本文選題：卡前列甲酯栓 + 生化湯加味�。� 參考：《青島大學》2017年碩士論文

【摘要】：目的本實驗是在傳統(tǒng)名方生化湯基礎上進行辨證施治而自擬的方劑,對產后患者可起到促惡露排出、減少產后出血,促子宮復舊的顯著療效。結合產后氣虛夾瘀最為常見的臨床特點,增加益母草,配五靈脂、蒲黃化瘀止痛,加伍芥穗炭散風止血而不留瘀,最終配方成生化湯加味。在常規(guī)治療基礎上,研究將生化湯加味與卡前列甲酯栓聯(lián)合應用于剖宮產術后治療,觀察其對產后出血、惡露不絕、子宮復舊、泌乳等的臨床效果,看是否優(yōu)于臨床常規(guī)治療效果。方法自2016年2月至2016年11月我院行剖宮產術產婦按實驗資料選取要求抽取60例,按隨機配對原則分為觀察組和對照組,每組各30例。對照組采用縮宮素等常規(guī)治療,觀察組采用常規(guī)治療的同時加卡前列甲酯栓1mg舌下含化,并且術后6小時口服生化湯加味每日一劑連續(xù)5天,觀察記錄兩組產婦產后出血量、自主排氣時間、子宮下降速度、惡露情況、乳汁分泌情況及不良反應。結果觀察組可見術后2h、24h出血量同對照組相比明顯減少(p0.0001)。觀察組術后首次排氣平均時間較對照組術后首次排氣時間明顯縮短,兩組數(shù)據(jù)相比差異有統(tǒng)計學意義(p0.0001)。觀察組在術后5天內的宮底高度、下降速度與對照組相比表現(xiàn)出明顯統(tǒng)計學差異(p0.05)。觀察組在產后血性惡露量、惡露持續(xù)時間與對照組相比有明顯統(tǒng)計學差異(p0.05或p0.01)。觀察組術后56天彩超子宮各徑線之和明顯小于對照組,兩組數(shù)據(jù)相比差異有顯著性意義(p0.001);觀察組術后56天宮腔無積血者29例,達97%,少量積血者1例,約占3%,對照組術后56天宮腔無積血者24例,占80%,少量積血6例,占20%,觀察組宮腔積血發(fā)生率明顯低于對照組。觀察組、對照組第2天泌乳率大致相同(p0.05),但第3、4、5天觀察組乳足率同對照組相比具有明顯優(yōu)勢,差異有統(tǒng)計學意義(p0.05)。治療有效率及顯效率觀察組與對照組相比表現(xiàn)出統(tǒng)計學差異(p0.05)。結論生化湯加味同卡前列甲酯栓共同應用能明顯減少產后出血,促進產后排氣,還能明顯促進子宮縮復,顯著減少血性惡露,促進惡露收斂干凈,能較好的促進子宮復舊,降低宮腔積血發(fā)生率,并能有效促進剖宮產術后產婦泌乳。術中卡前列甲酯栓與傳統(tǒng)縮宮素聯(lián)合起效迅速,作用時間較持久,能有效持續(xù)減少產后出血。術后應用生化湯加味充分發(fā)揮了祖國中醫(yī)藥不可替代的優(yōu)勢,藥物應用不良反應較少,用藥安全可靠,值得臨床廣泛應用。
[Abstract]:Objective this experiment is based on the traditional prescription of biochemical decoction dialectical treatment and self-prescription, postpartum patients can promote the excretion of lochia, reduce postpartum hemorrhage, promote the recovery of the uterus. Combined with the most common clinical characteristics of postpartum qi deficiency and blood stasis, the addition of Motherwort, with five Lingzhi, fuhuang Huayu to relieve pain, combined with mustard panicle charcoal wind to stop bleeding without leaving blood stasis, the final formula is modified biochemical soup. On the basis of routine treatment, the authors studied the clinical effect of modified biochemical decoction and carboprost methyl ester suppository on postpartum hemorrhage, lochia, uterine recovery, lactation, and so on. See if it is better than clinical routine treatment. Methods from February 2016 to November 2016, 60 cases of parturient undergoing cesarean section in our hospital were randomly divided into observation group and control group, 30 cases in each group. The control group was treated with oxytocin and other routine therapy, the observation group was treated with routine therapy and the treatment group was treated with carprost methyl ester suppository (1mg) with sublingual metaplasia, and was orally treated with Shenghua decoction for 5 days after operation. The amount of postpartum hemorrhage was observed and recorded in the two groups. Spontaneous venting time, uterine descending speed, lochia, milk secretion and adverse reactions. Results in the observation group, the blood loss at 2 hours after operation was significantly lower than that in the control group (p 0.0001). The mean time of the first exhaust in the observation group was significantly shorter than that in the control group, and the difference between the two groups was statistically significant (p 0.0001). There were significant differences in floor height and descending speed between the observation group and the control group within 5 days after operation (p0.05). The amount and duration of postpartum hematoxia in the observation group were significantly different from those in the control group (p0.05 or p0.01). In the observation group, the sum of the uterine lines on 56 days after operation was significantly smaller than that in the control group, and the difference between the two groups was significant (p0.001), and in the observation group, there were 29 cases (97%) with no hemorrhage in uterine cavity and 1 case with small amount of hemorrhage on the 56th day after operation. In the control group, 24 cases (80%) had no hemorrhage in uterine cavity at 56 days after operation, 6 cases (20%) had a small amount of hemorrhage, the incidence of uterine cavity hemorrhage in the observation group was significantly lower than that in the control group. In the observation group, the lactation rate of the control group on the second day was approximately the same (p0.05), but the milk foot rate of the observation group on the 3rd 4th day was significantly superior to that of the control group (p0.05). The effective rate and effective rate of treatment in the observation group were significantly different from those in the control group (p0.05). Conclusion the combined application of biochemical decoction and carboprost methyl ester suppository can significantly reduce postpartum hemorrhage, promote postpartum exhaust, significantly promote uterine contraction, significantly reduce hemorrhagic lochia, promote neatness of lochia, and promote uterine restoration. Reduce the incidence of intrauterine hemorrhage, and can effectively promote the lactation of parturient after cesarean section. The combination of carprost methyl ester suppository and traditional oxytocin was effective and lasting during operation, and could effectively reduce postpartum hemorrhage. The application of biochemical decoction after operation has brought into full play the irreplaceable advantages of traditional Chinese medicine, less adverse drug reactions, safe and reliable use of drugs, and worthy of extensive clinical application.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R719.8

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