独参汤结合米索前列醇对产后宫缩乏力性出血凝血功能和子宫复旧状况的影响  

Effects of Dushen Decoction(独参汤)Combined with Misoprostol on Coagulation Function and Uterine Involvement on Patients with Uterine Atonic Hemorrhage after Labor

作　　者：措毛吉[1] 才德吉 万玛南杰 李海艳 CUO Maoji;CAI Deji;WANMA Nanjie;LI Haiyan(Qinghai Red Cross Hospital,Xining 810000,Qinghai,China)

机构地区：[1]青海红十字医院,青海西宁810000

出　　处：《中华中医药学刊》2024年第7期214-217,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：青海省卫生健康委员会指导性项目(2019-wjzdx-73)。

摘　　要：目的评价独参汤结合米索前列醇对产后宫缩乏力性出血患者凝血功能和及子宫复旧状况的影响。方法选择2019年4月—2022年4月医院收治的产后宫缩乏力性出血患者96例为研究对象,依据随机数字表法将患者分为研究组和对照组,每组48例。对照组患者采用常规疗法治疗,密切监测患者的生命体征,包括血压、呼吸、心跳和心率等数据变化。检测出血量,并提前做好相应的准备,可按摩患者子宫,帮助止血。肌内注射宫缩素,每12 h注射1次,剂量为10 U,并将米索前列醇400置入产妇肛门。研究组患者在对照组治疗的基础上,口服独参汤治疗。将30 g生晒参和1000 mL蒸馏水煎,煎至150 mL,胎儿娩出后,每8 h口服1次,1次30 mL。比较两组患者产后24 h、产后48 h和产后72 h的出血量。收集方法:羊水排尽后,更换尿垫和吸引瓶,采用称重法计算。分别在生产前、治疗后24 h抽取静脉血,使用凝血分析仪检测凝血酶原时间(Prothrombin time, PT)、活化部分凝血活酶时间(Activated partial thromboplastin time, APTT)、纤维蛋白原(Fibrinogen, FIB)和凝血酶时间(Thrombin time, TT)。产后随访1个月,比较两组患者宫腔积血发生率、子宫复旧不良发生率、恶露持续时间和宫底高度,比较治疗疗效。结果研究组中达到显效标准的有21例,占比43.75%,达到有效标准的有23例,占比47.92%,无效的有4例,占比8.33,总有效率为91.67%(44/48)。对照组中达到显效标准的有17例,占比35.42%,达到有效标准的有20例,占比41.67%,无效的有11例,占比22.92%。组间结果比较显示,χ^(2)=3.872,P=0.049;研究组产后24 h、产后48 h和产后72 h的出血量均低于对照组(P<0.05);两组治疗后凝血相关指标PT、APTT和TT水平较治疗前降低,FIB水平较治疗前升高。组间结果比较显示,研究组治疗后PT、APTT和TT水平高于对照组,FIB水平低于对照组(P<0.05);研究组患者宫腔积血发生率、子宫复旧不良�Objective To evaluate the effect of Dushen Decoction(独参汤)combined with misoprostol on coagulation function and uterine involution in patients with uterine atonic hemorrhage after labor.Methods A total of 96 patients with postpartum uterine atonic bleeding admitted to the hospital from April 2019 to April 2022 were selected as the research objects.According to the random number table method,the patients were divided into the study group and the reference group,with 48 cases in each group.The patients in the reference group were treated with conventional therapy and their vital signs,including changes in blood pressure,respiration,heart rate and heart rate,were closely monitored.The amount of blood loss was detected and the appropriate preparations were made in advance.The uterus can be given massage to help to stop bleeding.Intramuscular injection of tenotropin was given every 12 h at a dose of 10 U,and 400 of misoprostol was placed into the anus of the puerpera.On the basis of the treatment of the reference group,the patients in the study group were treated with Danshen Decoction orally.30 g raw sundried ginseng and 1000 mL distilled water were decocted to 150 mL.After the fetus was delivered,30 mL was taken orally once every 8 h.The blood loss at 24 h,48 h and 72 h after delivery was compared between the two groups.Collection method:After the amniotic fluid was drained,the urine pad and suction bottle were replaced and calculated by weighing method.Venous blood samples were collected before production and 24 h after treatment.Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and thrombin time(TT)were detected by coagulation analyzer.After 1 month of postpartum follow-up,the incidence of intrauterine hemorrhage,the incidence of adverse uterine involution,the duration of lochia and the height of fundus were compared between the two groups,and the therapeutic effect was compared.Results In the study group,21 cases(43.75%)reached the effective standard,23 cases(47.92%)reached the

关 键 词：独参汤 米索前列醇 产后宫缩乏力性出血 凝血功能 子宫复旧 宫腔积血 研究 

分 类 号：R271.1[医药卫生—中医妇科学]