目的 探讨葆宫止血颗粒联合卡贝缩宫素注射液治疗产后出血的临床疗效。方法 选取2021年5月—2024年5月在衡水市第二人民医院就诊的136例产后出血患者，以随机数字表法分为对照组和治疗组，每组各68例。对照组一次性注射1支卡贝缩宫素注射液。治疗组在对照组基础上口服葆宫止血颗粒，2次/d，1袋/次。14 d为1个周期，连续治疗2个周期。比较两组的治疗效果、超声指标、出血和恶露情况、血清指标。结果 治疗后，治疗组的治愈率为97.06%，对照组的治愈率为88.24%，组间差异显著（P＜0.05）。治疗后，两组的子宫残留物面积明显降低，子宫下降高度明显升高（P＜0.05）；治疗组的子宫残留物面积小于对照组，子宫下降高度高于对照组（P＜0.05）。治疗组持续出血时间、持续恶露时间均短于对照组（P＜0.05）。治疗后，两组的血清血小板反应蛋白1（THBS-1）、D-二聚体（D-D）水平降低，血清抗凝血酶Ⅲ（AT-Ⅲ）水平升高（P＜0.05）；治疗组的血清THBS-1、D-D水平低于对照组，血清AT-Ⅲ水平高于对照组（P＜0.05）。结论 葆宫止血颗粒联合卡贝缩宫素可提高产后出血的临床疗效，缩短持续出血时间，改善子宫状态，可能与调节凝血功能有关。

Objective To explore the clinical efficacy of Baogong Zhixue Granules combined with Carbetocin Injection in treatment of postpartum hemorrhage. Methods 136 Patients with postpartum hemorrhage in The Second People's Hospital of Hengshui from May 2021 to May 2024 were divided into control and treatment groups using a random number table method, with 68 patients in each group. Patients in the control group received a one-time injection of Carbetocin Injection. On the basis of the control group, patients in the treatment group took Baogong Zhixue Granules orally, twice daily, 1 bag/time, with 14 d as a course of treatment, and 2 consecutive courses of treatment. The clinical efficacy, ultrasound indicators, bleeding and lochia status, and serum indicators were compared between two groups. Results The cure rate of the treatment group was 97.06%, the cure rate of the control group was 88.24%, and the difference between groups was significant (P < 0.05). After treatment, the area of uterine residue in both groups was significantly reduced, but the height of uterine descent was significantly increased (P < 0.05). After treatment, the uterine residual area of the treatment group was lower than that of the control group, but the uterine descent height was higher than that of the control group (P < 0.05). The continuous bleeding time and continuous lochia time of patients in the treatment group were shorter than those in the control group (P < 0.05). The serum levels of THBS-1 and D-dimer in both groups after treatment were decreased, but AT-Ⅲ was increased (P < 0.05). After treatment, the serum levels of THBS-1 and D-dimer in the treatment group were lower than those in the control group, but AT-Ⅲ were higher than those in the control group (P < 0.05). Conclusion Baogong Zhixue Granules combined with Carbetocin Injection can improve the efficacy of postpartum hemorrhage, further reduce the duration of bleeding and improve the state of the uterus, which may be related to the regulation of coagulation function.

R984

衡水市科技计划项目（2019014004Z）