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目的探讨中药对梅毒血清固定患者的妊娠结局的影响及婴儿的血清学特点。方法孕前采用中药治疗的(32例)育龄期梅毒血清固定女患者为中药治疗组;对照组选择同期56例妊娠合并梅毒血清固定患者,根据孕期是否规范治疗分为青霉素治疗组(31例)和未治疗组(25例)。比较三组孕妇的妊娠结局,并定期随访母婴的血清结果。结果妊娠结局:中药治疗组足月分娩率为90.63%,早产发生率为3.13%,不良结局(自然流产和死胎死产)发生率为6.25%青霉素治疗组分别为90.32%、6.45%和3.22%;未治疗组分别为88%、4%和8%;三组妊娠结局比较,差异无统计学意义(P20.05);新生儿预后:中药治疗组分娩正常新生儿占96.67%、早产儿占3.33%、先天梅毒为0;青霉素治疗组分别为93.33%、6.67%和0;未治疗组分别95.65%、4.34%和0。三组新生儿预后比较,差异无统计学意义(P20.05);婴儿血清结果:在随访过程中没有出现TRUST滴度持续上升,且滴度均<母亲TRUST滴度的4倍;TRUST在3～6个月内均逐渐阴转,TPPA在6～12个月内均逐渐阴转;所有婴儿的19S-IgM-TPPA(-)。结论梅毒血清固定患者在孕前给予中药治疗对妊娠结局无影响,定期随访是评估母婴预后的重要环节。
Objective To investigate the effect of traditional Chinese medicine (TCM) on pregnancy outcome in patients with syphilis sera and the serological characteristics of infants. Methods Fifty-six pregnant women with pregnancy-induced syphilis were randomly divided into penicillin-treated group (n = 31) and control group (n = Untreated group (n = 25). The pregnancy outcomes of three groups of pregnant women were compared, and the serum results of maternal and infant were followed up regularly. Results Pregnancy outcome: The full-term delivery rate was 90.63% in traditional Chinese medicine group, the incidence of preterm delivery was 3.13%, the incidence of adverse outcomes (spontaneous abortion and stillbirth) was 6.25% in penicillin-treated groups, 90.32%, 6.45% and 3.22% ; No treatment group were 88%, 4% and 8%; pregnancy outcomes in the three groups, the difference was not statistically significant (P20.05); newborn prognosis: Chinese medicine treatment group of normal newborn birth accounted for 96.67% 3.33%, congenital syphilis was 0; penicillin treatment group were 93.33%, 6.67% and 0; untreated group were 95.65%, 4.34% and 0. There was no significant difference in the prognosis between the three groups (P20.05). Serum levels of infant did not show any increase in TRUST titer during the follow-up, and the titers were all <4 times of the TRUST titer of the mother. TRUST was between 3 ~ 6 months were gradually overcast, TPPA in 6 to 12 months were gradually overcast; all infants 19S-IgM-TPPA (-). Conclusion Syphilis serum in patients with pre-pregnancy treatment of traditional Chinese medicine has no effect on pregnancy outcomes, regular follow-up is an important part of assessing the prognosis of maternal and infant.