生化汤合失笑散治疗不同因素导致宫内残留的临床观察

Shenghua decoction and Shixiaosan in treatment of intrauterine residual due to different factors

目的观察中药生化汤合失笑散治疗宫内残留的临床疗效。方法回顾性分析2016年1月至2018年12月在本院顺产、引产(孕14~28周)后宫内残留的患者2316例,其中顺产组1776例,引产组540例,全部纳入患者给予生化汤合失笑散口服治疗,1剂/d,2次煎服,共治疗14d,若B超提示宫腔仍有异常回声,再给予7~14d的生化汤合失笑散口服,观察并统计两组患者阴道流血持续时间、治疗前后B超检查宫腔组织情况、清宫率、盆腔感染发生率。结果顺产组阴道流血持续时间(15.25±2.51)d,明显少于引产组(20.38±3.26)d,差异有统计学意义(P<0.05);顺产组有3例行清宫术,清宫率为0.17%,明显低于引产组8例行清宫术,清宫率为1.48%,差异有统计学意义(P<0.05);两组盆腔感染发生率分别为0.06%、0.19%,差异无统计学意义(P>0.05);两组治愈、有效、无效例数比较,差异有统计学意义(P<0.05)。结论生化汤合失笑散可显著提高顺产后及引产后胎盘胎膜残留的临床疗效,降低清宫率,减少对产妇心理和生理的创伤,顺产组较引产组疗效更佳。

Objective To study the efficacy of Shenghua decoction and Shixiaosan in the treatment of intrauterine residuals. Methods The clinical data of 2 316 cases of intrauterine residual treated at our hospital from January, 2016 to December, 2018 were retrospectively analyzed. Among the 2 316 cases, 1 776 took spontaneous labor, and 540 induced labor. All the cases were given Shenghua decoction and Shixiaosan for 7-14 days, and for another 7-14 days if the ultrasound image showed intrauterine remaider. The vaginal bleeding time, ultrasonography examination, and rates of curettage and pelvic infection were observed in both groups. Results The vaginal bleeding time was shorter in the spontaneous labor group than in the induced labor group [(15.25±2.51) d vs.(20.38±3.26) d, P < 0.05]. 3 cases (0.17%) took curettage in the spontaneous labor group, and 8 (1.48%) in the induced labor group (P < 0.05). The incidence of pelvic infection was 0.06% in the spontaneous labor group, and was 0.19% in the induced labor group (P > 0.05). Conclusion Shenghua decotion and Shixiaosan for intrauterine residual can greatly improve the clinical efficacy, reduce the curettage rate, and lessen the mental and physiological harm of the puerperae, and it is more effective in the spontaneous labor group than in the induced labor group.