目的 探讨新生化片联合马来酸麦角新碱注射液治疗宫缩乏力性产后出血的临床疗效。方法 选择2021年10月—2022年6月在首都医科大学附属北京妇产医院怀柔妇幼保健院治疗的246例宫缩乏力性产后出血患者，根据用药的差别分为对照组和治疗组，每组各123例。对照组静脉注射马来酸麦角新碱注射液，0.2 mg/次加入生理盐水10 mL，持续时间最少1 min，必要时可2～4 h重复注射1次，最多5次；在对照组基础上，治疗组口服新生化片，4片/次，3次/d。两组患者均经5 d治疗。观察两组患者临床疗效，比较治疗前后两组患者出血量，止血时间，症状改善时间，CES-D评分、STAI评分和GSES评分，及血清抗凝血酶-Ⅲ（AT-III）、血管内皮生长因子（VEGF）、脑尿利肽（BNP）、去甲肾上腺素（NE）、肾上腺素（E）和一氧化氮（NO）水平。结果 经治疗，治疗组的临床总有效率为98.37%，明显高于对照组（88.62%，P＜0.05）。经治疗，治疗组在治疗2、12、24 h的出血量和止血时间均优于对照组（P＜0.05）。经治疗，治疗组症状改善时间均早于对照组（P＜0.05）。经治疗，两组GSES评分比治疗前明显升高，而STAI评分和CES-D评分比治疗前明显降低（P＜0.05），且治疗组评分明显好于对照组（P＜0.05）。经治疗，两组AT-Ⅲ、BNP、NO、NE、E水平比治疗前明显降低，而VEGF水平比治疗前明显升高（P＜0.05），且治疗组这些血清细胞因子水平明显好于对照组（P＜0.05）。结论 新生化片联合马来酸麦角新碱注射液治疗宫缩乏力性产后出血效果良好，可促提高患者自我效能感，减轻患者焦虑抑郁症状。

Objective To investigate the clinical effect of Xinshenghua Tablets combined with ergometrine maleate in treatment of postpartum hemorrhage due to uterine atony. Methods Patients (246 cases) with postpartum hemorrhage due to uterine atony in Huairou Maternity and Child Health Hospital of Beijing Maternity and Obstetrics Hospital of Capital Medical University from October 2021 to June 2022 were divided into control and treatment group bases on different treatments, and each group had 123 cases. Patients in the control group was iv administered with Ergometrine Maleate Injection, 0.2 mg added into normal saline 10 mL, the duration of the injection was at least 1 min, and another injection can be repeated once in 2 to 4 h if necessary, up to 5 times. Patients in the treatment group were po administered with Xinshenghua Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 5 d. After treatment, the clinical evaluation was evaluated, and the bleeding volume and the time of hemostatic, the improvement time of symptom, the scores of CES-D, STAI, and GSES, the levels of serum AT-Ⅲ, BNP, NO, NE, E, and VEGF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.37%, which was significantly higher than that of the control group (88.62%, P < 0.05). After treatment, the bleeding volume and hemostatic time in the treatment group were better than those in the control group at 2, 12 and 24 h (P < 0.05). After treatment, the time of symptom improvement in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the GSES score in two groups was significantly higher than that before treatment, while the STAI score and CES-D score in two groups were significantly lower than those before treatment (P < 0.05), and the scores in the treatment group were significantly better than that of the control group (P < 0.05). After treatment, the levels of AT-Ⅲ, BNP, NO, NE, and E in two groups were significantly lower than those before treatment, while the level of VEGF was significantly higher than that before treatment (P < 0.05), and the levels of serum cytokines in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The effect of Xinshenghua Tablets combined with ergometrine maleate in treatment of postpartum hemorrhage due to uterine atony is good, which can improve the patients' sense of self-efficacy and reduce the symptoms of anxiety and depression.

R984

北京市怀柔区卫生和计划生育委员会科研项目（2018-A-003）