绒毛及蜕膜中的表达依次降低,P值均<0.05。结论:米非司酮可以诱导人早孕绒毛和蜕膜促凋亡基因wtp53表达,这可能是其抗早孕机理之一;宫清颗粒可以增强早孕药物流产绒毛及蜕膜中促凋亡基因wtp53的表达,从而促进绒毛和蜕膜的细胞凋亡,减少绒毛和蜕膜残留,从而缩短米非司酮药物流产后出血时间。
Objective: To investigate the possible mechanism of Gongqing granule combined with mifepristone abortion to shorten the bleeding time after abortion. Methods: One hundred and twenty cases of intrauterine pregnancy in abortion within 49 days of unwanted pregnancy were randomly divided into: Group A: 150mg of Gongqing granule combined with mifepristone and 600μg of misoprostol; Group B: Qianzhi capsules with the same treatment group; C group: simple oral drug abortion drug. Immunohistochemical SP method was used to detect the expression of wtp53 in spontaneous villus and deciduas, and 40 cases of ascites villi and decidua were used as controls (group D). Results: wtp53 was expressed in both villus and decidua. The expression of villus and decidua in groups A, B, C and D decreased in turn, all P <0.05. Conclusion: Mifepristone can induce the expression of wtp53, a pro-apoptotic gene in human chorion and decidua in early pregnancy, which may be one of its mechanisms of anti-early pregnancy. Gongqing granule can enhance the expression of wtp53 Expression, thereby promoting the apoptosis of villi and decidua, reduce villi and decidual remnants, thus shortening the bleeding time after mifepristone abortion.