清热调血汤加减联合缩宫素治疗湿热瘀阻型产后恶露不绝临床观察

Clinical study on the combination of modified Qingre Tiaoxue decoction and oxytocin on the incessant postpartum dew with damp-heat and stasis type

目的观察清热调血汤加减联合缩宫素对湿热瘀阻型产后恶露不绝的临床疗效,及对患者贫血和凝血功能指标的影响。方法110例湿热瘀阻型产后恶露不绝患者随机分为试验组(清热调血汤加减联合缩宫素)和对照组(单用缩宫素)各55例,疗程7 d。比较两组患者治疗后临床总有效率、恶露排净时间,以及治疗前后中医证候积分、子宫三径之和、红细胞压积、血红蛋白、血纤维蛋白原和D-二聚体水平等指标变化;记录治疗期间两组药品不良反应发生率。结果试验组临床总有效率明显高于对照组,恶露排净时间明显短于对照组(P<0.05)。治疗后,两组患者各项中医证候评分的例数分布均较前明显改善,总积分明显下降(P<0.01);血红蛋白和红细胞压积较前明显升高,血纤维蛋白原和D-二聚体水平以及子宫三径之和较前明显降低(P<0.01);且试验组上述各项指标均优于对照组(P<0.01)。两组药品不良反应发生率差异无统计学意义(P>0.05)。结论清热调血汤加减与缩宫素联合使用可进一步改善湿热瘀阻型产后恶露不绝患者的临床症状,促进产后子宫恢复,纠正贫血症状和血液高凝状态,疗效显著且不增加患者用药安全风险。

Objective To observe the clinical efficacy of modified Qingre Tiaoxue decoction combined with oxytocin on postpartum malignant dew with damp-heat and stasis obstruction,and its effects on anemia and coagulation function indices.Methods 110 patients with damp-heat and stagnant dew were randomly divided into the experimental group(modified Qingre Tiaoxue decoction combined with oxytocin)and the control group(oxytocin alone)with 55 cases in each group for a treatment period of 7 d.The total clinical efficiency,the time to drain the dew,and the changes in the indices of Chinese medicine symptoms,the sum of the three diameters of the uterus,hematocrit,hemoglobin,fibrinogen and D-dimer levels before and after the treatment were compared between two groups.The incidence of adverse reactions between two groups during the treatment period was recorded.Results The total clinical efficiency of the experimental group was significantly higher than that of the control group,and the time to clear the malignant dew was significantly shorter than that of the control group(P<0.05).After treatment,the case distribution of TCM symptoms scores in the two groups was significantly better than before,and the total score was significantly lower(P<0.01).Hemoglobin and hematocrit were significantly higher than before,and the sum of blood fibrinogen,D-dimer levels and uterine triple diameter were significantly lower than before(P<0.01).All the above indices in the experimental group were better than those in the control group(P<0.01).The difference of the incidence of adverse reactions between two groups was not statistically significant(P>0.05).Conclusion The combination of modified Qingre Tiaoxue decoction and oxytocin can further improve the clinical symptoms of patients with damp-heat and stasis obstruction of postpartum malignant dew,promote the recovery of the uterus after delivery,and correct the symptoms of anemia and blood hypercoagulation,with significant efficacy and without increasing the safety risk of patients with the drug.