目的 探讨益母草颗粒联合卡贝缩宫素治疗宫缩乏力性产后出血的临床疗效。方法 选取2021年1月-2022年3月天津市中心妇产科医院收治的96例宫缩乏力性产后出血患者,按随机数字表法将所有患者分为对照组和治疗组,每组各48例。对照组静脉注射卡贝缩宫素注射液,单次100 μg。治疗组在对照组基础上口服益母草颗粒,1袋/次,2次/d,开水冲服。两组用药24 h后观察疗效。比较两组用药后2、12、24 h的出血量和止血时间。比较治疗前后两组症状自评量表(SCL-90)评分、血红蛋白(HGB)及凝血与纤溶指标水平。结果 治疗后,治疗组总有效率是100.00%,显著高于对照组的87.50%(P<0.05)。治疗组患者用药后2、12、24 h的出血量均显著少于同期对照组(P<0.05)。治疗组止血时间较对照组显著缩短(P<0.05)。治疗后,两组SCL-90评分、HGB水平均显著降低(P<0.05);且治疗后,治疗组SCL-90评分显著低于对照组,HGB水平则显著高于对照组(P<0.05)。治疗后,两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均显著缩短, D-二聚体(D-D)、纤维蛋白降解产物(FDP)均显著降低,抗凝血酶Ⅲ(AT-Ⅲ)均显著升高(P<0.05),均以治疗组改善更显著(P<0.05)。结论 益母草颗粒联合卡贝缩宫素治疗子宫收缩乏力性产后出血可获得良好疗效,能有效增强止血效果,促进凝血功能恢复及心理状态改善,值得临床推广应用。

Objective To explore the clinical efficacy of Yimucao Granules combined with carbetocin in treatment of postpartum hemorrhage caused by uterine fatigue. Methods A total of 96 patients with postpartum hemorrhage caused by uterine fatigue admitted to Tianjin Central Obstetrics and Gynecology Hospital from January 2021 to March 2022 were selected and divided into control group and treatment group according to random number table method, with 48 patients in each group. Patients in the control group were iv administered with Carbetocin Injection, 100 μg at a time. Patients in the treatment group were po administered with Yimucao Granules with boiling water on the basis of the control group, 1 bag/time, twice daily. The two groups were treated for 24 h and the curative effect was observed. The blood loss and hemostatic time of 2, 12 and 24 h after treatment were compared between the two groups. The score of SCL-90, hemoglobin (HGB), coagulation and fibrinolysis index were compared between two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 100.00%, which was significantly higher than that of the control group (87.50%, P < 0.05). The amount of blood loss in the treatment group was significantly lower than that in the control group at 2, 12 and 24 h after treatment (P < 0.05). The hemostatic time in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, SCL-90 score and HGB level were significantly decreased in both groups (P < 0.05). After treatment, SCL-90 score in the treatment group was significantly lower than that in the control group, and HGB level was significantly higher than that in the control group (P < 0.05). After treatment, PT and APTT were significantly shortened, D-D and FDP were significantly decreased, AT-Ⅲ was significantly increased in both groups (P < 0.05), and the improvement was more significant in the treatment group (P < 0.05). Conclusion Yimucao Granules combined with carbetocin in treatment of postpartum hemorrhage caused by uterine fatigue can obtain good curative effect, effectively enhance the hemostatic effect, promote the recovery of coagulation function and improve the psychological state, which is worthy of clinical application.

R984

天津市卫生健康科研项目资助项目(ZC20142)；天津市医学重点学科(专科)建设项目资助项目(TJYXZDXK-043A)