Clinical Observation of Gu Ben An Tai Decoction Combined with Dydrogesterone for Early Threatened Abortion Due to Spleen and Kidney Deficiency

Clinical Observation of Gu Ben An Tai Decoction Combined with Dydrogesterone for Early Threatened Abortion Due to Spleen and Kidney Deficiency | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Observation of Gu Ben An Tai Decoction Combined with Dydrogesterone for Early Threatened Abortion Due to Spleen and Kidney Deficiency Xuebing Li, Yang Wang, Zhuoxuan Su, Lu Pei, Yongwei Li, Chunxia Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8471415/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 Mar, 2026 Read the published version in Contraception and Reproductive Medicine → Version 1 posted 10 You are reading this latest preprint version Abstract Introduction We aimed to observe the clinical efficacy of Gu Ben An Tai Decoction (GBATD) combined with dydrogesterone for treating threatened abortion (TA)and assess the safety of the integrated Chinese-Western medicine approach for threatened miscarriage. We also aimed to provide a reference for designing larger, confirmatory studies in the future. Methods A retrospective analysis was conducted on 66 patients with early TA due to spleen and kidney deficiency. The control group received dydrogesterone, while the observation group received treatment with GBATD and dydrogesterone. The success rate of pregnancy maintenance was compared before 12 weeks of gestation. Safety and adverse reactions of GBATD, time to symptom resolution (vaginal bleeding and/or abdominal pain), laboratory examination indicators, imaging examination indicators, and traditional Chinese medicine (TCM) syndrome scores of the two groups were also compared. High-performance liquid chromatography-mass spectrometry was used to analyze GBATD’s major component. Results After treatment, the observation group showed a more significant increase in serum levels of β-HCG, Progesterone, estradiol, and Inhibin A compared to the control group. However, the serum CA125 level, uterine artery hemodynamic indicators S/D, PI, RI values, and TCM syndrome scores for spleen and kidney deficiency decreased more significantly in the observation group than those in the control group (P < 0.05). The observation group showed higher rates of effective TCM treatment, overall effectiveness, and successful retention at 12 weeks of pregnancy than the control group did, with statistically significant differences (P < 0.05). GBATD mainly contains 17 components. Discussion GBATD combined with dydrogesterone is effective for treating early TA. It significantly reduces symptoms of spleen and kidney deficiency, lowers the miscarriage rate, and shows no obvious adverse reactions. early threatened abortion Gu Ben An Tai Decoction spleen and kidney deficiency type clinical observation Figures Figure 1 Figure 2 Figure 3 Figure 4 1 Introduction Early threatened abortion (TA) is a typical early pregnancy complication, affecting up to 20% of pregnancies. Threatened miscarriage is defined as vaginal bleeding before the 20-week gestation period, a closed cervix, and no fetal loss. It is associated with a higher risk of adverse pregnancy and perinatal outcomes, including preterm delivery, hypertensive disorders of pregnancy (HDP), antepartum hemorrhage, placental abruption, perinatal death, and small for gestational age (SGA) infants. The cause of TA’s underlying pathology is unclear, leading to limited treatment options and insufficient evidence for their effectiveness ( 1 ). Consequently, many immune-based therapies have been used, including intravenous immunoglobulin, intrauterine leukocytes, endometrial scratch procedures, and steroids. However, empirical evidence supporting their ongoing use remains limited. Thus, patients and physicians have turned to alternative therapies, including Traditional Chinese Medicine (TCM) ( 2 ). In TCM, key factors, including kidney essence (Jing), sexual function (Tian Gui), Qi, and Yin-Yang, provide energy and substance. They also create essential conditions and guide movement in reproductive immunology. The early signs of miscarriage due to a deficiency of the spleen and kidney are clinical manifestations in women during early pregnancy. The risk of miscarriage increases owing to weak spleen energy and insufficient kidney yin. In TCM theory, the spleen is responsible for transportation and transformation, while the kidney stores essence. These two systems are interconnected. Spleen deficiency causes a lack of source for producing qi and blood. Nevertheless, kidney deficiency causes an imbalance of yin and yang, often leading to poor fetal development and miscarriage. Therefore, regulating the spleen and kidney, and strengthening the foundation to support the pregnancy, becomes a key measure for preventing and treating early miscarriage. Research indicates that a deficiency of the spleen and kidney can lead to insufficient qi and blood, thereby affecting the uterus and increasing the risk of miscarriage ( 3 ). TCM has advantages and characteristics in achieving overall balance, syndrome differentiation treatment, and preventing disease in early signs of miscarriage. Combining TCM with Western medicine to treat this condition is effective, providing safe and effective treatment plans for improving reproductive function, promoting fertility, preserving pregnancy, and treating recurrent miscarriage ( 2 ). The Gu Ben An Tai Decoction (GBATD) follows the TCM concept as a prescription for treating this condition, which states that "the kidney is the source of our innate energy, while the spleen is the source of our acquired energy," and has the effects of tonifying the kidney, strengthening the spleen, and nourishing qi and blood. In this study, a retrospective analysis was conducted to preliminarily explore the effectiveness of GBATD combined with dydrogesterone compared to dydrogesterone alone in patients with early signs of miscarriage due to spleen and kidney deficiency, and provide a reference for designing larger, confirmatory studies in the future. 2 Materials and methods 2.1 Gu Ben An Tai decoction composition Figure 1 shows the composition, usage parts, and dosage of GBATD for stabilizing the foundation and calming the fetus. The image is sourced from Plant Intelligence (https://www.iplant.cn/) 2.2 Clinical data A retrospective analysis was conducted on 66 patients with early threatened miscarriage (Spleen and Kidney Yang Deficiency type). These patients were admitted between December 2022 and October 2023 to the Reproductive Medicine Department of Henan Provincial Hospital of Traditional Chinese Medicine. The patients were categorized into two groups based on their therapeutic regimen, with the control group, having 33 patients, treated with dydrogesterone, and the observation group, having 33 patients, treated with GBATD + dydrogesterone. Given the study’s exploratory nature, the sample size was determined primarily using the number of eligible individuals available at our institution during the study period, rather than using a formal power calculation. All data were extracted from our hospital's electronic medical record system. The grouping of patients (treatment group vs. control group) was based on the actual treatment regimens they historically received, not randomized allocation by the investigators at the study's inception. Table 1 shows the eligibility criteria. The ethics committee of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine (NO.1626-02) approved this study. This study followed the Declaration of Helsinki. Each participant provided informed consent. 2.3 Treatment plans Medication was commenced in the groups following the symptoms of threatened miscarriage and confirmation of intrauterine pregnancy. Table 2 shows the treatment method, and each treatment course lasts 7 days, for a total of 2 treatment courses. After each course, relevant indicators were checked, and the pregnancy status was monitored. Adverse reactions were closely monitored during the treatment period. The data examined in this study compares patients' test results on the 14th day after treatment. This implies that there was no decrease in the dydrogesterone dosage and GBATD during this period. 2.4 Observation indexes The primary objective of this study is to compare the success rate of pregnancy maintenance before the 12-week gestation period between the two treatment groups. The secondary objectives were to compare the traditional Chinese medicine syndrome efficacy assessment, comprehensive efficacy assessment criteria, observation, and recording of adverse reactions between the two treatment groups (Table 3). When serious adverse events occur, the affected participant is immediately withdrawn from the study by the researchers. 2.5 Efficacy assessment criteria TCM syndrome efficacy assessment and comprehensive efficacy assessment criteria were based on "standards for the diagnosis and efficacy of TCM diseases" and clinical considerations. The assessment criteria are shown in Table 4. TCM syndrome efficacy index (n) = [(Total score before treatment - Total score after treatment) / Total score before treatment] × 100%. The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine provided all Chinese medicines. The TCM pharmacy of the hospital identified all plants as genuine herbs. The composition, used plant part, traditional Chinese name, and dosage of GBATD are shown in Figure 1. All the herbs were soaked in distilled water for 30 min. Then, they were boiled at high heat before simmering for 1 h. After cooking, the mixture was filtered and concentrated, and stored in a refrigerator at 4°C until needed. 2.6 Preparation of Gu Ben An Tai decoction containing serum Sprague-Dawley rats received GBATD (12.375 g/kg/d) through gavage consecutively for 7 days. Blood samples were collected from the abdominal aorta 1 h after the final administration, centrifuged, and the upper layer of pale-yellow serum was collected as the GBATD-containing serum. All animal experimental procedures followed the National Guidelines for Animal Usage in Research in China. The Ethics Committee of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine approved all animal studies. 2.7 Component analysis of Gu Ben An Tai decoction powder with high-performance liquid chromatography-mass spectrometry First, 50µL of serum containing GBAT was combined with 200 µL of methanol; then, 100µL of TCM extract was added to 400 µL of methanol. The solution was vortexed for 10 min to ensure it was thoroughly mixed. Following this, the solution was centrifuged at 13,000 rpm for 10 min, and then the supernatant was collected for the high-performance liquid chromatography-mass spectrometry (HPLC-MS) system. The HPLC operation was conducted using the UltiMate 3000RS (Thermo Fisher Scientific, USA) with an ACQUITY UPLC®BEH C18 column (2.1×150mm, 1.8μm) (Thermo Fisher Scientific, USA). Mobile phase A and mobile phase B were methanol and 0.1% methanoic acid, respectively. The gradient was applied over specific time intervals: 0-1 min (98%B and 2%A), 1-5min (80%B and 20%A), 5-10 min (50%B and 50%A), 10–15 min (20%B and 80%A), 15–27 min (5%B and 95%A), 28–30 min (98%B and 2%A). The flow rate was set at 0.3mL/min. The injection volume was 5μL, and the column temperature was maintained at 35°C. The high-resolution mass spectrometry conditions of the Q-Exactive (Thermo Fisher Scientific, USA) included ESI sources and a spray voltage of 3.2 kV for positive and negative modes. The capillary temperature was set to 300 °C. The Full mass/dd-MS 2 scanning mode was selected, allowing the simultaneous collection within a scan range of 100–1500 m/z. The spray gas used was nitrogen, and a high-pressure collision gas was used. The obtained data is first organized with Compound Discoverer 3.3 (Thermo Fisher), and then compared against the mzCloud database. 2.8 Statistical Processing SPSS 26.0 software and GraphPad Prism were used for statistical analysis and graphing. A two-sided P-value 0.05 showed no statistical significance. Measurement data are shown as mean ± standard deviation when they followed a normal distribution, or as median (interquartile range, IQR) otherwise. Categorical variables were shown as numbers (n) and percentages (%). The Shapiro-Wilk test was used to assess the normality of all continuous variables. For the continuous variables comparison of baseline characteristics between the two groups, the independent-samples t-test was used for normally distributed data, while the Mann-Whitney U test was used for non-normally distributed data. For continuous variables of intragroup comparisons (before vs after treatment), serological and hemodynamic indicators were determined using a paired-samples t-test when the differences between paired measurements were normally distributed; otherwise, the Wilcoxon signed-rank test was used. The TCM syndrome scores were analyzed using the Wilcoxon signed-rank test owing to their ordinal nature. For the continuous variables of intergroup comparisons after treatment, the independent-samples t-test or Mann-Whitney U test was used based on data distribution. For categorical data (total effective rate, pregnancy retention rate), the Chi-square test was used. When the data did not meet the assumptions of the Chi-square test (>20% of cells with an expected count <5), Fisher’s exact test was used. 3 Results 3.1 Comparison of general data No significant differences were observed in the general data between the groups before treatment (number of miscarriages, vaginal bleeding time, and TCM syndrome scoring were determined by the Mann-Whitney U test, and the other indicators were determined by the independent samples t-test, all P>0.05), indicating that they can be compared (Table 5). 3.2 Progesterone, estradiol, CA125, INH-A, and hemodynamic indicators S/D, PI, RI values before and after treatment between the groups, and comparison of serological indicators β-HCG After treatment, serum levels of estradiol (Figure 2A), β-HCG(Figure 2B), progesterone (P) (Figure 2C), and Inhibin A (INH-A) (Figure 2E) increased in the groups compared to their levels before treatment (by paired t-test, P<0.05), with the observation group showing significantly higher levels than the control group (determined by independent samples t-test, P<0.05). Conversely, serum CA125 (Figure 2D), S/D (Figure 2F), pulsatility index (PI) (Figure 2G), and resistance index (RI) (Figure 2H) values decreased after treatment (by paired t-test, P<0.05), with the observation group showing significantly lower values than those in the control group (determined by independent samples t-test, P<0.05). 3.3 Comparison of spleen and kidney deficiency syndrome scores before and after treatment and treatment efficacy for spleen and kidney deficiency syndrome between the groups after treatment After treatment, the scores for spleen and kidney deficiency syndrome decreased in the groups (determined by the Wilcoxon signed-rank test, P<0.05), with the observation group showing significantly lower scores than those in the control group (determined by the Mann-Whitney U test, P<0.05). (Figure 3 and Table 6). In the observation group of 33 patients, 13 were cured, 12 showed significant improvement, five were effective, and three were ineffective, leading to an overall effective rate of 90.91% of curative effects of spleen and kidney deficiency syndrome. In the control group, out of 33 patients, six were cured, eight showed marked improvement, nine were effective, and 10 were ineffective, resulting in an overall effective rate of 69.70% of curative effects of spleen and kidney deficiency syndrome. The observation group had a comprehensive effective rate of 87.88% and 66.67% in the control group. A Fisher’s exact test revealed a statistically significant difference in the total effective rates between the groups after treatment (determined by Fisher’s exact test for total effective rate, P<0.05) (Table 7). 3.4 Comparison of overall effective rates between the groups after treatment In the observation group of 33 patients, 12 were cured, 13 significantly effective, four effective, and four ineffective, resulting in a total effective rate of 87.88%. In the control group of 33 patients, three were cured, seven were significantly effective, 12 were effective, and 11 were ineffective, resulting in a total effective rate of 66.67%. A Fisher’s exact test was used to compare the total effective rates after treatment between the groups, showing a statistically significant difference (determined by Fisher’s exact test, P<0.05) (Table 8). 3.5 Comparison of successful pregnancy retention rates at 12 weeks between the groups after treatment In the observation group of 33 patients, 30 successfully carried the pregnancy to 12 weeks, while three did not, resulting in a success rate of 90.91%. In the control group of 33 patients, 22 successfully carried the pregnancy to 12 weeks, while 11 did not, resulting in a success rate of 66.67%. A Fisher’s exact test was used to compare the pregnancy retention success rates after treatment between the groups, showing a statistically significant difference (determined by Fisher’s exact test, P<0.05) (Table 9). 3.6 Safety evaluation Liver, kidney, complete blood count, and coagulation tests were conducted in each group before and after treatment. No patient experienced any adverse reactions throughout the treatment, including allergies or damage to liver and kidney function. 3.7 Gu Ben An Tai decoction chemical components analysis Based on HPLC-MS analysis, the chemical components in the herbal liquid of GBATD and the serum containing GBATD from mice were identified and compared to the mzCloud database. The analysis revealed a total of 693 compounds in the herbal liquid and 291 compounds in the serum. Among these, 404 compounds in the herbal liquid and 184 in the serum had a score >60 in the mzCloud best match. After removing duplicates, a Venn diagram that shows a total of 67 common components was created (Figure 4A). We screened for the main active components using the following criteria: mzCloud Best Match >80%, ΔMass 2 min, and a match to the Mass List from the Natural Products Atlas 2020_06 (Figure 4B and Table 10). 4 Discussion Early threatened miscarriage is a common pregnancy complication. Drug interventions primarily involving dydrogesterone have been widely used to treat early threatened miscarriage; nevertheless, their efficacy remains uncertain ( 4 ). Therefore, exploring new treatment methods to improve pregnancy outcomes is essential, especially in the population of patients experiencing early threatened miscarriage due to spleen and kidney deficiency, which is emphasized in TCM ( 5 ). In TCM, spleen and kidney deficiency is believed to significantly affect pregnancy, particularly regarding fetal development and the physical condition of the mother. The spleen deficiency can cause a lack of qi and blood production in the mother, thus affecting fetal growth and development. Also, kidney essence deficiency may cause a retardation in fetal growth and even adverse outcomes, including miscarriage. Spleen and kidney deficiency weakens the mother's constitution, including some pregnancy-related complications, such as gestational hypertension and gestational diabetes, and results in symptoms, including lower back pain, fatigue, and weakness. These symptoms affect daily life and work, also causing emotional fluctuations in the mother during pregnancy. It further increases the risk of anxiety and depression, which is detrimental to maternal and fetal health ( 6 ). While observing the efficacy of GBATD combined with dydrogesterone, the differences in efficacy between this combined treatment plan and the use of dydrogesterone alone were analyzed through a retrospective analysis. Baseline data of general information were compared between the two groups in this study, including age, days of amenorrhea, number of previous miscarriages, duration of illness, and serological and hemodynamic indicators, showing no statistical differences and comparability. Progesterone (P) can reduce the excitability of uterine smooth muscle during pregnancy, inhibit uterine contractions, and regulate immune response capabilities, thereby preventing the embryo from being rejected as a foreign body by the mother, thus maintaining pregnancy ( 7 ). The doubling of serum β-HCG was used to assess whether the growth and development of the embryo were good. Estradiol (E2) can be used to assess luteal function during pregnancy and evaluate the condition of the fetus and placenta, and also predict pregnancy outcomes ( 8 ). Monitoring CA125 levels has high clinical value for assessing patient prognosis ( 9 ). INH-A is essential for endometrial decidualization and embryo implantation and development, and can promote the secretion of reproductive hormones such as β-HCG and P, and generate red blood cells. Thus, it can be used to assess pregnancy status and fetal growth and development( 10 ). After treatment, serum levels of β-HCG, P, E2, and INH-A in both groups increased compared to before treatment, with the observation group levels higher than those in the control group, showing statistical significance. Meanwhile, serum CA125 levels decreased compared to before treatment, with the observation group having levels lower than those in the control group, also showing statistical significance. These results indicate that the treatment plan of GBATD combined with dydrogesterone can provide more support regarding reproductive hormones for the fetal source, thus being more beneficial for fetal growth and development, improving the prognosis of early threatened miscarriage, and maintaining better efficacy in pregnancy. The S/D, PI, and RI values decreased after treatment using ultrasound monitoring of the uterine artery blood flow indices (S/D, PI, and RI) before and after treatment in both groups, indicating that this treatment plan can optimize uterine artery blood flow perfusion and facilitate the nutritional supply route between the mother and fetus. This shows that the Chinese medicine group can maintain pregnancy by regulating hormone levels and improving the overall health status of the mother, boosting immunity, thereby providing better protection for the healthy development of the fetus. Previous studies have explored the efficacy of a single dose of dydrogesterone; nonetheless, there is a lack of systematic research on the combined use of Chinese medicine and modern drugs. TCM has significant advantages in improving the symptoms and signs of spleen and kidney deficiency and alleviating patient suffering. Moreover, the combined treatment improved the overall effective rate (treatment group 87.88%, control group 66.67%, p < 0.05) and significantly increased the success rate of maintaining pregnancy (treatment group 90.91%, control group 66.67%, p < 0.05). This integrative treatment model shows good prospects in practical application, offering new approaches for managing early threatened miscarriage. The GBATD has achieved good therapeutic effects in the clinical treatment of recurrent miscarriage, focusing on "tonifying the kidney, strengthening the spleen, benefiting qi, and nourishing blood." In the formula, Eucommia bark is spicy and sweet, warm in nature, primarily entering the kidney meridian. Chinese teasel root is bitter and spicy, also warm, entering the liver and kidney meridians. Combining these two herbs achieves the effects of tonifying the kidney and benefiting qi, while also strengthening tendons and bones and stabilizing the fetus ( 11 , 12 ). Fried Atractylodes macrocephala primarily enters the spleen meridian and strengthens the spleen, benefiting qi, and stabilizing the fetus ( 13 ). These three herbs work together to tonify the kidney and strengthen the spleen, acting as the main herbs ( 14 ). Donkey-hide gelatin nourishes blood, softens the liver, stops bleeding, and stabilizes the fetus. Prince ginseng excels at benefiting qi, nourishing the stomach, strengthening the spleen, and generating fluids. Fried white peony root nourishes blood, astringes yin, and reduces pain. Perilla stem is spicy and sweet, disperses qi, soothes the liver and relieves depression, and regulates qi to stabilize the fetus. These four herbs assist the main herbs to strengthen the spleen, nourish blood, and stabilize the fetus, serving as ministerial herbs. Scutellaria baicalensis clears heat, cools blood, stops bleeding, and stabilizes the fetus, acting as an assistant herb. Honey-fried licorice acts as a messenger herb to harmonize and moderate the actions of the other herbs. Overall, the formula boosts without causing stagnation and nourishes without being heavy, collectively achieving the effects of tonifying the kidney, strengthening the spleen, benefiting qi, and nourishing blood. The fetus is secured when qi is abundant and nourished when blood is abundant. Thus, tonifying the kidney and strengthening the spleen solidifies the foundation, while benefiting qi and nourishing blood stabilizes the fetus ( 15 ). Pharmacological studies report that Eucommia can inhibit the autonomous activity of the isolated uterus in rats, reducing the intensity and frequency of contractions, while also counteracting the uterine contractions triggered by posterior pituitary hormones. The alkaloids in Chinese teasel root can counteract oxytocin during pregnancy, thereby relaxing the smooth muscle of the uterus and reducing contractions. The α-boswellic acid in Atractylodes macrocephala can exert anti-infection effects, regulate hormone levels, and provide nutritional support in treating threatened miscarriage. The components of white peony root, including paeoniflorin and butanol, can promote the formation of blood vessels at the maternal-fetal interface, thereby improving placental blood perfusion. GBATD maintains the mother's health by enhancing spleen and stomach function and boosting kidney qi, which helps improve the mother's physical condition and provides a good foundation for fetal growth and development, effectively reducing the risk of miscarriage and maintaining pregnancy stability. Our HPLC-MS analysis identified 17 major constituents in the GBATD formulation. Importantly, the pharmacological actions of these compounds, as detailed in extensive literature, align synergistically with the observed therapeutic outcomes. This provides a compelling multi-targeted mechanism for its efficacy in treating TA. Several components are directly involved in steroid hormone signaling and endometrial preparation. Corticosterone, a key glucocorticoid, is involved in stress response and metabolic regulation. Its modulation may help create a conducive endocrine environment for pregnancy ( 16 ). Wogonin, a flavonoid known for its anti-inflammatory and phytoestrogenic properties, may enhance uterine receptivity by modulating estrogen receptor signaling ( 17 ). Furthermore, Deoxycholic acid and β-Muricholic acid, as bile acids, are now recognized as signaling molecules that can activate membrane receptors (TGR5) and nuclear receptors (FXR). This activation can influence metabolic homeostasis and potentially impact steroid hormone metabolism ( 18 ). The essential fatty acids Linoleic acid (LA) and α-Linolenic acid (ALA) are precursors to prostaglandins, which are vital mediators of ovulation, implantation, and the decidualization process ( 19 ). The presence of DL-Tryptophan, a precursor to serotonin, indicates a potential role in regulating mood and neurological functions, which could indirectly influence the hypothalamic-pituitary-gonadal axis ( 20 ). Another significant advantage of the GBATD combination therapy is its potent immunomodulatory capacity, addressing the chronic inflammatory state often associated with TA. Wogonin, a powerful NF-κB inhibitor, effectively suppresses the production of pro-inflammatory cytokines( 21 ). The omega-3 fatty acids Docosahexaenoic acid and Oleic Acid are precursors to specialized pro-resolving mediators, which actively promote the resolution of inflammation rather than mere immunosuppression ( 22 ). This transition from a pro-inflammatory to an anti-inflammatory and pro-resolving milieu is critical for maternal immune tolerance towards the semi-allogeneic embryo. The epoxy fatty acid (±)11( 12 )-EET, an epoxyeicosatrienoic acid, also shows anti-inflammatory and vasoprotective effects ( 23 ). Improved uterine perfusion, evidenced by the reduced PI and RI values in our Doppler ultrasound results, is fundamental to the therapy's success. Multiple factors contribute to this effect. Docosahexaenoic acid and eicosapentaenoic acid enhance blood flow and vascular function by improving the synthesis of endothelial nitric oxide and increasing erythrocyte membrane fluidity ( 24 ). Oleic and Stearic acids are involved in cell membrane integrity and fluidity ( 25 ). Dibutyl phthalate and Di(2-ethylhexyl) phthalate are environmental contaminants with known toxicities; however, their presence in herbs could potentially interact with various biological systems. However, their role in the therapeutic effect is likely ancillary and requires careful toxicological evaluation ( 26 ). The primary hemodynamic benefits are likely driven by the beneficial fatty acids and other active components. GBATD’s superiority over conventional single-pathway interventions (hormone supplementation alone) stems from this multi-component, multi-target, and multi-pathway approach. A progesterone supplement may only provide luteal phase support; nevertheless, GBATD concurrently modulates hormones and prepares the endometrium through multiple signaling layers (steroid, lipid, and bile acid signaling). GBATD shifts the uterine immune environment from a hostile state to a more tolerant one by simultaneously inhibiting NF-κB and promoting inflammation resolution. GBATD also improves the delivery of nutrients and oxygen to the endometrium by improving vascular function. In conclusion, the chemical profile of GBATD is not a mere list of constituents but a rational combinatorial pharmacopeia. Each component contributes to a network of pharmacological actions that converge on the shared therapeutic goal of improving reproductive outcomes. This synergistic network effect exemplifies the core principle of traditional medicine and provides a scientific rationale for the clinical advantage of using a complex herbal formulation instead of targeted monotherapies. Several studies have also explored the mechanisms and efficacy of TCM in treating recurrent pregnancy loss. Clinical cases indicate that older patients with diminished ovarian reserve and recurrent pregnancy loss can improve their pregnancy outcomes and achieve full-term live births through 6 months of weekly acupuncture and herbal treatment ( 27 ). The Anzi Tiao Chong Formula targets vascular endothelial growth factor A, interleukin-6, and STAT3 to inhibit inflammatory responses and promote placental cell activity (HTR-8/SVneo), with its key ingredients, liquiritigenin and nobiletin, identified as critical components ( 28 ). The Jiawei Shoutai Wan improves miscarriage outcomes by inhibiting ferroptosis, which is shown by reduced lipid peroxidation products (MDA), increased glutathione levels, and increased levels of ferroptosis inhibitory proteins GPX4 and SLC7A11( 29 ). The Chai Ge Kang Yi Formula addresses insulin resistance-related recurrent pregnancy loss by activating the interleukin-6/AKT1/STAT3 signaling pathway. This activation promotes the growth of endometrial stromal cells and enhances endometrial receptivity ( 30 ). However, studies still have limitations. Systematic reviews indicate that evaluating its efficacy is tough because there aren't enough high-quality randomized controlled trials and standardized treatment protocols despite TCM's application history of over 2000 years in Asian countries ( 31 ). Future research should integrate network pharmacology, molecular docking, and multi-omics technologies to clarify the multi-target action mechanisms of TCM and establish standardized treatment protocols through larger clinical trials. Despite the encouraging results of existing studies, limitations still exist. First, GBATD, as a TCM treatment, has a complex composition involving the synergistic effects of various herbs, thus lacking sufficient research on specific mechanisms. Dydrogesterone, as a Western medicine, has a relatively clear mechanism of action; however, the interactions and specific biological mechanisms of the combined use with the decoction need further exploration and validation. Second, different studies may provide different results owing to factors such as sample size, research design, and individual patient differences. Future research should concentrate on the diversity and representativeness of samples in design to enhance the reliability and generalizability of research findings. Future studies should also consider the long-term effects of combined treatment. Current research indicates that GBATD combined with dydrogesterone can improve symptoms and increase fetal survival rates in the short term; nonetheless, its long-term impacts remain unclear. Questions such as whether long-term use of Chinese medicine poses potential risks to the health of the mother and fetus, or whether there are individual differences in maintaining efficacy, are issues that require exploration in future research. In the study of early threatened miscarriage characterized by spleen and kidney deficiency, while existing clinical observations provide some data on treatment effects, our understanding of the specific mechanisms is still limited. Therefore, future research should strengthen the in-depth exploration of treatment mechanisms, especially the mechanisms of action of combined Chinese and Western medicines, including the components of GBATD and their roles in regulating immune function, improving the endocrine environment, and modulating cell proliferation, apoptosis, and inflammatory responses. The use of animal models for experiments can provide clearer observations of the effects of the drugs on embryo development, the maternal-fetal interface, and related signaling pathways, thereby providing a more solid theoretical basis for clinical application. This study is a retrospective analysis with a relatively small sample size from a single center, and its findings should be interpreted as preliminary and hypothesis-generating. Larger-scale, multi-center prospective studies are required in the future to further validate these results. In summary, in the study of early threatened miscarriage characterized by spleen and kidney deficiency, the efficacy of GBATD combined with dydrogesterone has been positively validated. This study shows that this combined treatment effectively improves patients' symptoms and significantly increases fetal survival rates using systematic clinical observation and data analysis, offering a new and effective treatment option for patients facing early threatened miscarriage due to spleen and kidney deficiency. Declarations 5 Conflict of Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 6 Author Contributions Xuebing Li: Investigation, Methodology, Software, Data curation, Writing-original draft, Writing-review & editing; Yang Wang: Methodology, Data curation, Writing-original draft, Writing-review & editing; Zhuoxuan Su: Methodology, Writing-review & editing; Lu Pei: Writing-review & editing; Chunxia Wang: Writing-review & editing; Yongwei Li: Conceptualization, Writing-review & editing, Supervision, Funding acquisition. 7 Funding The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Key Research Project of Higher Education Institutions in Henan Province (24A320007); Henan Province Medical Science and Technology Key Projects (LHGJ20240657); Henan Province Science and Technology Key Project (252102310471); Zhengzhou Municipal Bureau of Science and Technology(232102310207). 8 Acknowledgments The authors thank all members of the Henan Provincial Hospital of Traditional Chinese Medicine . We would like to thank Editage (www.editage.cn) for English language editing. 9 Ethics approval The ethics committee of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine (NO.1626-02) approved this study. This study followed the Declaration of Helsinki. Each participant provided informed consent. 10 Data availability All data and materials are accessible upon request from the corresponding author. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. References Kriplani A, Kamilya GS, Devi TR, Taneja A, Pawar A, Nagesh GK, et al. Oral dydrogesterone versus oral micronized progesterone in threatened miscarriage: protocol paper for a randomized controlled trial. Reprod fertility. 2025;6(1). 10.1530/raf-24-0044 . Epub 2025/01/20 22:54. Xiong Y, Liu C, Li M, Qin X, Guo J, Wei W, et al. The use of Chinese herbal medicines throughout the pregnancy life course and their safety profiles: a population-based cohort study. Am J Obstet Gynecol MFM. 2023;5(5):100907. 10.1016/j.ajogmf.2023.100907 . Epub 2023/02/23. Xu Y, Hu X, Ai KL, Sun ZG, Song JY. Gushen Antai pill for expected normal ovarian responders undergoing IVF-ET (GSATP-FreET): interim analysis of a randomized controlled trial. Contracept reproductive Med. 2025;10(1):19. 10.1186/s40834-025-00352-9 . Epub 2025/03/14. Haas DM, Bofill Rodriguez M, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. The Cochrane database of systematic reviews. 2025;6(6):Cd003511. Epub 2025/06/11. 10.1002/14651858.CD003511.pub6 . PubMed PMID: 40497447; PubMed Central PMCID: PMCPMC12153038 Cochrane Central Editorial Unit but receives no compensation for that work. Additionally, he had no editorial responsibilities or influence on this review. Magdalena Bofill: Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Description: I am employed to prepare evidence summaries for RANZCOG guidelines and the review is used as evidence. End Date: ongoing/no known end date. Taylor J Hathaway: none known related to this work. Patrick S Ramsey: Texas Collaborative for Healthy Mothers and Babies: I serve as Chief Medical Officer for TCHMB - TCHMB is the state perinatal quality collaborative. I receive 0.2 FTE to protect my time for my work in this role. UpToDate web‐based resource ‐ Author of ‘Obesity in Pregnancy’ chapter. Yang M, Luo J, Yang Q, Xu L. Research on the medication rules of Chinese herbal formulas on treatment of threatened abortion. Complementary therapies in clinical practice. 2021;43:101371. Epub 2021/03/25. 10.1016/j.ctcp.2021.101371 . PubMed PMID: 33761430. Yang Z, Chen K, Zhang Y, Xu B, Huang Y, Zhang X, et al. Study on pharmacokinetic and tissue distribution of hyperin, astragalin, kaempferol-3-O-β-D-glucuronide from rats with multiple administrations of Semen Cuscutae processed with salt solution with effect of treating recurrent spontaneous abortion. Front Pharmacol. 2024;15:1440810. 10.3389/fphar.2024.1440810 . Epub 2024/10/01. Farzaneh F, Ashrafi M, Mohammad Beigi R, Azadbakht T, Mohazzab A, Esmael E. Serum Progesterone Levels on the Day of Oocyte Retrieval as a Predictor of Pregnancy Outcomes in Fresh Embryo Transfer Cycles. J Reprod infertility. 2024;25(4):272–80. 10.18502/jri.v25i4.18125 . Epub 2025/05/12. Yan Y, Zhang J, Li W, Yin X. Value analysis of serum β -HCG, AMH, and P/E(2) for predicting freeze-thaw embryo transfer outcomes in patients with thin endometrium. Pakistan J Med Sci. 2025;41(4):973–8. 10.12669/pjms.41.4.9980 . Epub 2025/04/28. Gholami H, Garrosi L, Tofighi S, Ghadimi Z. The association among cancer-antigen-125 and pre-eclampsia and estimated fetal weight: A case-control study. 2024;22(8):651–60. 10.18502/ijrm.v22i8.17238 . PubMed PMID: 39494118. Hagg A, O'Shea E, Harrison CA. Targeting activins and inhibins to treat reproductive disorders and cancer cachexia. 2023;258(1). 10.1530/joe-22-0290 . PubMed PMID: 37194642. Shan ZF, Chen Y, Zhao YY, Mi WY, Liu L, Zheng XK, et al. [Duzhong Butiansu Capsules for improving fertility in male mice]. Zhonghua nan ke xue = Natl J Androl. 2020;26(5):457–63. Epub 2020/12/24. PubMed PMID: 33354957. Hyun JY, Jung HS, Park JY. Herbal therapeutics for female infertility: A systematic review and meta-analysis. J Ethnopharmacol. 2024;319(Pt 2):117258. 10.1016/j.jep.2023.117258 . Epub 2023/10/02. Dang CX, Wang D, Liu PF, Liu JX, Yu X. Network pharmacological analysis and molecular docking of Huangqin-Baizhu herb pair in the treatment of threatened abortion. Medicine. 2022;101(36):e30417. 10.1097/md.0000000000030417 . Epub 2022/09/11. Huang YT, Wang MC, Liao JA, Chen WC, Chou YT, Cheng WJ. Efficacy of Chinese herbal medicines combined with high-intensity focused ultrasound for patients with uterine fibroids: A meta-analysis with core herbs exploration. Phytomedicine: Int J phytotherapy phytopharmacology. 2025;143:156811. 10.1016/j.phymed.2025.156811 . Epub 2025/05/11. Jin H, Cheng J, Li H, Huang W, Lin D. Traditional Chinese medicine syndrome patterns in immune-related recurrent spontaneous abortion: A cross-sectional observational study based on cluster analysis. 2025;104(22):e42654. 10.1097 /md.0000000000042654. PubMed PMID: 40441183. Harders EP, Charboneau C, Paitz RT. Extraembryonic metabolism of corticosterone protects against effects of exposure. Gen Comp Endocrinol. 2024;347:114439. 10.1016/j.ygcen.2023.114439 . Epub 2024/01/02. Lu JJ, Zhou FM, Hu XJ, Fang JJ, Liu CX, Zhu BQ, et al. Molecular docking simulation and in vitro studies on estrogenic activities of flavonoids from leaves of Carya cathayensis Sarg. Steroids. 2020;163:108726. 10.1016/j.steroids.2020.108726 . Epub 2020/09/06. Bellafante E, McIlvride S, Nikolova V, Fan HM, Manna LB, Chambers J, et al. Maternal glucose homeostasis is impaired in mouse models of gestational cholestasis. Sci Rep. 2020;10(1):11523. 10.1038/s41598-020-67968-6 . Epub 2020/07/15. Basak S, Vilasagaram S, Duttaroy AK. Maternal dietary deficiency of n-3 fatty acids affects metabolic and epigenetic phenotypes of the developing fetus. Prostaglandins, leukotrienes, and essential fatty acids. 2020;158:102109. Epub 2020/06/01. 10.1016/j.plefa.2020.102109 . PubMed PMID: 32474355. Carabelli B, Delattre AM, Waltrick APF, Araújo G, Suchecki D, Machado RB, et al. Fish-oil supplementation decreases Indoleamine-2,3-Dioxygenase expression and increases hippocampal serotonin levels in the LPS depression model. Behav Brain Res. 2020;390:112675. 10.1016/j.bbr.2020.112675 . Epub 2020/05/15. Jin T, Hu B, Zhang T, Wang J, Zhang D, Sheng Y, et al. Wogonin Inhibits Oxidative Stress in Hypoxia-Induced hCMEC/D3 Cells Through Suppressing CXCL8-Mediated TLR4/NF-κB. Pathway. 2025;39(7):e70390. 10.1002/jbt.70390 . PubMed PMID: 40613545. Muñoz Y, Mercado L, Farias C, Beyer MP, Alvear I, Echeverría F et al. Impact of polyunsaturated fatty acids during and pregnancy and lactation: A comprehensive review. Prostaglandins, leukotrienes, and essential fatty acids. 2024;203:102656. Epub 2024/11/01. 10.1016/j.plefa.2024.102656 . PubMed PMID: 39481326. Li X, Kempf S, Günther S, Hu J, Fleming I. 11,12-EET Regulates PPAR-γ Expression to Modulate TGF-β-Mediated Macrophage Polarization. 2023;12(5). 10.3390/cells12050700 . PubMed PMID: 36899838. Capece U, Gugliandolo S, Morciano C, Avolio A, Splendore A, Di Giuseppe G, et al. Erythrocyte Membrane Fluidity and Omega-3 Fatty Acid Intake: Current Outlook and Perspectives for a Novel. Nutritionally Modifiable Cardiovasc Risk Factor. 2024;16(24). 10.3390/nu16244318 . PubMed PMID: 39770939. Oberhauser L, Granziera S, Colom A, Goujon A, Lavallard V, Matile S, et al. Palmitate and oleate modify membrane fluidity and kinase activities of INS-1E β-cells alongside altered metabolism-secretion coupling. Biochim et Biophys acta Mol cell Res. 2020;1867(2):118619. 10.1016/j.bbamcr.2019.118619 . Epub 2019/12/10. Chen H, Liu J, Hu L, Yang J, Wang Y, Sun W, et al. Mycotoxins from Alternaria Panax, the specific plant pathogen of Panax ginseng. Mycology. 2023;14(4):381–92. PubMed PMID: 38187879; PubMed Central PMCID: PMCPmc10769115. Hullender Rubin L, Cantor D, Marx BL. Recurrent Pregnancy Loss and Traditional Chinese Medicine. Med Acupunct. 2013;25(3):232–7. 10.1089/acu.2012.0911 . Epub 2014/04/25. He S, Ma F, Li J, Liu DY, Wang ZW, Chen PD, et al. Identification of quality markers and mechanisms of Anzi Tiaochong Fang in the treatment of antiphospholipid syndrome-related recurrent pregnancy loss: chemical analysis, network pharmacology, and in vitro approaches. BMC Complement Med Ther. 2025;25(1):20. 10.1186/s12906-025-04752-x . Epub 2025/01/23. Lai Y, Zhang Y, Zhang H, Chen Z, Zeng L, Deng G, et al. Modified Shoutai Pill inhibited ferroptosis to alleviate recurrent pregnancy loss. J Ethnopharmacol. 2024;319(Pt 2):117028. 10.1016/j.jep.2023.117028 . Epub 2023/08/20. Wu J, Pan Y, Lu Y, Qian J, Zhang J, Xue Y, et al. Exploring the mechanisms of Chaige Kangyi Recipe in treating recurrent pregnancy loss with insulin resistance. Sci Rep. 2025;15(1):13866. 10.1038/s41598-025-98869-1 . Epub 2025/04/23. Sun D, Lu S, Gan X, Lash GE. Is there a place for Traditional Chinese Medicine (TCM) in the treatment of recurrent pregnancy loss? J Reprod Immunol. 2022;152:103636. 10.1016/j.jri.2022.103636 . Epub 2022/05/15. Tables Table 1 Eligibility criteria. Inclusion criteria 1. Must meet Western medical diagnostic criteria: ① History: amenorrhea for up to 12 weeks and/or early pregnancy symptoms; ② Clinical symptoms: slight vaginal bleeding or brown discharge without expulsion of suspected pregnancy tissue, or accompanied by lower abdominal pain or lumbar pain; ③ Specialized examination: membranes intact, cervix closed, soft uterus with size consistent with gestational age; ④ Imaging examination: B ultrasound confirms intrauterine pregnancy, with gestational sac size and embryo development consistent with gestational age; ⑤ Laboratory examination: serum human chorionic gonadotropin (β-HCG), progesterone (P), and estradiol (E2) levels indicating pregnancy, with values consistent with gestational age. 2. Must meet Traditional Chinese Medicine diagnostic criteria: (1) Main symptoms: ① slight vaginal bleeding or brown discharge that is pale or dark and thin in consistency; ② dull or dragging pain in the lower abdomen; ③ weakness in the lower back and knees; ④ fatigue and lethargy. (2) Secondary symptoms: ① dizziness, tinnitus; ② frequent night urination; ③ pale or dull complexion; ④ abdominal distension and poor appetite; ⑤ loose stools. Tongue and pulse: pale tongue, possibly with tooth marks, white and moist coating, pulse slippery, deep, thin, and weak. Main symptoms must be present, and at least one secondary symptom must be present to diagnose Spleen and Kidney Yang Deficiency. 3. Age 20-35 years; early pregnancy (gestational age 5-8 weeks); patients must have a requirement for pregnancy maintenance and have signed an informed consent. Exclusion Criteria 1. Anyone who doesn't meet the inclusion criteria for both Western and Traditional Chinese Medicine, or those who conceived through assisted reproductive technology or received other pregnancy maintenance treatments after conception; 2. Patients with recurrent miscarriage, molar pregnancy, multiple pregnancies (including twins), uterine fibroids, anatomical abnormalities of the uterine cavity, or cervical bleeding, and those with serious diseases of the heart, liver, or kidneys; 3. Maternal infections with mycoplasma or chlamydia, thyroid dysfunction; those with mental illnesses who cannot take medication as prescribed; those with allergic constitutions or allergies to the components of the drugs used in this study; 4. Those who have recently taken similar medications, making efficacy difficult to determine. Dropout and Discontinuation Criteria 1. Patients who fail to adhere to the prescribed medication regimen or who discontinue their use independently. 2. Individuals who are concurrently utilizing other prescription drugs that may compromise the integrity of the study outcomes during the treatment phase. 3. Patients who encounter adverse effects from the medications that hinder their ability to persist with the treatment protocol. Table 2 Groups and interventions Groups Intervention Control group: Dydrogesterone Group Dydrogesterone was started with a dose of 40 mg, then taking 10 mg every 8 h for 14 days without tapering. Also known as Duphaston, produced by Abbott Healthcare Products B.V., imported drug registration number H20170221, specification: 10mg*20 tablets Observation group: GBATD+ Dydrogesterone GBATD was administered with 200 ml of warm water, one dose daily divided into two doses after meals, and Dydrogesterone was administered in the same manner as in the control group. The preparation room of Henan Provincial Hospital of Traditional Chinese Medicine provides GBATD, Table 3 Study objectives Primary objective To compare the success rate of pregnancy maintenance before 12 weeks of gestation between pregnant women with threatened miscarriage treated with GBATD combined with Dydrogesterone and those receiving oral progesterone alone. Secondary objectives 1. To compare the traditional Chinese medicine syndrome efficacy assessment between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone, 2. To compare the time to symptom (vaginal bleeding and/or abdominal pain) resolution between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone, 3. To compare safety and observe and record adverse reactions between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone, 4. To compare laboratory and imaging examination indicators between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone: Table 4 Observation Indicators observation indicators 1, General observation indicators patients' names, patients' ages, obstetric history, menstrual history, number of miscarriages, other general information. 2, Safety observation indicators patients' vital signs, such as temperature, pulse, blood pressure, and respiration; safety indicators, such as blood, liver function, and kidney function tests. Efficacy indicators 1, Laboratory examination indicators: We drew fasting venous blood samples the morning after treatment and at the end of each course to detect and record serum β-HCG, P, E2, cancer antigen 125 (CA125), and inhibin A (INH-A) levels. Serum CA125 and E2 were measured using chemiluminescent microparticle immunoassay, serum INH-A was measured using enzyme-linked immunosorbent assay, and serum β-HCG and P were measured using fluorescence immunoassay. 2, Imaging examination indicators: Ultrasound examinations were performed before treatment and after the end of each course to detect uterine artery hemodynamic indicators, specifically including the ratio of peak systolic velocity to end-diastolic velocity (PSV/EDV, S/D), pulsatility index (PI), and resistance index (RI) of the uterine artery. The sums of bilateral S/D, PI, and RI were recorded, and the size of the gestational sac and embryo development were examined. All measurements were conducted in the Reproductive Medicine Department of Henan Provincial Hospital of Traditional Chinese Medicine, with results uniformly recorded by researchers. 3, Traditional Chinese Medicine syndrome scoring The syndrome scoring was based on "Traditional Chinese Gynecology": scoring was performed based on the patient's symptoms and signs, with main and secondary symptoms graded as none, mild, moderate, or severe. Main symptoms were scored as 0, 2, 4, or 6 points, and secondary symptoms as 0, 1, 2, or 3 points. Evaluations were conducted before treatment and after the end of the course, with higher scores indicating more severe symptoms. Efficacy Assessment Criteria 1, Traditional Chinese Medicine syndrome efficacy assessment Cure: The Traditional Chinese Medicine syndrome disappears or is nearly gone, n ≥95%; marked effect: Traditional Chinese Medicine syndrome significantly improves compared with that before treatment, with symptom scores reduced, 70% ≤ n < 95%; effective: Traditional Chinese Medicine syndrome is alleviated compared with that before treatment, 30% ≤ n < 70%; ineffective: no improvement in Traditional Chinese Medicine syndrome, n < 30%. Note: Effective rate = [(Number of cured + marked effect + effective cases) / Total cases] × 100%. 2, Comprehensive efficacy assessment criteria Cure: vaginal bleeding stops within 5 days after treatment, and lower abdominal pain and lumbar discomfort symptoms disappear. Ultrasound examination shows that the size of the uterus and embryo development are consistent with gestational age. marked effect: vaginal bleeding stops within 7 days after treatment, and lower abdominal pain and lumbar discomfort symptoms significantly improve. Ultrasound examination shows that the size of the uterus and embryo development are consistent with gestational age. Effective: vaginal bleeding stops within 10 days after treatment, and lower abdominal pain and lumbar discomfort symptoms are somewhat alleviated. Ultrasound examination shows that the size of the uterus and embryo development are basically consistent with gestational age. Ineffective: vaginal bleeding lasts more than 10 days without stopping, and lower abdominal pain and lumbar discomfort symptoms show no improvement or worsen. Ultrasound examination shows that the size of the uterus is basically consistent with or smaller than gestational age, but embryo development is poor or fetal arrest occurs, even leading to inevitable miscarriage. 3, Success rate of pregnancy maintenance at 12 weeks success rate of pregnancy maintenance = number of cases at 12 weeks/number of observed cases × 100%. 4, Observation and recording of adverse reactions observe and record whether patients experience allergies, liver function, and kidney function damage during the trial, and analyze the correlation with the trial. Table 5 Comparison of General data Factor Observation Group(n=33) Control Group(n=33) t/Z P Age(years) 30.48±2.73 30.06±3.21 0.578 0.775 Gestational days 40.97±2.16 41.06±1.73 -1.89 0.851 Number of Miscarriages (Times) Median（ IQR ） 1（1） 1（1） -0.094 0.925 Vaginal Bleeding Time (day) Median（ IQR ）， 2（2） 2（1） -0.476 0.634 β-HCG（mIU/ml） 17120.85±5023.83 16228.09±4477.93 0.762 0.449 P（ng/ml） 20.48±2.29 20.67±2.50 0.310 0.758 E 2 （pg/ml） 384.39±70.42 359.70±80.69 1.325 0.190 CA125（U/ml） 36.98±4.70 36.89±3.72 0.084 0.933 INH-A（pg/ml） 338.50±28.18 337.22±26.69 0.190 0.850 PI 5.09±0.67 5.23±0.75 -0.777 0.440 RI 1.69±0.10 1.69±0.11 0.116 0.908 S/D 14.99±3.05 15.20±3.12 -0.274 0.785 TCM syndrome scoring(scores)Median (IQR) 29（7） 29（4） -0.980 0.327 Table 6 Comparison of spleen and kidney deficiency syndrome scores between the two groups of patients before and after treatment [Median ( IQR ), points] Group Pre-treatment score Post-treatment score Z * P Observation group 29（7） 6（8.5） * △ -6.361 <0.0001 Control group 29（4） 20（18） * -6.039 <0.0001 Z -0.980 -3.028 △ P 0.327 0.002 Compared with the pre-treatment of the observational group, *P < 0.05 (determined using the Wilcoxon signed-rank test); compared with the post-treatment of the control group, △ P < 0.05 (determined using the Mann-Whitney U test) Table 7 Comparison of curative effects of spleen and kidney deficiency syndrome between the two groups of patients after treatment (%) Group Cases Curative effects Total effective rate P Cure Marked effective Effective Ineffective Curative effects of spleen and kidney deficiency syndrome Observation group 33 13 12 5 3 90.91% 0.047 Control group 33 6 8 9 10 69.70% Comprehensive effective rate comparison Observation group 33 12 13 4 4 87.88% 0.045 Control group 33 3 7 12 11 66.67% Comparison of the total effective rate between the observation and control groups after treatment. P < 0.05 (determined using Fisher’s exact test for total effective rate) Table 8 Comparison of the overall effective rate between the two groups of patients after treatment (%) Group Cases Curative effects Total effective rate P Cure Markedly effective Effective Ineffective Observation group 33 12 13 4 4 87.88% 0.045 Control group 33 3 7 12 11 66.67% The comparison of the total effective rate between the observation and control groups after treatment. P < 0.05 (determined using Fisher’s exact test for total effective rate) Table 9 Comparison of the successful rate of pregnancy maintenance at 12 weeks between the two groups of patients after treatment (%) Group Cases Success Failure Success rate P Observation group 33 30 3 90.91% 0.020 Control group 33 22 11 66.67% Compared with the successful rate of pregnancy maintenance in the control group after treatment, P＜0.05 (determined using Fisher’s exact test for success rate) Table 10 The main active components based on several criteria RT [min] Name Formula Predicted Molecular Weight Measured Molecular Weight △ppm MS2 Reference Ion 1 7.261 DL-Tryptophan C 11 H 12 N 2 O 2 204.08988 204.0902 1.665932676 118.06555,146.06015,188.07083 [M+H-NH3]+1 2 15.75 Dibutyl phthalate C 16 H 22 O 4 278.15181 278.1527 3.235643155 149.02333 [M+H]+1 3 15.819 Corticosterone C 21 H 30 O 4 346.21441 346.2151 1.877449295 97.06538,121.06512,329.21106,347.22159 [M+H]+1 4 16.586 Wogonin C 16 H 12 O 5 284.06847 284.0691 2.288180733 270.05240,285.07587 [M+H]+1 5 17.137 Bis(4-ethylbenzylidene)sorbitol C 24 H 30 O 6 414.20424 414.2045 0.579424296 119.08578 [M+H]+1 6 17.862 Dipropyleneglycol dibenzoate C 20 H 22 O 5 342.14672 342.1472 1.490588599 105.03395,163.07538 [M+Na]+1 7 17.878 3,5-di-tert-Butyl-4-hydroxybenzaldehyde C 15 H 22 O 2 234.16198 234.1623 1.494691837 57.07084,179.10674,235.16916 [M+H]+1 8 18.529 Deoxycholic acid C 24 H 40 O 4 392.29266 392.2931 1.019646914 391.28555 [M+FA-H]-1 9 18.694 β-Muricholic acid C 24 H 40 O 5 408.28757 408.2878 0.661298604 407.2803 [M-H]-1 10 19.424 Citroflex A-4 C 20 H 34 O 8 402.22537 402.2265 2.68506186 129.01846,139.00270,157.01328,185.08112 [M+Na]+1 11 19.715 (±)11(12)-EET C 20 H 32 O 3 320.23514 320.2352 0.062454108 59.01237,179.10698,257.22748,301.21756,319.22815 [M-H]-1 12 20.275 Docosahexaenoic acid C 22 H 32 O 2 328.24023 328.2408 1.645136551 91.05477,117.07011,131.08565,329.24585 [M+H]+1 13 22.084 Linoleic acid C 18 H 32 O 2 280.24023 280.2404 0.535255056 279.23322 [M-H]-1 14 22.831 Oleic Acid C 18 H 34 O 2 282.25588 282.2561 0.850292295 281.24875 [M-H]-1 15 22.988 Di(2-ethylhexyl) phthalate C 24 H 38 O 4 390.27701 390.2772 0.461210872 57.07085,71.08638,149.02339,167.03400 [M+Na]+1 16 23.021 1-Stearoylglycerol C 21 H 42 O 4 358.30831 358.3083 -0.139544628 57.07085,71.08639,95.08611,267.26813,341.30493 [M+Na]+1 17 23.905 Stearic acid C 18 H 36 O 2 284.27153 284.2717 0.703552691 283.26465 [M-H]-1 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 02 Mar, 2026 Read the published version in Contraception and Reproductive Medicine → Version 1 posted Editorial decision: Revision requested 23 Jan, 2026 Reviews received at journal 22 Jan, 2026 Reviews received at journal 15 Jan, 2026 Reviewers agreed at journal 14 Jan, 2026 Reviewers agreed at journal 13 Jan, 2026 Reviewers agreed at journal 12 Jan, 2026 Reviewers invited by journal 12 Jan, 2026 Editor assigned by journal 05 Jan, 2026 Submission checks completed at journal 05 Jan, 2026 First submitted to journal 29 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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11:58:49","extension":"xml","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":158456,"visible":true,"origin":"","legend":"","description":"","filename":"6f22aaf1e1ba4633b197c3df7d24e32c1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/9a66299d509cc529f2d91a40.xml"},{"id":100399883,"identity":"6fc426ae-3ace-4be5-a429-1b6a618a2566","added_by":"auto","created_at":"2026-01-16 11:57:41","extension":"html","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":171036,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/31d2f118225eca83e90d9f85.html"},{"id":100401816,"identity":"5d521089-1d10-465b-a6ba-da7ff623edb9","added_by":"auto","created_at":"2026-01-16 11:59:20","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1627403,"visible":true,"origin":"","legend":"\u003cp\u003eThe scientific name, used plant part, and traditional Chinese name and dosage of herbal medicine of Gu Ben An Tai tin decoction.\u003c/p\u003e","description":"","filename":"Figure1.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/6032824d2cd26e4ad1218d17.jpg"},{"id":100402330,"identity":"1dcf70b3-1c5c-4ce4-ad02-8d0991f0d3e0","added_by":"auto","created_at":"2026-01-16 12:00:00","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":844121,"visible":true,"origin":"","legend":"\u003cp\u003eThe expression and comparison of serological indicators and hemodynamic indicators before and after treatment in the control groups and observation groups. Serological indicators, including (A)Estradiol, (B)HCG, (C)Progesterone, (D)CA125, (E)INH-A, and Hemodynamic Indicators (F)S/D, (G)RI, (H)PI. The black color shows the indicators change of the observation group before treatment and after treatment, while the gray color shows the indicators’ change in the control group before treatment and after treatment. *p \u0026lt; 0.05; **p \u0026lt; 0.01; ***p \u0026lt; 0.001, and ****p \u0026lt; 0.0001.\u003c/p\u003e","description":"","filename":"Figure2.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/1356d53b4196ac4e5c8ba9b9.jpg"},{"id":100402049,"identity":"a8cc6cf7-a9ec-48cb-9c6d-555b35a201e5","added_by":"auto","created_at":"2026-01-16 11:59:36","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":348027,"visible":true,"origin":"","legend":"\u003cp\u003eThe comparison of spleen and kidney deficiency syndrome scores before and after treatment. Blue represents before treatment, and orange represents after treatment.\u003c/p\u003e","description":"","filename":"Figure3.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/492a625071ce5b54fa442bb2.jpg"},{"id":100402206,"identity":"93b6c1b2-2041-4b5b-9484-a5625bed9548","added_by":"auto","created_at":"2026-01-16 11:59:48","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":586953,"visible":true,"origin":"","legend":"\u003cp\u003eA The mass spectrometry analysis of the chemical constituents in the herbal liquid of Gu Ben An Tai yin decoction and the serum from rats administered by gavage, as shown in the Venn diagram, represents the common chemical components of both. B The structure of the 17 main active components in Table 10.\u003c/p\u003e","description":"","filename":"Figure4.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/4dd41573a23a3bc70baf675b.jpg"},{"id":104250835,"identity":"199aa381-a11e-45ec-a20d-860c6f1fee78","added_by":"auto","created_at":"2026-03-09 16:09:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4659686,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8471415/v1/cb1a1384-fe22-4122-8855-718b9c57c381.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Observation of Gu Ben An Tai Decoction Combined with Dydrogesterone for Early Threatened Abortion Due to Spleen and Kidney Deficiency","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eEarly threatened abortion (TA) is a typical early pregnancy complication, affecting up to 20% of pregnancies. Threatened miscarriage is defined as vaginal bleeding before the 20-week gestation period, a closed cervix, and no fetal loss. It is associated with a higher risk of adverse pregnancy and perinatal outcomes, including preterm delivery, hypertensive disorders of pregnancy (HDP), antepartum hemorrhage, placental abruption, perinatal death, and small for gestational age (SGA) infants. The cause of TA\u0026rsquo;s underlying pathology is unclear, leading to limited treatment options and insufficient evidence for their effectiveness (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Consequently, many immune-based therapies have been used, including intravenous immunoglobulin, intrauterine leukocytes, endometrial scratch procedures, and steroids. However, empirical evidence supporting their ongoing use remains limited. Thus, patients and physicians have turned to alternative therapies, including Traditional Chinese Medicine (TCM) (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn TCM, key factors, including kidney essence (Jing), sexual function (Tian Gui), Qi, and Yin-Yang, provide energy and substance. They also create essential conditions and guide movement in reproductive immunology. The early signs of miscarriage due to a deficiency of the spleen and kidney are clinical manifestations in women during early pregnancy. The risk of miscarriage increases owing to weak spleen energy and insufficient kidney yin. In TCM theory, the spleen is responsible for transportation and transformation, while the kidney stores essence. These two systems are interconnected. Spleen deficiency causes a lack of source for producing qi and blood. Nevertheless, kidney deficiency causes an imbalance of yin and yang, often leading to poor fetal development and miscarriage. Therefore, regulating the spleen and kidney, and strengthening the foundation to support the pregnancy, becomes a key measure for preventing and treating early miscarriage. Research indicates that a deficiency of the spleen and kidney can lead to insufficient qi and blood, thereby affecting the uterus and increasing the risk of miscarriage (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). TCM has advantages and characteristics in achieving overall balance, syndrome differentiation treatment, and preventing disease in early signs of miscarriage. Combining TCM with Western medicine to treat this condition is effective, providing safe and effective treatment plans for improving reproductive function, promoting fertility, preserving pregnancy, and treating recurrent miscarriage (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe Gu Ben An Tai Decoction (GBATD) follows the TCM concept as a prescription for treating this condition, which states that \"the kidney is the source of our innate energy, while the spleen is the source of our acquired energy,\" and has the effects of tonifying the kidney, strengthening the spleen, and nourishing qi and blood. In this study, a retrospective analysis was conducted to preliminarily explore the effectiveness of GBATD combined with dydrogesterone compared to dydrogesterone alone in patients with early signs of miscarriage due to spleen and kidney deficiency, and provide a reference for designing larger, confirmatory studies in the future.\u003c/p\u003e"},{"header":"2 Materials and methods","content":"\u003ch2\u003e2.1 Gu Ben An Tai decoction composition\u003c/h2\u003e\n\u003cp\u003eFigure 1 shows the composition, usage parts, and dosage of GBATD for stabilizing the foundation and calming the fetus. The image is sourced from Plant Intelligence (https://www.iplant.cn/)\u003c/p\u003e\n\u003ch2\u003e2.2 Clinical data\u003c/h2\u003e\n\u003cp\u003eA retrospective analysis was conducted on 66 patients with early threatened miscarriage (Spleen and Kidney Yang Deficiency type). These patients were admitted between December 2022 and October 2023 to the Reproductive Medicine Department of Henan Provincial Hospital of Traditional Chinese Medicine. The patients were categorized into two groups based on their therapeutic regimen, with the control group, having 33 patients, treated with dydrogesterone, and the observation group, having 33 patients, treated with GBATD + dydrogesterone. Given the study\u0026rsquo;s exploratory nature, the sample size was determined primarily using the number of eligible individuals available at our institution during the study period, rather than using a formal power calculation. All data were extracted from our hospital\u0026apos;s electronic medical record system. The grouping of patients (treatment group vs. control group) was based on the actual treatment regimens they historically received, not randomized allocation by the investigators at the study\u0026apos;s inception. Table 1 shows the eligibility criteria.\u003c/p\u003e\n\u003cp\u003eThe ethics committee of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine (NO.1626-02) approved this study. This study followed the Declaration of Helsinki. Each participant provided informed consent.\u003c/p\u003e\n\u003ch2\u003e2.3 Treatment plans\u003c/h2\u003e\n\u003cp\u003eMedication was commenced in the groups following the symptoms of threatened miscarriage and confirmation of intrauterine pregnancy. Table 2 shows the treatment method, and each treatment course lasts 7 days, for a total of 2 treatment courses. After each course, relevant indicators were checked, and the pregnancy status was monitored. Adverse reactions were closely monitored during the treatment period. The data examined in this study compares patients\u0026apos; test results on the 14th day after treatment. This implies that there was no decrease in the dydrogesterone dosage and GBATD during this period.\u003c/p\u003e\n\u003ch2\u003e2.4 Observation indexes\u003c/h2\u003e\n\u003cp\u003eThe primary objective of this study is to compare the success rate of pregnancy maintenance before the 12-week gestation period between the two treatment groups. The secondary objectives were to compare the traditional Chinese medicine syndrome efficacy assessment, comprehensive efficacy assessment criteria, observation, and recording of adverse reactions between the two treatment groups (Table 3). When serious adverse events occur, the affected participant is immediately withdrawn from the study by the researchers.\u003c/p\u003e\n\u003ch2\u003e2.5 Efficacy assessment criteria\u003c/h2\u003e\n\u003cp\u003eTCM syndrome efficacy assessment and comprehensive efficacy assessment criteria were based on \u0026quot;standards for the diagnosis and efficacy of TCM diseases\u0026quot; and clinical considerations. The assessment criteria are shown in Table 4. TCM syndrome efficacy index (n) = [(Total score before treatment - Total score after treatment) / Total score before treatment] \u0026times; 100%.\u003c/p\u003e\n\u003cp\u003eThe Second Affiliated Hospital of Henan University of Traditional Chinese Medicine provided all Chinese medicines. The TCM pharmacy of the hospital identified all plants as genuine herbs. The composition, used plant part, traditional Chinese name, and dosage of GBATD are shown in Figure 1. All the herbs were soaked in distilled water for 30 min. Then, they were boiled at high heat before simmering for 1 h. After cooking, the mixture was filtered and concentrated, and stored in a refrigerator at 4\u0026deg;C until needed.\u003c/p\u003e\n\u003ch2\u003e2.6 Preparation of Gu Ben An Tai decoction containing serum\u003c/h2\u003e\n\u003cp\u003eSprague-Dawley rats received GBATD (12.375 g/kg/d) through gavage consecutively for 7 days. Blood samples were collected from the abdominal aorta 1 h after the final administration, centrifuged, and the upper layer of pale-yellow serum was collected as the GBATD-containing serum. All animal experimental procedures followed the National Guidelines for Animal Usage in Research in China. The Ethics Committee of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine approved all animal studies.\u003c/p\u003e\n\u003ch2\u003e2.7 Component analysis of Gu Ben An Tai decoction powder with high-performance liquid chromatography-mass spectrometry\u003c/h2\u003e\n\u003cp\u003eFirst, 50\u0026micro;L of serum containing GBAT was combined with 200 \u0026micro;L of methanol; then, 100\u0026micro;L of TCM extract was added to 400 \u0026micro;L of methanol. The solution was vortexed for 10 min to ensure it was thoroughly mixed. Following this, the solution was centrifuged at 13,000 rpm for 10 min, and then the supernatant was collected for the high-performance liquid chromatography-mass spectrometry (HPLC-MS) system. The HPLC operation was conducted using the UltiMate 3000RS (Thermo Fisher Scientific, USA) with an ACQUITY UPLC\u0026reg;BEH C18 column (2.1\u0026times;150mm, 1.8\u0026mu;m) (Thermo Fisher Scientific, USA). Mobile phase A and mobile phase B were methanol and 0.1% methanoic acid, respectively. The gradient was applied over specific time intervals: 0-1 min (98%B and 2%A), 1-5min (80%B and 20%A), 5-10 min (50%B and 50%A), 10\u0026ndash;15 min (20%B and 80%A), 15\u0026ndash;27 min (5%B and 95%A), 28\u0026ndash;30 min (98%B and 2%A). The flow rate was set at 0.3mL/min. The injection volume was 5\u0026mu;L, and the column temperature was maintained at 35\u0026deg;C. \u003c/p\u003e\n\u003cp\u003eThe high-resolution mass spectrometry conditions of the Q-Exactive (Thermo Fisher Scientific, USA) included ESI sources and a spray voltage of 3.2 kV for positive and negative modes. The capillary temperature was set to 300 \u0026deg;C. The Full mass/dd-MS\u003csub\u003e2\u003c/sub\u003e scanning mode was selected, allowing the simultaneous collection within a scan range of 100\u0026ndash;1500 m/z. The spray gas used was nitrogen, and a high-pressure collision gas was used. The obtained data is first organized with Compound Discoverer 3.3 (Thermo Fisher), and then compared against the mzCloud database.\u003c/p\u003e\n\u003ch2\u003e2.8 Statistical Processing\u003c/h2\u003e\n\u003cp\u003eSPSS 26.0 software and GraphPad Prism were used for statistical analysis and graphing. A two-sided P-value \u0026lt;0.05 was considered statistically significant, while a P-value \u0026gt;0.05 showed no statistical significance. Measurement data are shown as mean \u0026plusmn; standard deviation when they followed a normal distribution, or as median (interquartile range, IQR) otherwise. Categorical variables were shown as numbers (n) and percentages (%). The Shapiro-Wilk test was used to assess the normality of all continuous variables. For the continuous variables comparison of baseline characteristics between the two groups, the independent-samples t-test was used for normally distributed data, while the Mann-Whitney U test was used for non-normally distributed data. For continuous variables of intragroup comparisons (before vs after treatment), serological and hemodynamic indicators were determined using a paired-samples t-test when the differences between paired measurements were normally distributed; otherwise, the Wilcoxon signed-rank test was used. The TCM syndrome scores were analyzed using the Wilcoxon signed-rank test owing to their ordinal nature. For the continuous variables of intergroup comparisons after treatment, the independent-samples t-test or Mann-Whitney U test was used based on data distribution. For categorical data (total effective rate, pregnancy retention rate), the Chi-square test was used. When the data did not meet the assumptions of the Chi-square test (\u0026gt;20% of cells with an expected count \u0026lt;5), Fisher\u0026rsquo;s exact test was used.\u003c/p\u003e"},{"header":"3 Results","content":"\u003ch2\u003e3.1 Comparison of general data\u003c/h2\u003e\n\u003cp\u003eNo significant differences were observed in the general data between the groups before treatment (number of miscarriages, vaginal bleeding time, and TCM syndrome scoring were determined by the Mann-Whitney U test, and the other indicators were determined by the independent samples t-test, all P\u0026gt;0.05), indicating that they can be compared (Table 5).\u003c/p\u003e\n\u003ch2\u003e3.2 Progesterone, estradiol, CA125, INH-A, and hemodynamic indicators S/D, PI, RI values before and after treatment between the groups, and comparison of serological indicators \u0026beta;-HCG\u003c/h2\u003e\n\u003cp\u003eAfter treatment, serum levels of estradiol (Figure 2A), \u0026beta;-HCG(Figure 2B), progesterone (P) (Figure 2C), and Inhibin A (INH-A) (Figure 2E) increased in the groups compared to their levels before treatment (by paired t-test, P\u0026lt;0.05), with the observation group showing significantly higher levels than the control group (determined by independent samples t-test, P\u0026lt;0.05). Conversely, serum CA125 (Figure 2D), S/D (Figure 2F), pulsatility index (PI) (Figure 2G), and resistance index (RI) (Figure 2H) values decreased after treatment (by paired t-test, P\u0026lt;0.05), with the observation group showing significantly lower values than those in the control group (determined by independent samples t-test, P\u0026lt;0.05).\u003c/p\u003e\n\u003ch2\u003e3.3 Comparison of spleen and kidney deficiency syndrome scores before and after treatment and treatment efficacy for spleen and kidney deficiency syndrome between the groups after treatment\u003c/h2\u003e\n\u003cp\u003eAfter treatment, the scores for spleen and kidney deficiency syndrome decreased in the groups (determined by the Wilcoxon signed-rank test, P\u0026lt;0.05), with the observation group showing significantly lower scores than those in the control group (determined by the Mann-Whitney U test, P\u0026lt;0.05). (Figure 3 and Table 6).\u003c/p\u003e\n\u003cp\u003eIn the observation group of 33 patients, 13 were cured, 12 showed significant improvement, five were effective, and three were ineffective, leading to an overall effective rate of 90.91% of curative effects of spleen and kidney deficiency syndrome. In the control group, out of 33 patients, six were cured, eight showed marked improvement, nine were effective, and 10 were ineffective, resulting in an overall effective rate of 69.70% of curative effects of spleen and kidney deficiency syndrome. The observation group had a comprehensive effective rate of 87.88% and 66.67% in the control group. A Fisher\u0026rsquo;s exact test revealed a statistically significant difference in the total effective rates between the groups after treatment (determined by Fisher\u0026rsquo;s exact test for total effective rate, P\u0026lt;0.05) (Table 7). \u003c/p\u003e\n\u003ch2\u003e3.4 Comparison of overall effective rates between the groups after treatment\u003c/h2\u003e\n\u003cp\u003eIn the observation group of 33 patients, 12 were cured, 13 significantly effective, four effective, and four ineffective, resulting in a total effective rate of 87.88%. In the control group of 33 patients, three were cured, seven were significantly effective, 12 were effective, and 11 were ineffective, resulting in a total effective rate of 66.67%. A Fisher\u0026rsquo;s exact test was used to compare the total effective rates after treatment between the groups, showing a statistically significant difference (determined by Fisher\u0026rsquo;s exact test, P\u0026lt;0.05) (Table 8).\u003c/p\u003e\n\u003ch2\u003e3.5 Comparison of successful pregnancy retention rates at 12 weeks between the groups after treatment\u003c/h2\u003e\n\u003cp\u003eIn the observation group of 33 patients, 30 successfully carried the pregnancy to 12 weeks, while three did not, resulting in a success rate of 90.91%. In the control group of 33 patients, 22 successfully carried the pregnancy to 12 weeks, while 11 did not, resulting in a success rate of 66.67%. A Fisher\u0026rsquo;s exact test was used to compare the pregnancy retention success rates after treatment between the groups, showing a statistically significant difference (determined by Fisher\u0026rsquo;s exact test, P\u0026lt;0.05) (Table 9).\u003c/p\u003e\n\u003ch2\u003e3.6 Safety evaluation\u003c/h2\u003e\n\u003cp\u003eLiver, kidney, complete blood count, and coagulation tests were conducted in each group before and after treatment. No patient experienced any adverse reactions throughout the treatment, including allergies or damage to liver and kidney function.\u003c/p\u003e\n\u003ch2\u003e3.7 Gu Ben An Tai decoction chemical components analysis\u003c/h2\u003e\n\u003cp\u003eBased on HPLC-MS analysis, the chemical components in the herbal liquid of GBATD and the serum containing GBATD from mice were identified and compared to the mzCloud database. The analysis revealed a total of 693 compounds in the herbal liquid and 291 compounds in the serum. Among these, 404 compounds in the herbal liquid and 184 in the serum had a score \u0026gt;60 in the mzCloud best match. After removing duplicates, a Venn diagram that shows a total of 67 common components was created (Figure 4A). We screened for the main active components using the following criteria: mzCloud Best Match \u0026gt;80%, \u0026Delta;Mass \u0026lt;5 ppm (Annot. DeltaMass [Da]), retention time \u0026gt;2 min, and a match to the Mass List from the Natural Products Atlas 2020_06 (Figure 4B and Table 10).\u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eEarly threatened miscarriage is a common pregnancy complication. Drug interventions primarily involving dydrogesterone have been widely used to treat early threatened miscarriage; nevertheless, their efficacy remains uncertain (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Therefore, exploring new treatment methods to improve pregnancy outcomes is essential, especially in the population of patients experiencing early threatened miscarriage due to spleen and kidney deficiency, which is emphasized in TCM (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In TCM, spleen and kidney deficiency is believed to significantly affect pregnancy, particularly regarding fetal development and the physical condition of the mother. The spleen deficiency can cause a lack of qi and blood production in the mother, thus affecting fetal growth and development. Also, kidney essence deficiency may cause a retardation in fetal growth and even adverse outcomes, including miscarriage. Spleen and kidney deficiency weakens the mother's constitution, including some pregnancy-related complications, such as gestational hypertension and gestational diabetes, and results in symptoms, including lower back pain, fatigue, and weakness. These symptoms affect daily life and work, also causing emotional fluctuations in the mother during pregnancy. It further increases the risk of anxiety and depression, which is detrimental to maternal and fetal health (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile observing the efficacy of GBATD combined with dydrogesterone, the differences in efficacy between this combined treatment plan and the use of dydrogesterone alone were analyzed through a retrospective analysis. Baseline data of general information were compared between the two groups in this study, including age, days of amenorrhea, number of previous miscarriages, duration of illness, and serological and hemodynamic indicators, showing no statistical differences and comparability. Progesterone (P) can reduce the excitability of uterine smooth muscle during pregnancy, inhibit uterine contractions, and regulate immune response capabilities, thereby preventing the embryo from being rejected as a foreign body by the mother, thus maintaining pregnancy (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The doubling of serum β-HCG was used to assess whether the growth and development of the embryo were good. Estradiol (E2) can be used to assess luteal function during pregnancy and evaluate the condition of the fetus and placenta, and also predict pregnancy outcomes (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Monitoring CA125 levels has high clinical value for assessing patient prognosis (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). INH-A is essential for endometrial decidualization and embryo implantation and development, and can promote the secretion of reproductive hormones such as β-HCG and P, and generate red blood cells. Thus, it can be used to assess pregnancy status and fetal growth and development(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). After treatment, serum levels of β-HCG, P, E2, and INH-A in both groups increased compared to before treatment, with the observation group levels higher than those in the control group, showing statistical significance. Meanwhile, serum CA125 levels decreased compared to before treatment, with the observation group having levels lower than those in the control group, also showing statistical significance. These results indicate that the treatment plan of GBATD combined with dydrogesterone can provide more support regarding reproductive hormones for the fetal source, thus being more beneficial for fetal growth and development, improving the prognosis of early threatened miscarriage, and maintaining better efficacy in pregnancy. The S/D, PI, and RI values decreased after treatment using ultrasound monitoring of the uterine artery blood flow indices (S/D, PI, and RI) before and after treatment in both groups, indicating that this treatment plan can optimize uterine artery blood flow perfusion and facilitate the nutritional supply route between the mother and fetus. This shows that the Chinese medicine group can maintain pregnancy by regulating hormone levels and improving the overall health status of the mother, boosting immunity, thereby providing better protection for the healthy development of the fetus. Previous studies have explored the efficacy of a single dose of dydrogesterone; nonetheless, there is a lack of systematic research on the combined use of Chinese medicine and modern drugs. TCM has significant advantages in improving the symptoms and signs of spleen and kidney deficiency and alleviating patient suffering. Moreover, the combined treatment improved the overall effective rate (treatment group 87.88%, control group 66.67%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and significantly increased the success rate of maintaining pregnancy (treatment group 90.91%, control group 66.67%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). This integrative treatment model shows good prospects in practical application, offering new approaches for managing early threatened miscarriage.\u003c/p\u003e \u003cp\u003eThe GBATD has achieved good therapeutic effects in the clinical treatment of recurrent miscarriage, focusing on \"tonifying the kidney, strengthening the spleen, benefiting qi, and nourishing blood.\" In the formula, Eucommia bark is spicy and sweet, warm in nature, primarily entering the kidney meridian. Chinese teasel root is bitter and spicy, also warm, entering the liver and kidney meridians. Combining these two herbs achieves the effects of tonifying the kidney and benefiting qi, while also strengthening tendons and bones and stabilizing the fetus (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Fried Atractylodes macrocephala primarily enters the spleen meridian and strengthens the spleen, benefiting qi, and stabilizing the fetus (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). These three herbs work together to tonify the kidney and strengthen the spleen, acting as the main herbs (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Donkey-hide gelatin nourishes blood, softens the liver, stops bleeding, and stabilizes the fetus. Prince ginseng excels at benefiting qi, nourishing the stomach, strengthening the spleen, and generating fluids. Fried white peony root nourishes blood, astringes yin, and reduces pain. Perilla stem is spicy and sweet, disperses qi, soothes the liver and relieves depression, and regulates qi to stabilize the fetus. These four herbs assist the main herbs to strengthen the spleen, nourish blood, and stabilize the fetus, serving as ministerial herbs. Scutellaria baicalensis clears heat, cools blood, stops bleeding, and stabilizes the fetus, acting as an assistant herb. Honey-fried licorice acts as a messenger herb to harmonize and moderate the actions of the other herbs. Overall, the formula boosts without causing stagnation and nourishes without being heavy, collectively achieving the effects of tonifying the kidney, strengthening the spleen, benefiting qi, and nourishing blood. The fetus is secured when qi is abundant and nourished when blood is abundant. Thus, tonifying the kidney and strengthening the spleen solidifies the foundation, while benefiting qi and nourishing blood stabilizes the fetus (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Pharmacological studies report that Eucommia can inhibit the autonomous activity of the isolated uterus in rats, reducing the intensity and frequency of contractions, while also counteracting the uterine contractions triggered by posterior pituitary hormones. The alkaloids in Chinese teasel root can counteract oxytocin during pregnancy, thereby relaxing the smooth muscle of the uterus and reducing contractions. The α-boswellic acid in Atractylodes macrocephala can exert anti-infection effects, regulate hormone levels, and provide nutritional support in treating threatened miscarriage. The components of white peony root, including paeoniflorin and butanol, can promote the formation of blood vessels at the maternal-fetal interface, thereby improving placental blood perfusion. GBATD maintains the mother's health by enhancing spleen and stomach function and boosting kidney qi, which helps improve the mother's physical condition and provides a good foundation for fetal growth and development, effectively reducing the risk of miscarriage and maintaining pregnancy stability.\u003c/p\u003e \u003cp\u003eOur HPLC-MS analysis identified 17 major constituents in the GBATD formulation. Importantly, the pharmacological actions of these compounds, as detailed in extensive literature, align synergistically with the observed therapeutic outcomes. This provides a compelling multi-targeted mechanism for its efficacy in treating TA. Several components are directly involved in steroid hormone signaling and endometrial preparation. Corticosterone, a key glucocorticoid, is involved in stress response and metabolic regulation. Its modulation may help create a conducive endocrine environment for pregnancy (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Wogonin, a flavonoid known for its anti-inflammatory and phytoestrogenic properties, may enhance uterine receptivity by modulating estrogen receptor signaling (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Furthermore, Deoxycholic acid and β-Muricholic acid, as bile acids, are now recognized as signaling molecules that can activate membrane receptors (TGR5) and nuclear receptors (FXR). This activation can influence metabolic homeostasis and potentially impact steroid hormone metabolism (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). The essential fatty acids Linoleic acid (LA) and α-Linolenic acid (ALA) are precursors to prostaglandins, which are vital mediators of ovulation, implantation, and the decidualization process (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The presence of DL-Tryptophan, a precursor to serotonin, indicates a potential role in regulating mood and neurological functions, which could indirectly influence the hypothalamic-pituitary-gonadal axis (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Another significant advantage of the GBATD combination therapy is its potent immunomodulatory capacity, addressing the chronic inflammatory state often associated with TA. Wogonin, a powerful NF-κB inhibitor, effectively suppresses the production of pro-inflammatory cytokines(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The omega-3 fatty acids Docosahexaenoic acid and Oleic Acid are precursors to specialized pro-resolving mediators, which actively promote the resolution of inflammation rather than mere immunosuppression (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). This transition from a pro-inflammatory to an anti-inflammatory and pro-resolving milieu is critical for maternal immune tolerance towards the semi-allogeneic embryo. The epoxy fatty acid (\u0026plusmn;)11(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)-EET, an epoxyeicosatrienoic acid, also shows anti-inflammatory and vasoprotective effects (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Improved uterine perfusion, evidenced by the reduced PI and RI values in our Doppler ultrasound results, is fundamental to the therapy's success. Multiple factors contribute to this effect. Docosahexaenoic acid and eicosapentaenoic acid enhance blood flow and vascular function by improving the synthesis of endothelial nitric oxide and increasing erythrocyte membrane fluidity (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Oleic and Stearic acids are involved in cell membrane integrity and fluidity (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Dibutyl phthalate and Di(2-ethylhexyl) phthalate are environmental contaminants with known toxicities; however, their presence in herbs could potentially interact with various biological systems. However, their role in the therapeutic effect is likely ancillary and requires careful toxicological evaluation (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). The primary hemodynamic benefits are likely driven by the beneficial fatty acids and other active components. GBATD\u0026rsquo;s superiority over conventional single-pathway interventions (hormone supplementation alone) stems from this multi-component, multi-target, and multi-pathway approach. A progesterone supplement may only provide luteal phase support; nevertheless, GBATD concurrently modulates hormones and prepares the endometrium through multiple signaling layers (steroid, lipid, and bile acid signaling). GBATD shifts the uterine immune environment from a hostile state to a more tolerant one by simultaneously inhibiting NF-κB and promoting inflammation resolution. GBATD also improves the delivery of nutrients and oxygen to the endometrium by improving vascular function. In conclusion, the chemical profile of GBATD is not a mere list of constituents but a rational combinatorial pharmacopeia. Each component contributes to a network of pharmacological actions that converge on the shared therapeutic goal of improving reproductive outcomes. This synergistic network effect exemplifies the core principle of traditional medicine and provides a scientific rationale for the clinical advantage of using a complex herbal formulation instead of targeted monotherapies.\u003c/p\u003e \u003cp\u003eSeveral studies have also explored the mechanisms and efficacy of TCM in treating recurrent pregnancy loss. Clinical cases indicate that older patients with diminished ovarian reserve and recurrent pregnancy loss can improve their pregnancy outcomes and achieve full-term live births through 6 months of weekly acupuncture and herbal treatment (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The Anzi Tiao Chong Formula targets vascular endothelial growth factor A, interleukin-6, and STAT3 to inhibit inflammatory responses and promote placental cell activity (HTR-8/SVneo), with its key ingredients, liquiritigenin and nobiletin, identified as critical components (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). The Jiawei Shoutai Wan improves miscarriage outcomes by inhibiting ferroptosis, which is shown by reduced lipid peroxidation products (MDA), increased glutathione levels, and increased levels of ferroptosis inhibitory proteins GPX4 and SLC7A11(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The Chai Ge Kang Yi Formula addresses insulin resistance-related recurrent pregnancy loss by activating the interleukin-6/AKT1/STAT3 signaling pathway. This activation promotes the growth of endometrial stromal cells and enhances endometrial receptivity (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). However, studies still have limitations. Systematic reviews indicate that evaluating its efficacy is tough because there aren't enough high-quality randomized controlled trials and standardized treatment protocols despite TCM's application history of over 2000 years in Asian countries (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Future research should integrate network pharmacology, molecular docking, and multi-omics technologies to clarify the multi-target action mechanisms of TCM and establish standardized treatment protocols through larger clinical trials.\u003c/p\u003e \u003cp\u003eDespite the encouraging results of existing studies, limitations still exist. First, GBATD, as a TCM treatment, has a complex composition involving the synergistic effects of various herbs, thus lacking sufficient research on specific mechanisms. Dydrogesterone, as a Western medicine, has a relatively clear mechanism of action; however, the interactions and specific biological mechanisms of the combined use with the decoction need further exploration and validation. Second, different studies may provide different results owing to factors such as sample size, research design, and individual patient differences. Future research should concentrate on the diversity and representativeness of samples in design to enhance the reliability and generalizability of research findings. Future studies should also consider the long-term effects of combined treatment. Current research indicates that GBATD combined with dydrogesterone can improve symptoms and increase fetal survival rates in the short term; nonetheless, its long-term impacts remain unclear. Questions such as whether long-term use of Chinese medicine poses potential risks to the health of the mother and fetus, or whether there are individual differences in maintaining efficacy, are issues that require exploration in future research. In the study of early threatened miscarriage characterized by spleen and kidney deficiency, while existing clinical observations provide some data on treatment effects, our understanding of the specific mechanisms is still limited. Therefore, future research should strengthen the in-depth exploration of treatment mechanisms, especially the mechanisms of action of combined Chinese and Western medicines, including the components of GBATD and their roles in regulating immune function, improving the endocrine environment, and modulating cell proliferation, apoptosis, and inflammatory responses. The use of animal models for experiments can provide clearer observations of the effects of the drugs on embryo development, the maternal-fetal interface, and related signaling pathways, thereby providing a more solid theoretical basis for clinical application. This study is a retrospective analysis with a relatively small sample size from a single center, and its findings should be interpreted as preliminary and hypothesis-generating. Larger-scale, multi-center prospective studies are required in the future to further validate these results.\u003c/p\u003e \u003cp\u003eIn summary, in the study of early threatened miscarriage characterized by spleen and kidney deficiency, the efficacy of GBATD combined with dydrogesterone has been positively validated. This study shows that this combined treatment effectively improves patients' symptoms and significantly increases fetal survival rates using systematic clinical observation and data analysis, offering a new and effective treatment option for patients facing early threatened miscarriage due to spleen and kidney deficiency.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e5 Conflict of Interest\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.\u003c/p\u003e\n\u003cp\u003e6 Author Contributions\u003c/p\u003e\n\u003cp\u003eXuebing Li: Investigation, Methodology, Software, Data curation, Writing-original draft, Writing-review \u0026amp; editing; Yang Wang: Methodology, Data curation, Writing-original draft, Writing-review \u0026amp; editing; Zhuoxuan Su: Methodology, Writing-review \u0026amp; editing; Lu Pei: Writing-review \u0026amp; editing; Chunxia Wang: Writing-review \u0026amp; editing; Yongwei Li: Conceptualization, Writing-review \u0026amp; editing, Supervision, Funding acquisition.\u003c/p\u003e\n\u003cp\u003e7 Funding\u003c/p\u003e\n\u003cp\u003eThe author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Key Research Project of Higher Education Institutions in Henan Province (24A320007); Henan Province Medical Science and Technology Key Projects (LHGJ20240657); Henan Province Science and Technology Key Project (252102310471); Zhengzhou Municipal Bureau of Science and Technology(232102310207).\u003c/p\u003e\n\u003cp\u003e8 Acknowledgments\u003c/p\u003e\n\u003cp\u003eThe authors thank all members of the \u003cem\u003eHenan Provincial Hospital of Traditional Chinese Medicine\u003c/em\u003e. We would like to thank Editage (www.editage.cn) for English language editing.\u003c/p\u003e\n\u003cp\u003e9 Ethics approval\u003c/p\u003e\n\u003cp\u003eThe ethics committee of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine (NO.1626-02) approved this study. This study followed the Declaration of Helsinki. Each participant provided informed consent.\u003c/p\u003e\n\u003cp\u003e10\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Data availability\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll data and materials are accessible upon request from the corresponding author.\u003c/p\u003e\n\n\u003cp\u003eThe raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKriplani A, Kamilya GS, Devi TR, Taneja A, Pawar A, Nagesh GK, et al. Oral dydrogesterone versus oral micronized progesterone in threatened miscarriage: protocol paper for a randomized controlled trial. Reprod fertility. 2025;6(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1530/raf-24-0044\u003c/span\u003e\u003cspan address=\"10.1530/raf-24-0044\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/01/20 22:54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXiong Y, Liu C, Li M, Qin X, Guo J, Wei W, et al. The use of Chinese herbal medicines throughout the pregnancy life course and their safety profiles: a population-based cohort study. Am J Obstet Gynecol MFM. 2023;5(5):100907. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ajogmf.2023.100907\u003c/span\u003e\u003cspan address=\"10.1016/j.ajogmf.2023.100907\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023/02/23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu Y, Hu X, Ai KL, Sun ZG, Song JY. Gushen Antai pill for expected normal ovarian responders undergoing IVF-ET (GSATP-FreET): interim analysis of a randomized controlled trial. Contracept reproductive Med. 2025;10(1):19. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s40834-025-00352-9\u003c/span\u003e\u003cspan address=\"10.1186/s40834-025-00352-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/03/14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaas DM, Bofill Rodriguez M, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. The Cochrane database of systematic reviews. 2025;6(6):Cd003511. Epub 2025/06/11. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/14651858.CD003511.pub6\u003c/span\u003e\u003cspan address=\"10.1002/14651858.CD003511.pub6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 40497447; PubMed Central PMCID: PMCPMC12153038 Cochrane Central Editorial Unit but receives no compensation for that work. Additionally, he had no editorial responsibilities or influence on this review. Magdalena Bofill: Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Description: I am employed to prepare evidence summaries for RANZCOG guidelines and the review is used as evidence. End Date: ongoing/no known end date. Taylor J Hathaway: none known related to this work. Patrick S Ramsey: Texas Collaborative for Healthy Mothers and Babies: I serve as Chief Medical Officer for TCHMB - TCHMB is the state perinatal quality collaborative. I receive 0.2 FTE to protect my time for my work in this role. UpToDate web‐based resource ‐ Author of \u0026lsquo;Obesity in Pregnancy\u0026rsquo; chapter.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang M, Luo J, Yang Q, Xu L. Research on the medication rules of Chinese herbal formulas on treatment of threatened abortion. Complementary therapies in clinical practice. 2021;43:101371. Epub 2021/03/25. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ctcp.2021.101371\u003c/span\u003e\u003cspan address=\"10.1016/j.ctcp.2021.101371\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 33761430.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang Z, Chen K, Zhang Y, Xu B, Huang Y, Zhang X, et al. Study on pharmacokinetic and tissue distribution of hyperin, astragalin, kaempferol-3-O-β-D-glucuronide from rats with multiple administrations of Semen Cuscutae processed with salt solution with effect of treating recurrent spontaneous abortion. Front Pharmacol. 2024;15:1440810. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fphar.2024.1440810\u003c/span\u003e\u003cspan address=\"10.3389/fphar.2024.1440810\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2024/10/01.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFarzaneh F, Ashrafi M, Mohammad Beigi R, Azadbakht T, Mohazzab A, Esmael E. Serum Progesterone Levels on the Day of Oocyte Retrieval as a Predictor of Pregnancy Outcomes in Fresh Embryo Transfer Cycles. J Reprod infertility. 2024;25(4):272\u0026ndash;80. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.18502/jri.v25i4.18125\u003c/span\u003e\u003cspan address=\"10.18502/jri.v25i4.18125\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/05/12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan Y, Zhang J, Li W, Yin X. Value analysis of serum β -HCG, AMH, and P/E(2) for predicting freeze-thaw embryo transfer outcomes in patients with thin endometrium. Pakistan J Med Sci. 2025;41(4):973\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.12669/pjms.41.4.9980\u003c/span\u003e\u003cspan address=\"10.12669/pjms.41.4.9980\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/04/28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGholami H, Garrosi L, Tofighi S, Ghadimi Z. The association among cancer-antigen-125 and pre-eclampsia and estimated fetal weight: A case-control study. 2024;22(8):651\u0026ndash;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.18502/ijrm.v22i8.17238\u003c/span\u003e\u003cspan address=\"10.18502/ijrm.v22i8.17238\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 39494118.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHagg A, O'Shea E, Harrison CA. Targeting activins and inhibins to treat reproductive disorders and cancer cachexia. 2023;258(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1530/joe-22-0290\u003c/span\u003e\u003cspan address=\"10.1530/joe-22-0290\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 37194642.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShan ZF, Chen Y, Zhao YY, Mi WY, Liu L, Zheng XK, et al. [Duzhong Butiansu Capsules for improving fertility in male mice]. Zhonghua nan ke xue = Natl J Androl. 2020;26(5):457\u0026ndash;63. Epub 2020/12/24. PubMed PMID: 33354957.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHyun JY, Jung HS, Park JY. Herbal therapeutics for female infertility: A systematic review and meta-analysis. J Ethnopharmacol. 2024;319(Pt 2):117258. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jep.2023.117258\u003c/span\u003e\u003cspan address=\"10.1016/j.jep.2023.117258\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023/10/02.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDang CX, Wang D, Liu PF, Liu JX, Yu X. Network pharmacological analysis and molecular docking of Huangqin-Baizhu herb pair in the treatment of threatened abortion. Medicine. 2022;101(36):e30417. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/md.0000000000030417\u003c/span\u003e\u003cspan address=\"10.1097/md.0000000000030417\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2022/09/11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang YT, Wang MC, Liao JA, Chen WC, Chou YT, Cheng WJ. Efficacy of Chinese herbal medicines combined with high-intensity focused ultrasound for patients with uterine fibroids: A meta-analysis with core herbs exploration. Phytomedicine: Int J phytotherapy phytopharmacology. 2025;143:156811. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.phymed.2025.156811\u003c/span\u003e\u003cspan address=\"10.1016/j.phymed.2025.156811\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/05/11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJin H, Cheng J, Li H, Huang W, Lin D. Traditional Chinese medicine syndrome patterns in immune-related recurrent spontaneous abortion: A cross-sectional observational study based on cluster analysis. 2025;104(22):e42654. \u003cdiv class=\"ExternalRefDOI\"\u003e10.1097\u003c/div\u003e/md.0000000000042654. PubMed PMID: 40441183.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarders EP, Charboneau C, Paitz RT. Extraembryonic metabolism of corticosterone protects against effects of exposure. Gen Comp Endocrinol. 2024;347:114439. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ygcen.2023.114439\u003c/span\u003e\u003cspan address=\"10.1016/j.ygcen.2023.114439\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2024/01/02.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLu JJ, Zhou FM, Hu XJ, Fang JJ, Liu CX, Zhu BQ, et al. Molecular docking simulation and in vitro studies on estrogenic activities of flavonoids from leaves of Carya cathayensis Sarg. Steroids. 2020;163:108726. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.steroids.2020.108726\u003c/span\u003e\u003cspan address=\"10.1016/j.steroids.2020.108726\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020/09/06.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBellafante E, McIlvride S, Nikolova V, Fan HM, Manna LB, Chambers J, et al. Maternal glucose homeostasis is impaired in mouse models of gestational cholestasis. Sci Rep. 2020;10(1):11523. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41598-020-67968-6\u003c/span\u003e\u003cspan address=\"10.1038/s41598-020-67968-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020/07/15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBasak S, Vilasagaram S, Duttaroy AK. Maternal dietary deficiency of n-3 fatty acids affects metabolic and epigenetic phenotypes of the developing fetus. Prostaglandins, leukotrienes, and essential fatty acids. 2020;158:102109. Epub 2020/06/01. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.plefa.2020.102109\u003c/span\u003e\u003cspan address=\"10.1016/j.plefa.2020.102109\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 32474355.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCarabelli B, Delattre AM, Waltrick APF, Ara\u0026uacute;jo G, Suchecki D, Machado RB, et al. Fish-oil supplementation decreases Indoleamine-2,3-Dioxygenase expression and increases hippocampal serotonin levels in the LPS depression model. Behav Brain Res. 2020;390:112675. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.bbr.2020.112675\u003c/span\u003e\u003cspan address=\"10.1016/j.bbr.2020.112675\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020/05/15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJin T, Hu B, Zhang T, Wang J, Zhang D, Sheng Y, et al. Wogonin Inhibits Oxidative Stress in Hypoxia-Induced hCMEC/D3 Cells Through Suppressing CXCL8-Mediated TLR4/NF-κB. Pathway. 2025;39(7):e70390. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/jbt.70390\u003c/span\u003e\u003cspan address=\"10.1002/jbt.70390\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 40613545.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMu\u0026ntilde;oz Y, Mercado L, Farias C, Beyer MP, Alvear I, Echeverr\u0026iacute;a F et al. Impact of polyunsaturated fatty acids during and pregnancy and lactation: A comprehensive review. Prostaglandins, leukotrienes, and essential fatty acids. 2024;203:102656. Epub 2024/11/01. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.plefa.2024.102656\u003c/span\u003e\u003cspan address=\"10.1016/j.plefa.2024.102656\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 39481326.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi X, Kempf S, G\u0026uuml;nther S, Hu J, Fleming I. 11,12-EET Regulates PPAR-γ Expression to Modulate TGF-β-Mediated Macrophage Polarization. 2023;12(5). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/cells12050700\u003c/span\u003e\u003cspan address=\"10.3390/cells12050700\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 36899838.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCapece U, Gugliandolo S, Morciano C, Avolio A, Splendore A, Di Giuseppe G, et al. Erythrocyte Membrane Fluidity and Omega-3 Fatty Acid Intake: Current Outlook and Perspectives for a Novel. Nutritionally Modifiable Cardiovasc Risk Factor. 2024;16(24). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/nu16244318\u003c/span\u003e\u003cspan address=\"10.3390/nu16244318\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PubMed PMID: 39770939.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOberhauser L, Granziera S, Colom A, Goujon A, Lavallard V, Matile S, et al. Palmitate and oleate modify membrane fluidity and kinase activities of INS-1E β-cells alongside altered metabolism-secretion coupling. Biochim et Biophys acta Mol cell Res. 2020;1867(2):118619. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.bbamcr.2019.118619\u003c/span\u003e\u003cspan address=\"10.1016/j.bbamcr.2019.118619\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2019/12/10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen H, Liu J, Hu L, Yang J, Wang Y, Sun W, et al. Mycotoxins from Alternaria Panax, the specific plant pathogen of Panax ginseng. Mycology. 2023;14(4):381\u0026ndash;92. PubMed PMID: 38187879; PubMed Central PMCID: PMCPmc10769115.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHullender Rubin L, Cantor D, Marx BL. Recurrent Pregnancy Loss and Traditional Chinese Medicine. Med Acupunct. 2013;25(3):232\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1089/acu.2012.0911\u003c/span\u003e\u003cspan address=\"10.1089/acu.2012.0911\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2014/04/25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHe S, Ma F, Li J, Liu DY, Wang ZW, Chen PD, et al. Identification of quality markers and mechanisms of Anzi Tiaochong Fang in the treatment of antiphospholipid syndrome-related recurrent pregnancy loss: chemical analysis, network pharmacology, and in vitro approaches. BMC Complement Med Ther. 2025;25(1):20. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12906-025-04752-x\u003c/span\u003e\u003cspan address=\"10.1186/s12906-025-04752-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/01/23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLai Y, Zhang Y, Zhang H, Chen Z, Zeng L, Deng G, et al. Modified Shoutai Pill inhibited ferroptosis to alleviate recurrent pregnancy loss. J Ethnopharmacol. 2024;319(Pt 2):117028. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jep.2023.117028\u003c/span\u003e\u003cspan address=\"10.1016/j.jep.2023.117028\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023/08/20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu J, Pan Y, Lu Y, Qian J, Zhang J, Xue Y, et al. Exploring the mechanisms of Chaige Kangyi Recipe in treating recurrent pregnancy loss with insulin resistance. Sci Rep. 2025;15(1):13866. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41598-025-98869-1\u003c/span\u003e\u003cspan address=\"10.1038/s41598-025-98869-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2025/04/23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun D, Lu S, Gan X, Lash GE. Is there a place for Traditional Chinese Medicine (TCM) in the treatment of recurrent pregnancy loss? J Reprod Immunol. 2022;152:103636. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jri.2022.103636\u003c/span\u003e\u003cspan address=\"10.1016/j.jri.2022.103636\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2022/05/15.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable\u0026nbsp;1 Eligibility criteria.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1. \u0026nbsp; Must meet Western medical diagnostic criteria:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e①\u0026nbsp;History: amenorrhea for up to 12 weeks and/or early pregnancy symptoms;\u003c/p\u003e\n \u003cp\u003e② Clinical symptoms: slight vaginal bleeding or brown discharge without expulsion of suspected pregnancy tissue, or accompanied by lower abdominal pain or lumbar pain;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e③ Specialized examination: membranes intact, cervix closed, soft uterus with size consistent with gestational age;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e④ Imaging examination: B ultrasound confirms intrauterine pregnancy, with gestational sac size and embryo development consistent with gestational age;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e⑤\u0026nbsp;Laboratory examination: serum human chorionic gonadotropin (\u0026beta;-HCG), progesterone (P), and estradiol (E2) levels indicating pregnancy, with values consistent with gestational age.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e2. \u0026nbsp; Must meet Traditional Chinese Medicine diagnostic criteria:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e(1)\u0026nbsp;Main symptoms:\u003c/p\u003e\n \u003cp\u003e① slight vaginal bleeding or brown discharge that is pale or dark and thin in consistency;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e② dull or dragging pain in the lower abdomen;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e③ weakness in the lower back and knees;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e④ fatigue and lethargy.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(2) Secondary symptoms:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e① dizziness, tinnitus;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e② frequent night urination;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e③ pale or dull complexion;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e④ abdominal distension and poor appetite;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e⑤\u0026nbsp;loose stools. Tongue and pulse: pale tongue, possibly with tooth marks, white and moist coating, pulse slippery, deep, thin, and weak.\u003c/p\u003e\n \u003cp\u003eMain symptoms must be present, and at least one secondary symptom must be present to diagnose Spleen and Kidney Yang Deficiency.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e3. Age 20-35 years; early pregnancy (gestational age 5-8 weeks); patients must have a requirement for pregnancy maintenance and have signed an informed consent.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1. Anyone who doesn\u0026apos;t meet the inclusion criteria for both Western and Traditional Chinese Medicine, or those who conceived through assisted reproductive technology or received other pregnancy maintenance treatments after conception;\u003c/p\u003e\n \u003cp\u003e2. Patients with recurrent miscarriage, molar pregnancy, multiple pregnancies (including twins), uterine fibroids, anatomical abnormalities of the uterine cavity, or cervical bleeding, and those with serious diseases of the heart, liver, or kidneys;\u003c/p\u003e\n \u003cp\u003e3. Maternal infections with mycoplasma or chlamydia, thyroid dysfunction; those with mental illnesses who cannot take medication as prescribed; those with allergic constitutions or allergies to the components of the drugs used in this study;\u003c/p\u003e\n \u003cp\u003e4. Those who have recently taken similar medications, making efficacy difficult to determine.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDropout and Discontinuation Criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1. Patients who fail to adhere to the prescribed medication regimen or who discontinue their use independently.\u003c/p\u003e\n \u003cp\u003e2. Individuals who are concurrently utilizing other prescription drugs that may compromise the integrity of the study outcomes during the treatment phase.\u003c/p\u003e\n \u003cp\u003e3. Patients who encounter adverse effects from the medications that hinder their ability to persist with the treatment protocol.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 Groups and interventions\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eGroups\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eIntervention\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eControl group: Dydrogesterone Group\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDydrogesterone was started with a dose of 40 mg, then taking 10 mg every 8 h for 14 days without tapering.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eAlso known as Duphaston, produced by Abbott Healthcare Products B.V., imported drug registration number H20170221, specification: 10mg*20 tablets\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eObservation group: GBATD+ Dydrogesterone\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGBATD was administered with 200 ml of warm water, one dose daily divided into two doses after meals, and Dydrogesterone was administered in the same manner as in the control group.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003eThe preparation room of Henan Provincial Hospital of Traditional Chinese Medicine provides GBATD,\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 3 Study objectives\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary objective\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eTo compare the success rate of pregnancy maintenance before 12 weeks of gestation between pregnant women with threatened miscarriage treated with GBATD combined with Dydrogesterone and those receiving oral progesterone alone.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary objectives\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1. \u0026nbsp; To compare the traditional Chinese medicine syndrome efficacy assessment between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2. \u0026nbsp; To compare the time to symptom (vaginal bleeding and/or abdominal pain) resolution between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3. \u0026nbsp; To compare safety and observe and record adverse reactions between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone,\u003c/p\u003e\n \u003cp\u003e4. \u0026nbsp; To compare laboratory and imaging examination indicators between pregnant women with threatened miscarriage treated with GBATD and Dydrogesterone versus oral progesterone alone:\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 4 Observation Indicators\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eobservation indicators\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1, General observation indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003epatients\u0026apos; names,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003epatients\u0026apos; ages,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eobstetric history,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003emenstrual history,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003enumber of miscarriages,\u003c/p\u003e\n \u003cp\u003eother general information.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e2, Safety observation indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003epatients\u0026apos; vital signs, such as temperature, pulse, blood pressure, and respiration;\u003c/p\u003e\n \u003cp\u003esafety indicators, such as blood, liver function, and kidney function tests.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEfficacy indicators\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1, Laboratory examination indicators:\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eWe drew fasting venous blood samples the morning after treatment and at the end of each course to detect and record serum \u0026beta;-HCG, P, E2, cancer antigen 125 (CA125), and inhibin A (INH-A) levels. Serum CA125 and E2 were measured using chemiluminescent microparticle immunoassay, serum INH-A was measured using enzyme-linked immunosorbent assay, and serum \u0026beta;-HCG and P were measured using fluorescence immunoassay.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e2, Imaging examination indicators:\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eUltrasound examinations were performed before treatment and after the end of each course to detect uterine artery hemodynamic indicators, specifically including the ratio of peak systolic velocity to end-diastolic velocity (PSV/EDV, S/D), pulsatility index (PI), and resistance index (RI) of the uterine artery. The sums of bilateral S/D, PI, and RI were recorded, and the size of the gestational sac and embryo development were examined. All measurements were conducted in the Reproductive Medicine Department of Henan Provincial Hospital of Traditional Chinese Medicine, with results uniformly recorded by researchers.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e3, Traditional Chinese Medicine syndrome scoring\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eThe syndrome scoring was based on \u0026quot;Traditional Chinese Gynecology\u0026quot;: scoring was performed based on the patient\u0026apos;s symptoms and signs, with main and secondary symptoms graded as none, mild, moderate, or severe. Main symptoms were scored as 0, 2, 4, or 6 points, and secondary symptoms as 0, 1, 2, or 3 points. Evaluations were conducted before treatment and after the end of the course, with higher scores indicating more severe symptoms.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEfficacy Assessment Criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e1, Traditional Chinese Medicine syndrome efficacy assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eCure: The Traditional Chinese Medicine syndrome disappears or is nearly gone, n \u0026ge;95%;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003emarked effect: Traditional Chinese Medicine syndrome significantly improves compared with that before treatment, with symptom scores reduced, 70% \u0026le; n \u0026lt; 95%;\u003c/p\u003e\n \u003cp\u003eeffective: Traditional Chinese Medicine syndrome is alleviated compared with that before treatment, 30% \u0026le; n \u0026lt; 70%;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eineffective: no improvement in Traditional Chinese Medicine syndrome, n \u0026lt; 30%.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNote: Effective rate = [(Number of cured + marked effect + effective cases) / Total cases] \u0026times; 100%.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e2, Comprehensive efficacy assessment criteria\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eCure: vaginal bleeding stops within 5 days after treatment, and lower abdominal pain and lumbar discomfort symptoms disappear. Ultrasound examination shows that the size of the uterus and embryo development are consistent with gestational age.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003emarked effect: vaginal bleeding stops within 7 days after treatment, and lower abdominal pain and lumbar discomfort symptoms significantly improve. Ultrasound examination shows that the size of the uterus and embryo development are consistent with gestational age.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eEffective: vaginal bleeding stops within 10 days after treatment, and lower abdominal pain and lumbar discomfort symptoms are somewhat alleviated. Ultrasound examination shows that the size of the uterus and embryo development are basically consistent with gestational age.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eIneffective: vaginal bleeding lasts more than 10 days without stopping, and lower abdominal pain and lumbar discomfort symptoms show no improvement or worsen. Ultrasound examination shows that the size of the uterus is basically consistent with or smaller than gestational age, but embryo development is poor or fetal arrest occurs, even leading to inevitable miscarriage.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e3, Success rate of pregnancy maintenance at 12 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003esuccess rate of pregnancy maintenance = number of cases at 12 weeks/number of observed cases \u0026times; 100%.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003e4, Observation and recording of adverse reactions\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 553px;\"\u003e\n \u003cp\u003eobserve and record whether patients experience allergies, liver function, and kidney function damage during the trial, and analyze the correlation with the trial.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 5 Comparison of General data\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eFactor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003eObservation Group(n=33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003eControl Group(n=33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003et/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e30.48\u0026plusmn;2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e30.06\u0026plusmn;3.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.775\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eGestational days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e40.97\u0026plusmn;2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e41.06\u0026plusmn;1.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.851\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eNumber of Miscarriages (Times) Median（\u003cem\u003eIQR\u003c/em\u003e）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e1（1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e1（1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eVaginal Bleeding Time (day)\u003c/p\u003e\n \u003cp\u003eMedian（\u003cem\u003eIQR\u003c/em\u003e），\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e2（2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e2（1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-0.476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.634\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003e\u0026beta;-HCG（mIU/ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e17120.85\u0026plusmn;5023.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e16228.09\u0026plusmn;4477.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.762\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.449\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eP（ng/ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e20.48\u0026plusmn;2.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e20.67\u0026plusmn;2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.758\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eE\u003csub\u003e2\u003c/sub\u003e（pg/ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e384.39\u0026plusmn;70.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e359.70\u0026plusmn;80.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1.325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eCA125（U/ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e36.98\u0026plusmn;4.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e36.89\u0026plusmn;3.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eINH-A（pg/ml）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e338.50\u0026plusmn;28.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e337.22\u0026plusmn;26.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003ePI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e5.09\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e5.23\u0026plusmn;0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-0.777\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e1.69\u0026plusmn;0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e1.69\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.908\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eS/D\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e14.99\u0026plusmn;3.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e15.20\u0026plusmn;3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.785\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp\u003eTCM syndrome scoring(scores)Median (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e29（7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e29（4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-0.980\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 6 Comparison of spleen and kidney deficiency syndrome scores between the two groups of patients before and after treatment [Median (\u003cem\u003eIQR\u003c/em\u003e), points]\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003ePre-treatment score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003ePost-treatment score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003csup\u003e*\u003c/sup\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e29（7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e6（8.5）\u003csup\u003e*\u003c/sup\u003e\u003csup\u003e△\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e-6.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026lt;0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e29（4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e20（18）\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e-6.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026lt;0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e-0.980\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e-3.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 29px;\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003csup\u003e△\u003c/sup\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCompared with the pre-treatment of the observational group, *P \u0026lt; 0.05 (determined using the Wilcoxon signed-rank test); compared with the post-treatment of the control group, \u003csup\u003e△\u003c/sup\u003eP \u0026lt; 0.05 (determined using the Mann-Whitney U test)\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 7 Comparison of curative effects of spleen and kidney deficiency syndrome between the two groups of patients after treatment (%) \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 15px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003eCases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 45px;\"\u003e\n \u003cp\u003eCurative effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003eTotal effective rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003eCure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003eMarked effective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003eEffective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eIneffective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" style=\"width: 0px;\"\u003e\n \u003cp\u003eCurative effects of spleen and kidney deficiency syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 12px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e90.91%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 12px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e69.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" style=\"width: 0px;\"\u003e\n \u003cp\u003eComprehensive effective rate comparison\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 12px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e87.88%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 12px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e66.67%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eComparison of the total effective rate between the observation and control groups after treatment. P \u0026lt; 0.05\u0026nbsp;(determined using Fisher\u0026rsquo;s exact test for total effective rate)\u003c/p\u003e\n\u003cp\u003eTable 8 Comparison of the overall effective rate between the two groups of patients after treatment (%)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"95%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003eCases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 46px;\"\u003e\n \u003cp\u003eCurative effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003eTotal effective rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003eCure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eMarkedly effective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003eEffective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003eIneffective\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e87.88%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e66.67%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe comparison of the total effective rate between the observation and control groups after treatment. P \u0026lt; 0.05\u0026nbsp;(determined using Fisher\u0026rsquo;s exact test for total effective rate)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 9 Comparison of the successful rate of pregnancy maintenance at 12 weeks between the two groups of patients after treatment (%)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"84%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003eCases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003eSuccess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003eFailure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eSuccess rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eObservation group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cspan id=\"_Toc21749\"\u003e33\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cspan id=\"_Toc4594\"\u003e30\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cspan id=\"_Toc13147\"\u003e3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e90.91%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cspan id=\"_Toc5320\"\u003e33\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cspan id=\"_Toc14558\"\u003e22\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cspan id=\"_Toc5837\"\u003e11\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e66.67%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCompared with the successful rate of pregnancy maintenance in the control group after treatment, P＜0.05 (determined using Fisher\u0026rsquo;s exact test for success rate)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 10 The main active components based on several criteria\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"931\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003eRT [min]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eName\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eFormula\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003ePredicted Molecular Weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eMeasured Molecular Weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e△ppm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003eMS2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eReference Ion\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e7.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eDL-Tryptophan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e11\u003c/sub\u003eH\u003csub\u003e12\u003c/sub\u003eN\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e204.08988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e204.0902\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.665932676\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e118.06555,146.06015,188.07083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H-NH3]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e15.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eDibutyl phthalate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e22\u003c/sub\u003eO\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e278.15181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e278.1527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.235643155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e149.02333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e15.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eCorticosterone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e21\u003c/sub\u003eH\u003csub\u003e30\u003c/sub\u003eO\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e346.21441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e346.2151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.877449295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e97.06538,121.06512,329.21106,347.22159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e16.586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eWogonin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e12\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e284.06847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e284.0691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2.288180733\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e270.05240,285.07587\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e17.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eBis(4-ethylbenzylidene)sorbitol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e24\u003c/sub\u003eH\u003csub\u003e30\u003c/sub\u003eO\u003csub\u003e6\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e414.20424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e414.2045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.579424296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e119.08578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e17.862\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eDipropyleneglycol dibenzoate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e20\u003c/sub\u003eH\u003csub\u003e22\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e342.14672\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e342.1472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.490588599\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e105.03395,163.07538\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+Na]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e17.878\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e3,5-di-tert-Butyl-4-hydroxybenzaldehyde\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e15\u003c/sub\u003eH\u003csub\u003e22\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e234.16198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e234.1623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.494691837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e57.07084,179.10674,235.16916\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e18.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eDeoxycholic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e24\u003c/sub\u003eH\u003csub\u003e40\u003c/sub\u003eO\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e392.29266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e392.2931\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.019646914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e391.28555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+FA-H]-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e18.694\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026beta;-Muricholic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e24\u003c/sub\u003eH\u003csub\u003e40\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e408.28757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e408.2878\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.661298604\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e407.2803\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M-H]-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e19.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eCitroflex A-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e20\u003c/sub\u003eH\u003csub\u003e34\u003c/sub\u003eO\u003csub\u003e8\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e402.22537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e402.2265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2.68506186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e129.01846,139.00270,157.01328,185.08112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+Na]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e19.715\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e(\u0026plusmn;)11(12)-EET\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e20\u003c/sub\u003eH\u003csub\u003e32\u003c/sub\u003eO\u003csub\u003e3\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e320.23514\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e320.2352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.062454108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e59.01237,179.10698,257.22748,301.21756,319.22815\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M-H]-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e20.275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eDocosahexaenoic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e22\u003c/sub\u003eH\u003csub\u003e32\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e328.24023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e328.2408\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.645136551\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e91.05477,117.07011,131.08565,329.24585\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+H]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e22.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eLinoleic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e18\u003c/sub\u003eH\u003csub\u003e32\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e280.24023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e280.2404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.535255056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e279.23322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M-H]-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e22.831\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eOleic Acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e18\u003c/sub\u003eH\u003csub\u003e34\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e282.25588\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e282.2561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.850292295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e281.24875\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M-H]-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e22.988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eDi(2-ethylhexyl) phthalate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e24\u003c/sub\u003eH\u003csub\u003e38\u003c/sub\u003eO\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e390.27701\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e390.2772\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.461210872\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e57.07085,71.08638,149.02339,167.03400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+Na]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e23.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e1-Stearoylglycerol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e21\u003c/sub\u003eH\u003csub\u003e42\u003c/sub\u003eO\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e358.30831\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e358.3083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e-0.139544628\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e57.07085,71.08639,95.08611,267.26813,341.30493\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M+Na]+1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e23.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003eStearic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eC\u003csub\u003e18\u003c/sub\u003eH\u003csub\u003e36\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e284.27153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e284.2717\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.703552691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e283.26465\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e[M-H]-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"contraception-and-reproductive-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"carm","sideBox":"Learn more about [Contraception and Reproductive Medicine](http://contraceptionmedicine.biomedcentral.com)","snPcode":"40834","submissionUrl":"https://submission.nature.com/new-submission/40834/3","title":"Contraception and Reproductive Medicine","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"early threatened abortion, Gu Ben An Tai Decoction, spleen and kidney deficiency type, clinical observation","lastPublishedDoi":"10.21203/rs.3.rs-8471415/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8471415/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe aimed to observe the clinical efficacy of Gu Ben An Tai Decoction (GBATD) combined with dydrogesterone for treating threatened abortion (TA)and assess the safety of the integrated Chinese-Western medicine approach for threatened miscarriage. We also aimed to provide a reference for designing larger, confirmatory studies in the future.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective analysis was conducted on 66 patients with early TA due to spleen and kidney deficiency. The control group received dydrogesterone, while the observation group received treatment with GBATD and dydrogesterone. The success rate of pregnancy maintenance was compared before 12 weeks of gestation. Safety and adverse reactions of GBATD, time to symptom resolution (vaginal bleeding and/or abdominal pain), laboratory examination indicators, imaging examination indicators, and traditional Chinese medicine (TCM) syndrome scores of the two groups were also compared. High-performance liquid chromatography-mass spectrometry was used to analyze GBATD’s major component.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter treatment, the observation group showed a more significant increase in serum levels of β-HCG, Progesterone, estradiol, and Inhibin A compared to the control group. However, the serum CA125 level, uterine artery hemodynamic indicators S/D, PI, RI values, and TCM syndrome scores for spleen and kidney deficiency decreased more significantly in the observation group than those in the control group (P \u0026lt; 0.05). The observation group showed higher rates of effective TCM treatment, overall effectiveness, and successful retention at 12 weeks of pregnancy than the control group did, with statistically significant differences (P \u0026lt; 0.05). GBATD mainly contains 17 components.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGBATD combined with dydrogesterone is effective for treating early TA. It significantly reduces symptoms of spleen and kidney deficiency, lowers the miscarriage rate, and shows no obvious adverse reactions.\u003c/p\u003e","manuscriptTitle":"Clinical Observation of Gu Ben An Tai Decoction Combined with Dydrogesterone for Early Threatened Abortion Due to Spleen and Kidney Deficiency","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-16 09:06:20","doi":"10.21203/rs.3.rs-8471415/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-23T09:08:40+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-23T02:53:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-16T01:52:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"213312624676404830100155230888027028781","date":"2026-01-15T02:12:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"154255712298300980133977020087016482678","date":"2026-01-14T00:58:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"241660697170356953139761345144836512560","date":"2026-01-12T21:35:12+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-12T14:34:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-05T06:10:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-05T06:09:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"Contraception and Reproductive Medicine","date":"2025-12-29T09:10:56+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"contraception-and-reproductive-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"carm","sideBox":"Learn more about [Contraception and Reproductive Medicine](http://contraceptionmedicine.biomedcentral.com)","snPcode":"40834","submissionUrl":"https://submission.nature.com/new-submission/40834/3","title":"Contraception and Reproductive Medicine","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6825da99-2abd-436b-bed9-ba251b4e10df","owner":[],"postedDate":"January 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:05:37+00:00","versionOfRecord":{"articleIdentity":"rs-8471415","link":"https://doi.org/10.1186/s40834-026-00440-4","journal":{"identity":"contraception-and-reproductive-medicine","isVorOnly":false,"title":"Contraception and Reproductive Medicine"},"publishedOn":"2026-03-02 15:59:59","publishedOnDateReadable":"March 2nd, 2026"},"versionCreatedAt":"2026-01-16 09:06:20","video":"","vorDoi":"10.1186/s40834-026-00440-4","vorDoiUrl":"https://doi.org/10.1186/s40834-026-00440-4","workflowStages":[]},"version":"v1","identity":"rs-8471415","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8471415","identity":"rs-8471415","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}