益气通瘀方治疗气虚血瘀型产后恶露不绝临床研究  

Clinical Study on the Treatment of Persistent Postpartum Lochia Caused by Qi Deficiency and Blood Stasis with Qi-Replenishing and Stasis-Dredging Formula

作　　者：蔡文颖 包红霞 CAI Wenying;BAO Hongxia(Xiqing District Women's Health and Family Planning Service Center in Tianjin,Tianjin,China,300380;Hexi District Maternal and Child Health and Family Planning Service Center in Tianjin,Tianjin,China,300200)

机构地区：[1]天津市西青区妇女保健计划生育服务中心,天津300380 [2]天津市河西区妇幼保健计划生育服务中心,天津300200

出　　处：《河南中医》2023年第7期1046-1050,共5页Henan Traditional Chinese Medicine

基　　金：天津市中医药管理局中西医结合科研课题项目(2018064)。

摘　　要：目的:观察自拟益气通瘀方治疗气虚血瘀型产后恶露不绝的临床疗效。方法:将80例气虚血瘀型产后恶露不绝患者按照随机数字表法分为对照组和观察组,每组各40例。对照组给予缩宫素肌肉注射、口服头孢拉定胶囊和米非司酮片,观察组给予自拟益气通瘀方治疗。比较两组患者的临床疗效、主要症状消失时间及治疗前后中医证候积分、子宫三径之和、子宫血流动力学恢复情况[子宫动脉收缩期峰值流速(peak systolic velocity,PSV)、阻力指数(resistance index,RI)、搏动指数(pulsatility index,PI)]变化情况。结果:观察组有效率为92.5%,对照组有效率为72.5%,两组患者有效率比较,差异有统计学意义(P<0.05)。观察组腰腹重坠消失时间、止血时间、子宫压痛消失时间、恶露结束时间短于对照组(P<0.05)。两组患者治疗后子宫三径之和及中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后PSV高于本组治疗前,RI、PI低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。结论:自拟益气通瘀方治疗气虚血瘀型产后恶露不绝,可改善患者临床症状,促进子宫复旧,缩短恶露持续时间,加快产妇后期恢复。Objective:To observe the clinical efficacy of self-made Qi-Replenishing and Stasis-Dredging Formula on persistent postpartum lochia caused by qi deficiency and blood stasis.Methods:A total of 80 patients with persistent postpartum lochia of qi deficiency and blood stasis type were randomly divided into the control group and the observation group,with 40 cases in each group.The control group was given intramuscular injection of Oxytocin,oral administration of Cefradine Capsules,and Mifepristone Tablets,while the observation group was treated with self-made Qi-Replenishing and Stasis-Dredging Formula.The clinical efficacy,time of disappearance of main symptoms,and changes in TCM syndrome scores,the sum of three uterine diameters,and recovery of uterine hemodynamics[including peak systolic velocity(PSV),resistance index(RI),and pulsatility index(PI)] between the two groups before and after treatment were compared.Results:The effective rate of the observation group was 92.5%,while that of the control group was 72.5%,and the difference was statistically significant(P<0.05).The observation group had shorter disappearance time,hemostasis time,disappearance time of uterine tenderness,and end time of lochia than that of the control group(P<0.05).After treatment,the uterine diameter and TCM syndrome scores of the two groups were lower than those before treatment,and the observation group's scores were lower than those of the control group(P<0.05);The PSV of the two groups was higher than that before treatment,while the RI and PI were lower than those before treatment,and all the differences were statistically significant(P<0.05).Conclusion:Self-made Qi-Replenishing and Stasis-Dredging Formula can treat persistent postpartum lochia of qi deficiency and blood stasis type,improve clinical symptoms,promote uterine involution,shorten the duration of lochia,and accelerate postpartum recovery.

关 键 词：产后恶露不绝 气虚血瘀证 益气通瘀方 缩宫素 头孢拉定胶囊 米非司酮片 

分 类 号：R271.914.65[医药卫生—中西医结合]