米非司酮联合桃红四物汤治疗产后胎盘残留及对机体应激反应的影响

Effect of Taohong siwu decoction combined with mifepristone for treating women with postpartum placenta residual on their body stress

目的:观察米非司酮联合桃红四物汤治疗产后胎盘残留效果及对机体应激反应的影响。方法:选取2016年8月—2018年5月本院收治的产后胎盘残留患者138例,随机单双编号后分为中西药组(n=69)与西药组(n=69)。两组均予米非司酮治疗,中西药组在此基础上联合桃红四物汤治疗。观察两组治疗前后胎盘残留面积、人绒毛膜促性腺激素(β-hCG)、血性恶露持续时间、子宫收缩期、盆腔感染及机体应激反应。结果:治疗后中西药组治疗总有效率(97.1%)高于西药组(84.1%),胎盘残留面积(2.92±0.96cm^3)小于西药组(14.38±2.64cm^3),β-hCG水平(26.03±8.15 mIU/ml)低于西药组(70.65±13.88 mIU/ml),血性恶露持续时间(10.2±1.9d)短于对照组(16.4±3.8d),子宫收缩期体积(128.6±35.0cm^3)小于对照组(400.3±62.4cm^3)(均P<0.05),盆腔感染率(4.4%)与西药组(8.7%)无差异(P>0.05);治疗后超氧化物歧化酶、过氧化氢酶两组均较治疗前降低但中西药组高于西药组,活性氧簇两组均较治疗前升高但中西药组低于西药组(P<0.05)。结论:米非司酮联合桃红四物汤治疗产后胎盘残留疗效更佳,可更好地减少胎盘残留面积,促进子宫恢复,减少盆腔感染,减轻患者机体应激反应。

Objective:To observe the effect of Taohong siwu decoction combined with mifepristone for treating women with postpartum placenta residual on their body stress.Methods:138 women with postpartum placenta residual were randomly divided into observation group(n=69)and control group(n=69)by random single and double numbers from August 2016 to May 2018.The women in the control group were treated with mifepristone,while the women in the observation group were treated with Taohong siwu decoction combined with mifepristone.The placental residual area,βhCG level,duration of haemorrhagic lochia,the volume when uterine systole,pelvic infection rate,and stress response situation of women in the two groups were observed.Results:The total effective rate of women in the observation group was 97.1%,which was significant higher than that(84.1%)of women in the control group(P<0.05).The placental residual area(2.92±0.96cm^3)of women in the observation group was significant smaller than that(14.38±2.64cm^3)of women in the control group.The hCG level(26.03±8.15 U/ml)of women in the observation group was significant lower than that(70.65±13.88 U/ml)of women in the control group.The duration of haemorrhagic lochia(10.2±1.9d)of women in the observation group was significant lower than that(16.4±3.8d)of women in the control group.The volume when uterine systole(128.6±35.0cm^3)of women in the observation group was significant less than that(400.3±62.4cm^3)of women in the control group(all P<0.05).There was no significant difference in the pelvic infection rate(4.4%VS.8.7%)between the two groups(P>0.05).After treatment,the levels of SOD and CAT of women in both groups had decreased significantly,but that of women in the observation group was significant higher.After treatment,ROS level of women in both groups had increased significantly,but that of women in the observation group was significant lower(P<0.05).Conclusion:Taohong siwu decoction combined with mifepristone for treating women with postpartum placenta residual is effective,which can effectively reduce the placental residual area,promote uterine recovery,reduce pelvic infection,and alleviate body stress.