生化汤治疗宫缩乏力性产后出血的临床疗效及对RhoA、ROCK蛋白的影响

Clinical Effect of Shenghua Decoction for Treatment of Atonic Postpartum Hemorrhage and its Effect on RhoA and ROCK protein

目的:探讨生化汤治疗宫缩乏力性产后出血(PHH)的临床疗效及对患者应激指标及Rho A蛋白、Rho激酶Ⅰ(ROCKⅠ)和Rho激酶Ⅱ(ROCKⅡ)蛋白水平的影响。方法:选取2015年1月至2016年5月我院收治的PHH患者100例,随机分为实验组和对照组,各50例。对照组在胎儿娩出后注射卡贝缩宫素,实验组在对照组的基础上服用生化汤,观察比较2组止血时间、产后出血量,产后血红蛋白(Hb)水平、血压及应激指标变化、Rho A蛋白、ROCKⅠ和ROCKⅡ蛋白水平及不良反应情况。结果:治疗后实验组止血时间、产时、产后2 h、产后24 h出血量、Hb下降值、E、NE、R、AngⅡ水平均低于对照组(P<0.01);2组间及治疗前后SBP、DBP比较,差异无统计学意义(P>0.05);治疗后2组Rho A、ROCKⅠ和ROCKⅡ蛋白水平均显著高于治疗前(P<0.05或P<0.01),但2组比较,差异无统计学意义(P>0.05)。结论:生化汤联合卡贝缩宫素治疗PHH无明显不良反应且疗效显著,能缩短患者的止血时间,减少出血量,降低机体应激反应,增强患者子宫平滑肌的收缩作用。

Objective：To observe the clinical effect of Shenghua decoction for treatment of atonic postpartum hemorrhage （PHH） and its effect on stress indices and protein levels of RhoA, Rho kinaseⅠ（ROCKⅠ） and Rho kinaseⅡ （ROCKⅡ）.Methods：A total of 100 cases with PHH were randomly divided into experimental group and control group, with 50 cases in each group.The control group was treated with carbetocin, while the experimental group was treated with shenghua decoction on the basis of control group.The hemostatic time, amount of bleeding, postpartum hemoglobin （Hb） level, blood pressure and stress indices, RhoA protein, Rho protein and ROCK protein levels and adverse reactions were observed and compared between the two groups.Results：After treatment, hemostatic time, postpartum hemorrhage, the decrease of Hb, levels of E, NE, R and Ang II of the experimental group were lower than those of the control group （P〈0.01）;SBP and DBP of two groups before and after treatment have no significant difference（P〉0.05）;RhoA, ROCK I and ROCK II protein levels of 2 groups after treatment were significantly higher after treatment （P〈0.05 or P〈0.01）, but there was no significant difference between two groups （P〉0.05）.Conclusion：Use Shenghua decoction combined with carbetocin in treating PHH panteins have significant effect and no obvious adverse reactions, which can shorten hemostatic time, reduce postpartum hemorrhage and stress reaction, enhance the function of patients with uterine smooth muscle contraction.