补气凉血汤联合米索前列醇治疗产后出血的疗效及对氧化应激和炎症因子的影响
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摘要
目的:评价补气凉血汤联合米索前列醇治疗产后出血的疗效及对氧化应激和炎症因子的影响。方法:产后出血患者140例,根据Excel随机表格法分为对照组和治疗组各70例,对照组产妇在分娩后采用米索前列醇联合欣母沛治疗。治疗组产妇分娩后在口服米索前列醇的基础上联合补气凉血汤内服治疗。均治疗两周。比较两组临床疗效、比较两组产妇的出血情况、比较两组产妇治疗前后SOD、LPO和GSH-Px水平、比较两组治疗前后血清炎性因子CRP、TNF-α、IL-8水平。结果:经研究结果显示,治疗组总有效率为95.71%高于对照组总有效率为80.00%(P<0.05);治疗组产妇的出血量、出血时间、后期出血率、产褥期感染率均低于对照组(P<0.05);治疗后治疗组和对照组患者SOD和GSH-Px水平均显著升高,治疗组高于对照组,且LPO水平明显低于对照组(P<0.05);和治疗前相比,两组治疗后血清炎性因子CRP、TNF-α、IL-8水平均有所下降。治疗组治疗后血清炎性因子CRP、TNF-α、IL-8水平低于对照组(P<0.05)。结论:本研究所用内服中药汤剂补气凉血汤,功效益气凉血、固本培元、活血止血,与米索前列醇联合应用,可以缓解患者血清SOD、LPO和GSH-Px氧化应激水平,降低血清CRP、TNF-α和IL-8炎症因子表达,提高治疗疗效,值得临床推广运用。
Objective: To evaluate the effect of Supplementing Qi and Cooling Blood Decoction combined with misoprostol on postpartum hemorrhage and its effects on oxidative stress and inflammatory factors. Methods: According to the Excel random form, 140 cases of postpartum hemorrhage were divided into the control group and the treatment group. The control group was treated with misoprostol and copperate after delivery. The treatment group was given oral administration of misoprostol combined with Supplementing Qi and Cooling Blood Decoction after delivery. All patients were treated for two weeks. We compared the clinical effect of the two groups, the bleeding of the two groups, the levels of SOD, LPO and GSH-Px before and after treatment, and the levels of serum inflammatory factors CRP, TNF-αand IL-8 before and after treatment. Results:The results showed that the total effective rate of the treatment group was 95.71%,higher than that of the control group(P<0.05), and the amount of bleeding, bleeding time, late bleeding rate and puerperium infection rate in the treatment group were all lower than those of the control group(P<0.05), and the levels of SOD and GSH-Px in the treatment group and the control group were significantly increased. Tthe level of LPO was significantly lower than that of the control group(P<0.05). The serum inflammatory factors CRP, TNF-α and IL-8 in the treatment group and the control group were lower than those beforetreatment. After treatment, the levels of serum inflammatory factors CRP, TNF-α and IL-8 were lower in the treatment group than those in the control group(P<0.05). Conclusion:In this study, Supplementing Qi and Cooling Blood Decoction is used in the study. It can relieve the oxidative stress levels of SOD, LPO and GSH-Px in serum, reduce the levels of serum CRP, TNF-α and IL-8 inflammatory factors, and highlight the advantages of the combination of Chinese and Western medicine. The effect is obvious and worthy of clinical promotion and application.
Objective: To evaluate the effect of Supplementing Qi and Cooling Blood Decoction combined with misoprostol on postpartum hemorrhage and its effects on oxidative stress and inflammatory factors. Methods: According to the Excel random form, 140 cases of postpartum hemorrhage were divided into the control group and the treatment group. The control group was treated with misoprostol and copperate after delivery. The treatment group was given oral administration of misoprostol combined with Supplementing Qi and Cooling Blood Decoction after delivery. All patients were treated for two weeks. We compared the clinical effect of the two groups, the bleeding of the two groups, the levels of SOD, LPO and GSH-Px before and after treatment, and the levels of serum inflammatory factors CRP, TNF-αand IL-8 before and after treatment. Results:The results showed that the total effective rate of the treatment group was 95.71%,higher than that of the control group(P<0.05), and the amount of bleeding, bleeding time, late bleeding rate and puerperium infection rate in the treatment group were all lower than those of the control group(P<0.05), and the levels of SOD and GSH-Px in the treatment group and the control group were significantly increased. Tthe level of LPO was significantly lower than that of the control group(P<0.05). The serum inflammatory factors CRP, TNF-α and IL-8 in the treatment group and the control group were lower than those beforetreatment. After treatment, the levels of serum inflammatory factors CRP, TNF-α and IL-8 were lower in the treatment group than those in the control group(P<0.05). Conclusion:In this study, Supplementing Qi and Cooling Blood Decoction is used in the study. It can relieve the oxidative stress levels of SOD, LPO and GSH-Px in serum, reduce the levels of serum CRP, TNF-α and IL-8 inflammatory factors, and highlight the advantages of the combination of Chinese and Western medicine. The effect is obvious and worthy of clinical promotion and application.
引文
[1] 谢蓉蓉, 吴柏群. 益母绝露汤治疗剖宫产后恶露不绝患者40例[J]. 中国中医药科技, 2017,24(5):665-666.
[2] 陈莉, 周红, 温海燕,等. HBV感染对单胎妊娠孕妇孕期围产结局的影响[J]. 中华医院感染学杂志, 2018,28(3):455-458.
[3] 丁南萍, 康建颖. 中药汤剂联合复方益母草胶囊治疗剖宫产后恶露不绝临床疗效观察 [J]. 中华中医药学刊, 2017,35(6):1604-1606.
[4] 韩宁, 沈晓明. 中西医结合对子宫收缩乏力产后出血患者出血量、晚期再出血率及应激反应水平的影响 [J]. 中华中医药学刊, 2017,35(6):1593-1596.
[5] 王丽秀, 王月兰, 薛娟. 益气凉血安宫汤联合益母草片对急性产后出血(血热型)中医证候积分、氧化应激及炎症因子的影响 [J]. 中医药信息, 2017,34(5):55-58.
[6] 侯纪湘, 张芙蓉. 益母草注射液预防非凶险性前置胎盘剖宫产术中及术后出血临床研究 [J]. 陕西中医, 2017,38(5):623-624.
[7] 黄静云. 益母草注射液联合缩宫素预防剖宫产产后出血的临床疗效及安全性分析 [J]. 中医临床研究, 2017,24(9):33-34.
[8] 金萍, 石少权. 麦角新碱联合缩宫素治疗临产后剖宫产产后出血的临床观察 [J]. 药物评价研究, 2018,41(2):302-304.
[9] 劳力, 张婷. 宫缩乏力性产后出血产妇子宫平滑肌自发性收缩功能变化及产后出血关系研究 [J]. 中国妇幼保健, 2018,33(2):278-280.
[10] 杨春旭. 少腹逐瘀颗粒治疗寒凝血瘀型产后恶露不绝30例疗效观察 [J]. 中医临床研究, 2017,9(33):98-99.
[11] 王晶, 刘春华, 陈丽, 等. 益母草联用氧疗及缩宫素对产妇产后出血和生活质量的影响研究 [J]. 陕西中医, 2018,39(5):599-601.
[12] 李贺南, 胡海霞. 归母祛瘀汤联合西药防治产后出血的效果观察 [J]. 中国中医药科技, 2017,24(5):643-644.
[13] 朱云霞, 杨华升, 王明, 等. 生化汤治疗宫缩乏力性产后出血的临床疗效及对RhoA、ROCK蛋白的影响 [J]. 世界中医药, 2017,12(5):1007-1010.
[14] 李焕香, 何妍. 生化汤联合米索前列醇片预防产后出血临床观察 [J]. 新中医, 2017,49(5):77-79.
[15] 李苑瑛. 参芪化瘀方结合常规西药对宫缩乏力型产后出血的疗效及对FIB、D-D的影响 [J]. 中华中医药学刊, 2018,36(4):942-945.
[16] 刘梅毅, 司越, 李广太. 子宫压迫缝合术联合子宫动脉上行支结扎术在预防前置胎盘并发产后出血中的应用 [J]. 中国妇幼保健, 2018,33(3):686-688.
[17] 罗华丽. 产妇精神因素对分娩方式及产后出血影响的研究 [J]. 中医临床研究, 2017,9(12):138-139.
[18] 罗永芳. 益母草注射液联合缩宫素预防剖宫产后出血效果观察 [J]. 内蒙古中医药, 2017,36(1):40-41.
[19] 吕小玲. 产复康颗粒联合缩宫素注射液治疗产后出血临床观察 [J]. 新中医, 2017,49(4):89-91.
[20] 闵敏, 张治萍, 程海东, 等. 阴道分娩产后出血发病率及影响因素的队列研究 [J]. 中华生殖与避孕杂志, 2017,37(10):815-819.
[21] 宋学丽. 生化汤联合卡孕栓治疗产后出血的临床疗效评价 [J]. 内蒙古中医药, 2017,36(4):81.
[22] 杨霄, 罗丹. 目测法与血红蛋白检测法评估产后出血的临床分析 [J]. 中华妇幼临床医学杂志(电子版), 2017,13(6):663-668.
[2] 陈莉, 周红, 温海燕,等. HBV感染对单胎妊娠孕妇孕期围产结局的影响[J]. 中华医院感染学杂志, 2018,28(3):455-458.
[3] 丁南萍, 康建颖. 中药汤剂联合复方益母草胶囊治疗剖宫产后恶露不绝临床疗效观察 [J]. 中华中医药学刊, 2017,35(6):1604-1606.
[4] 韩宁, 沈晓明. 中西医结合对子宫收缩乏力产后出血患者出血量、晚期再出血率及应激反应水平的影响 [J]. 中华中医药学刊, 2017,35(6):1593-1596.
[5] 王丽秀, 王月兰, 薛娟. 益气凉血安宫汤联合益母草片对急性产后出血(血热型)中医证候积分、氧化应激及炎症因子的影响 [J]. 中医药信息, 2017,34(5):55-58.
[6] 侯纪湘, 张芙蓉. 益母草注射液预防非凶险性前置胎盘剖宫产术中及术后出血临床研究 [J]. 陕西中医, 2017,38(5):623-624.
[7] 黄静云. 益母草注射液联合缩宫素预防剖宫产产后出血的临床疗效及安全性分析 [J]. 中医临床研究, 2017,24(9):33-34.
[8] 金萍, 石少权. 麦角新碱联合缩宫素治疗临产后剖宫产产后出血的临床观察 [J]. 药物评价研究, 2018,41(2):302-304.
[9] 劳力, 张婷. 宫缩乏力性产后出血产妇子宫平滑肌自发性收缩功能变化及产后出血关系研究 [J]. 中国妇幼保健, 2018,33(2):278-280.
[10] 杨春旭. 少腹逐瘀颗粒治疗寒凝血瘀型产后恶露不绝30例疗效观察 [J]. 中医临床研究, 2017,9(33):98-99.
[11] 王晶, 刘春华, 陈丽, 等. 益母草联用氧疗及缩宫素对产妇产后出血和生活质量的影响研究 [J]. 陕西中医, 2018,39(5):599-601.
[12] 李贺南, 胡海霞. 归母祛瘀汤联合西药防治产后出血的效果观察 [J]. 中国中医药科技, 2017,24(5):643-644.
[13] 朱云霞, 杨华升, 王明, 等. 生化汤治疗宫缩乏力性产后出血的临床疗效及对RhoA、ROCK蛋白的影响 [J]. 世界中医药, 2017,12(5):1007-1010.
[14] 李焕香, 何妍. 生化汤联合米索前列醇片预防产后出血临床观察 [J]. 新中医, 2017,49(5):77-79.
[15] 李苑瑛. 参芪化瘀方结合常规西药对宫缩乏力型产后出血的疗效及对FIB、D-D的影响 [J]. 中华中医药学刊, 2018,36(4):942-945.
[16] 刘梅毅, 司越, 李广太. 子宫压迫缝合术联合子宫动脉上行支结扎术在预防前置胎盘并发产后出血中的应用 [J]. 中国妇幼保健, 2018,33(3):686-688.
[17] 罗华丽. 产妇精神因素对分娩方式及产后出血影响的研究 [J]. 中医临床研究, 2017,9(12):138-139.
[18] 罗永芳. 益母草注射液联合缩宫素预防剖宫产后出血效果观察 [J]. 内蒙古中医药, 2017,36(1):40-41.
[19] 吕小玲. 产复康颗粒联合缩宫素注射液治疗产后出血临床观察 [J]. 新中医, 2017,49(4):89-91.
[20] 闵敏, 张治萍, 程海东, 等. 阴道分娩产后出血发病率及影响因素的队列研究 [J]. 中华生殖与避孕杂志, 2017,37(10):815-819.
[21] 宋学丽. 生化汤联合卡孕栓治疗产后出血的临床疗效评价 [J]. 内蒙古中医药, 2017,36(4):81.
[22] 杨霄, 罗丹. 目测法与血红蛋白检测法评估产后出血的临床分析 [J]. 中华妇幼临床医学杂志(电子版), 2017,13(6):663-668.