目的 探討產后逐瘀膠囊聯合馬來酸麥角新堿注射液治療產后出血的臨床療效。方法 選取2018年2月—2019年4月在萬寧市人民醫(yī)院進行治療的82例產后出血患者為研究對象，根據用藥的差別將患者分為觀察組（41例）和對照組（41例）。對照組iv馬來酸麥角新堿注射液，0.2 mg/次，必要時可2～4 h重復注射1次，最多5次；觀察組在對照組基礎上給予產后逐瘀膠囊，0.9 g/次，3次/d。兩組均治療4 d。觀察兩組的臨床療效和產后出血量，同時比較兩組治療前后的血紅蛋白（Hb）、D-二聚體（D-D）和纖維蛋白原（FIB）、一氧化氮（NO）、腦鈉肽（BNP）、抗凝血酶-Ⅲ（AT-III）水平。結果經治療，對照組總有效率為80.49%，顯著低于的觀察組的97.56%，兩組總有效率比較差異具有統(tǒng)計學意義（P<0.05）。治療2 h、2～24 h后，觀察組患者產后出血量均顯著低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。經治療，兩組Hb、D-D和FIB水平均顯著降低，同組治療前后比較差異具有統(tǒng)計意義（P<0.05）；且觀察組Hb、D-D和FIB水平顯著低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。經治療，兩組NO、BNP水平均顯著下降，而AT-III表達均增高，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且觀察組NO、BNP和AT-III水平均顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結論 產后逐瘀膠囊聯合馬來酸麥角新堿注射液治療產后出血有著良好的止血作用，有利于改善子宮收縮，促進凝血，利于產后恢復，具有良好臨床應用價值。

Objective To explore the clinical effect of Chanhou Zhuyu Capsules combined with Ergometrine Maleate Injection in treatment of postpartum hemorrhage. Methods Patients (82 cases) with postpartum hemorrhage treated in People's Hospital of Wanning from February 2018 to April 2019 were divided into observation group (41 cases) and control group (41 cases) according to the difference of medication. Patients in the control group were iv administered with Ergometrine Maleate Injection, 0.2 mg/time, which could be repeated for 2 — 4 h if necessary, up to 5 times. Patients in the observation group were given Chanhou Zhuyu Capsules on the basis of the control group, 0.9 g/time, three times daily. After treatment, the clinical effects and postpartum hemorrhage amount were observed, and the levels of Hb, D-D, FIB, NO, BNP, and AT-III in two groups before and after treatment were compared. Results After treatment, the effective rate in the control group was 80.49%, which was significantly lower than 97.56% in the observation group, and there were differences between two groups (P < 0.05). After 2 h and 2 — 24 h of treatment, the amount of postpartum hemorrhage in the observation group was significantly lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the levels of Hb, D-D, and FIB in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the levels of Hb, D-D, and FIB in the observation group were significantly lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the levels of NO and BNP in two groups were significantly decreased, while the level of AT-III were increased, and the difference was statistically significant in the same group (P < 0.05). And the levels of NO, BNP, and AT-III were significantly better than those in the control group, and there were differences between two groups (P < 0.05). Conclusion Chanhou Zhuyu Capsules combined with Ergometrine Maleate Injection has a good hemostatic effect in treatment of postpartum hemorrhage, is conducive to improving uterine contraction, promoting coagulation, conducive to postpartum recovery, which has a good clinical application value.

R984

萬寧市科學研究課題（C03030401）