妇康丸、耳穴贴压联合电针治疗产后子宫复旧不全临床研究

Clinical Study on Fukang Pills and Auricular Point Pressing Combined with Electroacupuncture for Postpartum Uterine Subinvolution

目的:观察妇康丸、耳穴贴压联合电针治疗产后子宫复旧不全的临床疗效。方法:选取204例产后子宫复旧不全患者,采用随机数字表法分为研究组、对照A组、对照B组,每组68例。3组均给予米非司酮治疗,在此基础上,对照A组予以妇康丸治疗,对照B组给予耳穴贴压及电针治疗,研究组予以妇康丸联合耳穴贴压、电针治疗,3组均治疗4 d。比较3组临床疗效,恶露异常、腹痛、子宫压痛改善时间,子宫三径(长径、横径、前后径)及子宫三径之和;比较3组治疗前后血液流变学指标、血清性激素、一氧化氮(NO)、一氧化氮合酶(NOS)水平。结果:研究组总有效率为97.06%,高于对照A组、对照B组的83.82%和79.41%(P<0.05)。研究组恶露异常、腹痛、子宫压痛改善时间均短于对照A组、对照B组(P<0.05)。治疗后,研究组全血高切黏度、全血中切黏度、全血低切黏度及血浆黏度均低于对照A组、对照B组(P<0.05);研究组子宫长径、横径、前后径及三径之和均小于对照A组、对照B组(P<0.05),对照A组子宫长径、横径、前后径及三径之和均小于对照B组(P<0.05)。治疗后,研究组血清NO、NOS、孕酮(P)水平均低于对照A组、对照B组(P<0.05),血清雌二醇(E2)水平高于对照A组、对照B组(P<0.05);对照A组血清NO、NOS、P水平均低于对照B组(P<0.05),血清E2水平高于对照B组(P<0.05)。结论:妇康丸、耳穴贴压联合电针治疗产后子宫复旧不全,可改善患者的血液流变学指标及血清性激素水平,下调血清NO、NOS水平,促进子宫复旧。

Objectives: To observe the clinical effect of Fukang pills and auricular point pressing combined with electroacupuncture for postpartum uterine subinvolution. Methods:A total of 204 cases of patients with postpartum uterine subinvolution were randomly divided into the study group,the control group A,and the control group B,with 68 cases in each group. The three groups were treated with mifepristone. The control group A was additionally treated with Fukang pills,the control group B was additionally treated with auricular point pressing and electroacupuncture,and the study group was additionally treated with Fukang pills combined with auricular point pressing and electroacupuncture. The three groups were treated for four days. The clinical effects,the improvement time of abnormal lochia,abdominal pain and uterine tenderness,the three dimensions of uterus including length,width,and thickness,and the sum of three dimensions of uterus in the three groups were compared. Before and after treatment,levels of hemorheological values,sex hormones in serum,nitric oxide(NO) and nitric oxide synthase(NOS) in the three groups were compared. Results:The total effective rate was 97.06% in the study group,higher than those of 83.82% and 79.41% in the control group A and B(P<0.05). The improvement time of abnormal lochia,abdominal pain and uterine tenderness in the study group was shorter than that in the control group A and that in the control group B(P<0.05). After treatment, the high-shear whole blood viscosity, middle-shear whole blood viscosity,low-shear whole blood viscosity,and plasma viscosity in the study group were lower than those in the control group A and B(P<0.05);the uterine length,width,thickness and their sum in the study group were fewer than those in the control group A and B(P<0.05),and the above indexes in the control group A were fewer than those in the control group B(P<0.05). After treatment,the levels of NO,NOS and progesterone(P) in serum in the study group were lower than those in the control group A and B(P<0.05),and the level of serum estradiol(E2) was higher(P<0.05). The levels of NO,NOS and P in serum in the control group A were lower than those in control group B(P<0.05),and the level of serum E2 was higher(P<0.05). Conclusion: Fukang pills and auricular point pressing combined with electroacupuncture for postpartum uterine subinvolution can improve the levels of hemorheology and serum sex hormones,down-regulate the levels of NO and NOS in serum,and promote uterine involution.