重楼生化汤预防剖宫产术后恶露不绝的临床研究

Study of Chonglou Shenghua Tang on preventing lochiorrhagia after caesarean section

目的:探讨重楼生化汤预防剖宫产术后恶露不绝的有效性和安全性。方法:采用随机单盲研究法,选择2011年1月至2013年1月在浙江中医药大学附属第二医院住院行子宫下段剖宫产产妇584例为研究对象。其中试验组(重楼生化汤组)198例,于术后6h起予重楼生化汤100mL,2次/d,连服14d;对照1组(经典生化汤组)198例,术后6h起予经典生化汤100mL,2次/d,连服14d;安慰剂组188例,术后6h起予安慰剂100mL,2次/d,连服14d。观察:(1)子宫复旧:住院期间宫底高度,术后42dB超监测子宫三径之和、宫腔积血、子宫切口愈合;(2)恶露:血性恶露的量及持续时间、恶露持续时间;(3):术后肛门排气时间,服药期间不良反应。结果:(1)子宫复旧:宫底高度:术后第2天至第5天宫子底高度及平均宫底下降速度,各组间均有显著差异,重楼生化汤组显著优于经典生化汤组及安慰剂组(P均<0.05)。术后42dB超测量子宫三径之和三组间比较均有统计学差异,重楼生化汤组均显著小于经典生化汤组及安慰剂组(P均<0.05)。子宫切口I类愈合率,重楼生化汤组显著优于其他两组(P均<0.05)。(2)恶露:血性恶露量及持续时间,三组间比较均有统计学差异,重楼生化汤组均显著优于经典生化汤组及安慰剂组(P均<0.05)。(3)术后肛门排气时间及安全性观察:术后重楼生化汤组平均肛门排气时间显著早于对照组(P<0.05)。用药期间重楼生化汤组4例在服药初期有轻微腹泻。结论:剖宫产术后应用重楼生化汤可明显预防恶露不绝的发生,且药物安全性较好。

AIM：To evaluate the efficacy and safty of Chonglou Shenghua Tang for preventing lochiorrhagia after caesarian section（CS）. Methods：The prospective study ws designed as randomized and single blind research from Jan 2011 to Jan 2013.584women underwent caesarian section（CS） indicated by obstetric factors were enrolled from The 2ED Clinical Medical College of Zhejiang Chinese Medical University and assigned into three groups ：group of Chonglou Shenghua Tang： 198 cases were administered by Chonglou Shenghua Tang 100 ml, per 12 hours 14 days after CS;group of Classical Shenghua Tang： 198 cases were administered by Classical Shenghua Tang 100 ml, per 12 hours 14 days after CS and group of placebo： 184 cases were administered by placebo 100 ml, per 12 hours 14 days after CS.The following clinical parameter were collected and analyzed： （1） uterine instauration： hospital fundus height, the average drop speed of fundus；the sum of the three paths of uterus and uterine hemorrhage, uterine incision healing by ultrasound monitoring 42 days after CS; （2） the lochia： the amount and duration of lochia rubra , duration of lochia. （3） ： the anus exhaust time, adverse reactions.RESULTS： Uterine instauration： fundus height： the height of fundus from the second day to the fifth day after CS and the average drop speed of fundus , all have significant differences between groups, and Chonglou Shenghua Tang group was significantly better than the classical Shenghua Tang group and placebo group （P＜0.05）. The sum of the three paths of uterus were statistically significant differences between the three groups, Chonglou Shenghua Tang group were significantly less than the Shenghua Tang group group and placebo group（P＜0.05） Uterine cavity hemorrhage and uterine incision healing rate, Chonglou Shenghua Tang group was significantly better than the other two groups （P＜0.05）. 2） the lochia： the amount and duration of lochia rubra, duration of lochia, was statistically significant differences between the three groups, Chonglou Shenghua Tang group were significantly superior to the classical Shenghua Tang group and placebo group（P＜0.05）.（3） the postoperative anal exhaust time and safety observation： postoperative Chonglou Shenghua Tang group average anal exhaust time was earlier than the control group significantly（P＜0.05）.4 cases with mild diarrhea at the beginning of the drug have was observed. CONCLUSIONIt is efficacious and safe that use of Chonglou Shenghua Tang was to prevent lochiorrhagia after caesarian section.