中药治疗产后血虚发热的临床及机理研究

Clinical and mechanism studies of traditional Chinese medicine to treat postpartum massive hemorrhage fever

目的探讨当归补血合四物汤加减治疗产后血虚发热的临床疗效，并探讨其作用机理。方法选取2013年3月至2016年9月我院门诊及病房诊断为产后血虚发热患者60例，随机分为2组。中药组30例，给予当归补血合四物汤加减口服治疗5天。对照组30例，给予抗生素静滴和琥珀酸亚铁口服治疗5天。分别观察2组患者退热时间、治疗前后体温、中医证候积分、白细胞介素（IL）-2、IL-6、血清促红细胞生成素（EPO）、血红蛋白及白细胞计数等指标。结果中药组的疗效优于对照组，差异有统计学意义（P〈0．05）。治疗后中药组及对照组体温、中医证侯积分、白细胞计数较治疗前均下降，血红蛋白均较治疗前升高，差异有统计学意义（P〈0．05或P〈0．01）；退热时间中药组快于对照组，差异有统计学意义（P〈0．01）。结论当归补血合四物汤加减治疗产后血虚发热疗效显著，且可降低IL-6水平和白细胞计数，升高血红蛋白水平，无副作用，值得临床推广应用。

Objective To investigate the clinical efficacy and mechanism of danggui buxue tang combined with siwu tang subtraction to treat postpartum massive hemorrhage fever. Methods A total of 60 patients with postpartum massive hemorrhage fever who were admitted into our hospital from March 2013 to September 2016 were randomly divided into two groups. The traditional Chinese medicine （TCM） group （n = 30） was danggui buxue tang combined with siwu tang subtraction for five days. The control group （ n = 30 ） was administrated with ferrous succinate and antibiotics for five days. Then, both groups were observed for antipyetic time,body temperature, TCM syndrome scores, interleukin （IL） - 2, IL -6, erythropoietin （EPO）, hemoglobin and white blood cell counts before and after treatment. Results The TCM group presented significantly better clinical efficacy than the control （ P 〈 0.05 ）. After treatment, both the TCM and control groups showed remarkably reduced body temperature, TCM syndrome scores, and white blood cell counts, and markedly increased hemoglobin levels （P 〈 0.05 or P 〈 0.01 ）. The TCM group required remarkably shorter antipyetic time than the control （ P 〈 0. 01 ）. Conclusions Danggui buxue tang combined with siwu tang subtraction can treat postpartum massive hemorrhage fever, decreasing serum IL -6 levels and white blood cell counts and increasing emoglobin levels, without side effects.