加味逐瘀汤联合缩宫素对产后胎盘残留患者子宫复旧和残留物的影响  

Effect of modified Zhuyu Decoction combined with oxytocin on uterine involvment and residual of placenta in postpartum patients

作　　者：林文静[1] 扈玉婷[2] 王梅梅 王珺 严雅洁 Lin Wenjing;Hu Yuting;Wang Meimei;Wang Jun;Yan Yajie(Department of Obstetrics,Baoji Central Hospital,Baoji 721008,China;Department of Obstetrics,Baoji Traditional Chinese Medicine Hospital,Baoji 721000,China;Department of Obstetrics and Gynecology,Tangdu Hospital of the Chinese People's Liberation Army Air Force Medical University,Xi'an 710032,China)

机构地区：[1]宝鸡市中心医院产科,宝鸡721008 [2]宝鸡市中医医院产科,宝鸡721000 [3]中国人民解放军空军军医大学唐都医院妇产科,西安710032

出　　处：《中国医师杂志》2024年第11期1642-1646,共5页Journal of Chinese Physician

基　　金：陕西省重点研发计划项目(2021SF-012)。

摘　　要：目的探讨加味逐瘀汤联合缩宫素对产后胎盘残留患者子宫复旧和残留物的影响。方法选择宝鸡市中心医院2023年1月至2024年1月收治的91例产后胎盘残留患者为研究对象。按照随机数字表法, 将患者分为观察组45例和对照组46例。对照组采用缩宫素治疗, 观察组在对照组基础上加用加味逐瘀汤。比较两组患者治疗效果、中医症候积分、视觉模拟量表(VAS)评分、健康调查简表(SF-36)评分、子宫复旧情况、子宫残留物面积, β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E_(2))水平, 阴道持续出血时间、住院时间及不良反应。结果观察组的总有效率高于对照组[95.6%(43/45) vs 78.3%(36/46), χ^(2)=5.943, P=0.015]。治疗后, 两组患者中医症候积分、VAS评分及SF-36评分均明显改善(均P<0.05), 且观察组中医症候积分和VAS评分低于对照组, SF-36评分高于对照组(均P<0.05)。治疗后, 两组患者子宫三径和、子宫内膜厚度、子宫残留物面积均减小(均P<0.05), 且观察组子宫三径和、子宫内膜厚度、子宫下降速度、子宫残留物面积均小于对照组(均P<0.05)。治疗后, 两组患者的β-HCG、P、E_(2)水平均较前改善(均P<0.05), 且观察组β-HCG、P水平低于对照组, E_(2)水平高于对照组(均P<0.05)。观察组阴道持续出血时间、住院时间短于对照组(均P<0.05)。观察组不良反应发生率低于对照组[6.67%(3/45) vs 21.7%(10/46), χ^(2)=4.220, P=0.040]。结论加味逐瘀汤联合缩宫素对产后胎盘残留具有较好的效果, 可有效减少宫内胎盘残留, 促进子宫复旧, 加速患者的康复。Objective To investigate the effect of Jiawei Zhuyu Decoction combined with oxytocin on uterine involvement and residual of placenta in postpartum patients.Methods A total of 91 patients with postpartum placenta residue admitted to Baoji Central Hospital from January 2023 to January 2024 were selected as the study objects.According to random number table method,the patients were divided into observation group(45 cases)and control group(46 cases).The control group was treated with oxytocin,and the observation group was treated with Jiawei Zhuyu decoction.Treatment effect,Traditional Chinese Medicine(TCM)symptom score,Visual Analogue Scale(VAS)score,SF-36 score,uterine reversion,uterine residual area,levels of beta human chorionic gonadotropin(β-HCG),progesterone(P),estradiol(E_(2)),duration of vaginal bleeding,length of hospital stay and adverse reactions were compared between the two groups.ResultsThe total effective rate of the observation group was higher than that of the control group[95.6%(43/45)vs 78.3%(36/46),X^(2)=5.943,P=0.015].After treatment,TCM syndrome scores,VAS scores and SF-36 scores of 2 groups were significantly improved(all P<0.05),and TCM syndrome scores and VAS scores of observation group were lower than those of control group,and SF-36 scores were higher than those of control group(all P<0.05).After treatment,the sum of three diameters of uterus,endometrial thickness and area of uterine residue in both groups decreased(all P<0.05),and the sum of three diameters of uterus,endometrial thickness,rate of uterine decline and area of uterine residue in the observation group were smaller than those in the control group(all P<0.05).After treatment,the levels ofβ-HCG,P,E_(2) in 2 groups were improved compared with before(all P<0.05),and the levels ofβ-HCG and P in observation group were lower than those in the control group,and E,levels were higher than those in the control group(all P<0.05).The duration of vaginal bleeding and hospitalization in the observation group were shorter than those in the

关 键 词：逐瘀汤 缩宫素 胎盘残留 性激素 

分 类 号：R714.5[医药卫生—妇产科学]