益母草注射液联合缩宫素预防自然分娩产妇产后出血的Meta分析  

Efficacy and safety of motherwort injection and oxytocin in preventing postpartum hemorrhage after vaginal delivery: a Meta analysis

作　　者：曾林淼[1] 俞晓莲[2] 俞婷婷[2] 张烨铃 潘炜飘 彭清妹[5] 

机构地区：[1]福建福安福建医科大学附属闽东医院呼吸内科,355000 [2]福州福建中医药大学护理学专业,350108 [3]福建泉州解放军180医院麻醉科,362000 [4]福州福建医科大学临床医学专业,350108 [5]江西吉安井冈山大学临床医学院妇产科,343000

出　　处：《解放军医学杂志》2015年第10期826-832,共7页Medical Journal of Chinese People's Liberation Army

摘　　要：目的评价益母草注射液联合缩宫素预防自然分娩产妇产后出血的有效性及安全性。方法计算机检索Pub Med（1980-2013.9）、Wiley Online Library（1990-2013.9）、Embase（1990-2013.9）、中国知网（1990-2013.9）、维普数据库（1990-2013.9）和万方数据库（1990-2013.9）,纳入益母草注射液联合缩宫素或单用缩宫素预防自然分娩产妇产后出血的随机对照试验的文献,对比采用两种方法在预防自然分娩产妇产后出血量、产后出血发生率和不良反应发生率的差异。按Cochrane系统评价方法,评价纳入研究的方法学质量并提取有效数据,并采用Rev Man 5.1软件进行Meta分析。结果最终纳入13个随机对照临床试验文献,共纳入2186例患者。Meta分析结果显示：益母草联合缩宫素组与单用缩宫素组相比,在产后2h出血量和产后24h出血量方面均明显减少。益母草联合缩宫素组的产后出血发生率明显低于对照组（RR=0.30,95%CI 0.19~0.47,P〈0.00001）。但两组的不良反应发生率差异无统计学意义（RR=0.63,95%CI0.37~1.05,P=0.08）。结论益母草注射液联合缩宫素在预防自然分娩产妇产后出血量、产后出血发生率方面均优于单用缩宫素组,且并不增加药物不良反应。Objective To evaluate the clinical efficacy and safety of motherwort injection and oxytocin in preventing postpartum hemorrhage after vaginal delivery. Methods Data of randomly controlled trials （RCTs） of motherwort iniection and oxytocin in preventing postpartum hemorrhage after vaginal delivery were collected by searching PubMed （1980-2013.9）, Wiley Online Library （1990-2013.9）, Embase （1990-2013.9）, CNKI （1990-2013.9）, VIP database （1990-2013.9） and WanFang Data （1990-2013.9）. The amount and incidence of postpartum hemorrhage and quantity of blood loss, as well as the incidence of postpartum morbidity were then collected in those puerperal women treated with motherwort injection and oxytocin. The quality of included studies was assessed according to Cochrane Systematic Review, and Meta-analysis was conducted by RevMan 5.1 software. Results A total of 13 studies involving 2186 patients were included. Compared with oxytocin group, motherwort and oxytocin decreased the amount of vaginal bleeding within 2 hours after delivery and 24 hours after delivery. Furthermore, motherwort and oxytocin significantly decreased the incidence of postpartum hemorrhage （RR=0.30, 95%CI 0.19-0.47, P〈0.00001）. No difference was found between the two groups in the postpartum adverse reaction rate （RR=0.63, 95%CI 0.37-1.05, P=0.08）. Conclusions Motherwort injection and oxytocin are effective in preventing postpartum hemorrhage after vaginal delivery, and they can effectively reduce incidence of postpartum hemorrhage and the amount of blood loss without increasing the side effects in patients.

关 键 词：益母草注射液 催产素 自然分娩 产后出血 META分析 

分 类 号：R347.531[医药卫生—基础医学]