桂枝茯苓胶囊联合戊酸雌二醇治疗产后胎盘残留临床研究

Clinical Study of Guizhi Fuling Capsule(桂枝茯苓胶囊) Combined with Estradiol Valerate in Treatment of Postpartum Placenta Residue

目的 探讨桂枝茯苓胶囊联合戊酸雌二醇治疗产后胎盘残留的疗效,为产后胎盘残留的治疗提供理论依据。方法 选取2016年1月—2021年12月我院收治的产后胎盘残留患者64例,随机分为对照组(34例)和观察组(30例),对照组给予戊酸雌二醇,推荐剂量为1 mg/次,1次/d;观察组在此基础上口服桂枝茯苓胶囊,3粒/次,3次/d;两组治疗4周。对比两组治疗后临床疗效,采用健康调查简表(the MOS item short from health survey, SF-36)评价患者生活质量,治疗前后采用阴道B超测定两组子宫内膜厚度,采用超声诊断仪测定两组胎盘残留面积,采用视觉模拟评分(visual analogue scale, VAS评分)评价两组疼痛程度,治疗前对两组主症和次症根据严重程度评分,采用酶联免疫吸附测定(enzyme linked immunosorbent assay, ELISA)测定血清活性氧(reactive oxygen species, ROS)、超氧化物歧化酶(superoxide dismutase, SOD)和过氧氢酶(catalase, CAT)水平,采用全自动化学发光免疫分析仪测定血清人绒毛膜促性腺激素(β-human chorionic gonadotropin, β-HCG)、黄体生成素(luteinizing hormone, LH)、促卵泡激素(follicle-stimulating hormone, FSH)和孕酮(progesterone, P)水平。结果 治疗后观察组疗效明显较高(P<0.05);治疗后两组子宫内膜厚度、胎盘残留面积和VAS评分显著降低,SF-36评分显著升高(P<0.05);且观察组改善较明显(P<0.05);治疗后两组主症、次症及中医证候总评分明显降低(P<0.05);且观察组降低较多(P<0.05);治疗后两组血清ROS、CAT、SOD水平及血清β-HCG、LH、FSH和P水平明显改善(P<0.05);且观察组改善较多(P<0.05)。结论 桂枝茯苓胶囊联合戊酸雌二醇治疗产后胎盘残留具有较好的疗效,可提高机体抗氧化能力,改善生活质量。

Objective To investigate the curative effect of Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with estradiol valerate on postpartum placenta residue and provide theoretical basis for the treatment of postpartum placenta residue.Methods A total of 64 patients with postpartum residual placenta admitted to the hospital from January 2016 to December 2021 were randomly divided into control group(34 cases)and observation group(30 cases).The control group was given estradiol valerate with the recommended dose of 1 mg/time,once a day.The observation group was given Guizhi Fuling Capsule orally,3 capsules per time,3 times per day.Both groups were treated for 4 weeks.After treatment,the clinical curative effect and the MOS item short from health survey(SF-36)scale were observed to evaluate the quality of life of the patients.Before and after treatment,vaginal ultrasound was used to measure the endometrial thickness of the two groups,ultrasonic diagnostic apparatus was used to measure the residual area of placenta in the two groups and VAS score was used to evaluate the pain degree of the two groups.Before treatment,the main symptoms and secondary symptoms of the two groups were scored according to the severity,and enzyme-linked immunosorbent assay(ELISA)was used to measure serum levels of reactive oxygen species(ROS),superoxide dismutase(SOD)and catalase(CAT).Automatic chemiluminescence immunoassay was used to measure the levels ofβ-human chorionic gonadotropin(β-HCG),luteinizing hormone(LH),follicle stimulating hormone(FSH)and progesterone(P).Results The effective rate of the observation group was significantly higher after treatment(P<0.05).After treatment,endometrial thickness,placental residual area and VAS score were decreased significantly,while SF-36 score was significantly increased in both groups(P<0.05).Those of the observation group was improved significantly(P<0.05).After treatment,the total scores of primary symptoms,secondary symptoms and TCM symptoms in the two groups were decreased significantly(P<0.05).And those of the observation group decreased significantly(P<0.05).After treatment,the levels of serum ROS,CAT,SOD,β-hCG,LH,FSH and P in two groups were improved significantly(P<0.05).The levels of the observation group improved significantly(P<0.05).Conclusion The combination of Guizhi Fuling Capsule and estradiol valerate in the treatment of postpartum placenta residue has a good effect.It can improve the antioxidant capacity of the body and improve the quality of life.