目的 探讨益宫颗粒联合卡前列素氨丁三醇注射液治疗产后出血的临床疗效。方法 选择2018年6月-2019年12月在黄河三门峡医院治疗的92例产后出血患者，根据用药的差别分为对照组（46例）和治疗组（46例）。对照组在胎儿娩出后立即宫体内注射卡前列素氨丁三醇注射液250μg，若宫缩不佳，有出血可能，15 min后再注射250 μg。治疗组在对照组的基础上口服益宫颗粒，10 g/次，3次/d。观察两组患者临床疗效，同时比较治疗前后两组患者产后出血量和止血时间及抗凝血酶-Ⅲ（AT-Ⅲ）、脑尿利肽（BNP）和一氧化氮（NO）水平。结果 治疗后，对照组和治疗组临床有效率分别为80.43%和97.83%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组患者在娩出后、产后2 h、产后2~24 h出血量均低于对照组（P<0.05），且治疗组止血时间明显短于对照组（P<0.05）。治疗后，两组AT-Ⅲ水平明显升高（P<0.05），而BNP和NO明显降低（P<0.05），且治疗组好转程度明显优于对照组（P<0.05）。结论 益宫颗粒联合卡前列素氨丁三醇注射液治疗产后出血效果显著，可促进机体AT-Ⅲ、BNP、NO水平改善，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Yigong Granules combined with carboprost tromethamine in treatment of postpartum hemorrhage. Methods Patients (92 cases) with postpartum hemorrhage in Huanghe Sanmenxia Hospital from June 2018 to December 2019 were divided into control (46 cases) and treatment (46 cases) groups based on different treatments. Patients in the control group were immediately intrauterine injection administered with 250 μg Carboprost Tromethamine Injection after delivery of the fetus, if the uterine contraction was not good, and there may be bleeding, then inject 250 μg in 15 min. Patients in the treatment group were po administered with Yigong Granules on the basis of the control group, 10 g/time, three times daily. After treatment, the clinical efficacy was evaluated, and the amount of bleeding and haemostatic time, the levels of AT-Ⅲ, BNP and NO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.43% and 97.83%, respectively, and there were differences between two groups (P<0.05). After treatment, the amount of bleeding after delivery, 2 h and 2-24 h postpartum in the treatment group was significantly less than that in the control group (P<0.05), and the haemostatic time in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the AT-Ⅲ levels in two groups were significantly increased (P<0.05), but the levels of BNP, and NO were significantly decreased (P<0.05), and the improvement in the treatment group was significantly better than that in the control group (P<0.05). Conclusion Yigong Granules combined with carboprost tromethamine has a significant effect in treatment of postpartum hemorrhage, can promoting the improvement of the AT-Ⅲ, BNP and NO levels, which has a certain clinical application value.

R984