补虚祛瘀方联合穴位贴敷促进产后子宫复旧及对患者泌乳功能的影响
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摘要
目的:探讨产妇产后应用补虚祛瘀方联合穴位贴敷治疗对其子宫复旧及泌乳功能的影响。方法:选取134例产妇,按照随机数字表法分为观察组和对照组各67例。对照组常规予以缩宫素静脉滴注,观察组则采取补虚祛瘀方合穴位贴敷联合治疗,所有产妇均治疗5天。比较2组产后1～5天的宫底下降高度和阴道恶露量,治疗前后检测2组血红蛋白(Hb)水平、红细胞计数(RBC),产后1～5天测定2组血清泌乳素(PRL)水平,治疗结束后统计2组泌乳量,并记录不良反应发生情况。结果:2组产后1天时宫底均有升高,随后逐渐下降;且观察组产后2、3、4、5天时宫底下降高度均显著大于对照组同期(P <0.05)。2组产后1、2天时阴道恶露量比较,差异无统计学意义(P> 0.05);而观察组产后3、4、5天时阴道恶露量均显著低于对照组同期(P <0.05)。治疗后,2组Hb水平均较治疗前降低(P <0.05),但对照组下降更显著(P <0.05)。治疗后,2组RBC较治疗前均降低,但差异均无统计学意义(P> 0.05)。2组产后1、2、3天时血清PRL水平逐渐升高,而产后4、5天时开始逐渐降低;观察组产后1、2、3、4、5天时血清PRL水平均显著高于对照组同期(P <0.05)。观察组治疗结束后泌乳量显著高于对照组(P <0.05)。对照组不良反应率为3.0%,观察组为1.5%,2组比较,差异无统计学意义(P> 0.05)。结论:联合使用补虚祛瘀方合穴位贴敷治疗能有效促进产妇产后子宫复旧,改善泌乳功能,有助于产后恢复,且产妇耐受性良好。
Objective: To discuss the effect of Buxu Quyu prescription combined with point application on uterine involution and lactation function in postpartum period. Methods: A total of 134 cases of puerperas were divided into the observation group and the control group according to the random number table method,67 cases in each group. The control group was given oxytocin by intravenous drip,and the observation group was treated with Buxu Quyu prescription combined with point application. Both groups were treated for five days. One to five days after delivery, the descending height of uterine fundus and the volume of vaginal lochia in the two groups were compared;before and after treatment,the levels of hemoglobin(Hb) and the red blood cell(RBC) count in the two groups were detected;one to five days after delivery,the levels of prolactin(PRL) in serum in the two groups were detected;after treatment,the milk yields in the two groups were counted and the adverse reactions were recorded. Results: On the first day after delivery, the height of uterine fundus in the two groups were increased,then decreased gradually;on the second to fifth day after delivery,the descending height of uterine fundus in the observation group was significantly larger than that in the control group in the same period respectively(P < 0.05).On the first and second day after delivery, compared the volume of vaginal lochia in the two groups, there was no significance in the difference(P > 0.05); on the third to fifth day after delivery, the volume in the observation group was significantly lower than that in the control group in the same period respectively(P < 0.05). After treatment,the levels of Hb in the two groups were decreased when compared with those before treatment(P < 0.05),but the decrease in the control group was more significant(P < 0.05). After treatment,the RBC in the two groups was decreased when compared with that before treatment,but there was no significance in differences(P > 0.05). On the first to third day after delivery,the levels of PRL in serum in the two groups were increased gradually,but on the fourth and fifth day after delivery,the levels began to decrease gradually;on the first to fifth day after delivery,the above level in the observation group was significantly higher than that in the control group in the same period respectively(P < 0.05). After treatment, the milk yield in the observation group was significantly higher than that in the control group(P < 0.05). The incidence of adverse reactions was 3.0% in the control group and 1.5% in the observation group,there being no significance in the difference(P > 0.05). Conclusion:The therapy of Buxu Quyu prescription combined with point application can effectively promote postpartum uterine involution, improve lactation function,contribute to postpartum recovery,and with good puerperas' tolerance.
Objective: To discuss the effect of Buxu Quyu prescription combined with point application on uterine involution and lactation function in postpartum period. Methods: A total of 134 cases of puerperas were divided into the observation group and the control group according to the random number table method,67 cases in each group. The control group was given oxytocin by intravenous drip,and the observation group was treated with Buxu Quyu prescription combined with point application. Both groups were treated for five days. One to five days after delivery, the descending height of uterine fundus and the volume of vaginal lochia in the two groups were compared;before and after treatment,the levels of hemoglobin(Hb) and the red blood cell(RBC) count in the two groups were detected;one to five days after delivery,the levels of prolactin(PRL) in serum in the two groups were detected;after treatment,the milk yields in the two groups were counted and the adverse reactions were recorded. Results: On the first day after delivery, the height of uterine fundus in the two groups were increased,then decreased gradually;on the second to fifth day after delivery,the descending height of uterine fundus in the observation group was significantly larger than that in the control group in the same period respectively(P < 0.05).On the first and second day after delivery, compared the volume of vaginal lochia in the two groups, there was no significance in the difference(P > 0.05); on the third to fifth day after delivery, the volume in the observation group was significantly lower than that in the control group in the same period respectively(P < 0.05). After treatment,the levels of Hb in the two groups were decreased when compared with those before treatment(P < 0.05),but the decrease in the control group was more significant(P < 0.05). After treatment,the RBC in the two groups was decreased when compared with that before treatment,but there was no significance in differences(P > 0.05). On the first to third day after delivery,the levels of PRL in serum in the two groups were increased gradually,but on the fourth and fifth day after delivery,the levels began to decrease gradually;on the first to fifth day after delivery,the above level in the observation group was significantly higher than that in the control group in the same period respectively(P < 0.05). After treatment, the milk yield in the observation group was significantly higher than that in the control group(P < 0.05). The incidence of adverse reactions was 3.0% in the control group and 1.5% in the observation group,there being no significance in the difference(P > 0.05). Conclusion:The therapy of Buxu Quyu prescription combined with point application can effectively promote postpartum uterine involution, improve lactation function,contribute to postpartum recovery,and with good puerperas' tolerance.
引文
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[12]KIM H,JUNG B M,LEE B N,et al.Retinol,α-tocopherol,and selected minerals in breast milk of lactating women with full-term infants in South Korea[J].Nutr Res Pract,2017,11(1):64-69.
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[14]陈凌波,张珂胜,黄小平,等.黄芪当归配伍对骨髓造血功能抑制小鼠造血祖细胞增殖的影响[J].中草药,2016,47(24):4395-4400.
[15]王逸娜,田丹,田丽杰.三穴配合按摩在自然分娩产妇产后缺乳中的应用效果[J].中华现代护理杂志,2015,21(21):2560-2561.
[16]AINI Y N,RAHAYU S,PRAMONO N,et al.Effect of combination of oxytocin massage and hypnobreastfeeding on uterine involution and prolactin levels in postpartum mothers[J].Belitung Nursing Journal,2017,3(3):213-220.
[2]冯丽霞.补气化瘀方治疗气虚血瘀型剖宫产后子宫复旧不全恶露不绝临床观察[J].陕西中医,2017,38(5):621-622.
[3]鲁燕燕,刘丽萍,程子文,等.催乳汤治疗产后乳汁不足临床研究[J].陕西中医,2018,39(2):241-243.
[4]阳子兑娣,蒋桂湘,唐庆.中医药在产妇产后恢复中的临床应用新进展[J].海南医学,2017,28(6):964-965.
[5]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:288-292.
[6]叶璐,高小雅,吴昆仑,等.中医体质辨识对不同分娩方式产后恢复情况的评估[J].中医学报,2017,32(6):1029-1031.
[7]赵春幸,郭小霞,刘鑫,等.从气血同治理论探讨产后缺乳[J].中华中医药杂志,2017,32(10):4506-4508.
[8]郭晓玲,贾留顺,孔灿.养血复宫丸对血瘀型剖宫产后子宫复旧不良的疗效分析[J].世界中西医结合杂志,2017,12(6):821-824.
[9]GAUDERNACK L C,FR?SLIE K F,MICHELSEN T M,et al.De-medicalization of birth by reducing the use of oxytocin for augmentation among first-time mothers-a prospective intervention study[J].BMC Pregnancy Childbirth,2018,18(1):76.
[10]张尚智,朱田田,晋玲,等.当归单体成分与复合制剂功效研究进展[J].中国中医药信息杂志,2016,23(12):128-132.
[11]何云,史登玉.益母草注射液对人工流产患者子宫血流及宫缩强度的影响[J].实用临床医药杂志,2016,20(5):157-158.
[12]KIM H,JUNG B M,LEE B N,et al.Retinol,α-tocopherol,and selected minerals in breast milk of lactating women with full-term infants in South Korea[J].Nutr Res Pract,2017,11(1):64-69.
[13]CACHO N T,LAWRENCE R M.Innate Immunity and Breast Milk[J].Front Immunol,2017,8:584.
[14]陈凌波,张珂胜,黄小平,等.黄芪当归配伍对骨髓造血功能抑制小鼠造血祖细胞增殖的影响[J].中草药,2016,47(24):4395-4400.
[15]王逸娜,田丹,田丽杰.三穴配合按摩在自然分娩产妇产后缺乳中的应用效果[J].中华现代护理杂志,2015,21(21):2560-2561.
[16]AINI Y N,RAHAYU S,PRAMONO N,et al.Effect of combination of oxytocin massage and hypnobreastfeeding on uterine involution and prolactin levels in postpartum mothers[J].Belitung Nursing Journal,2017,3(3):213-220.