目的 探討益母草膏聯(lián)合卡前列素氨丁三醇治療宮縮乏力性產(chǎn)后出血的臨床療效。方法 選取2020年3月—2023年12月咸寧市中心醫(yī)院收治的118例宮縮乏力性產(chǎn)后出血患者，按隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各59例。對(duì)照組患者單次子宮肌層注射卡前列素氨丁三醇注射液，250 μg。治療組在對(duì)照組治療基礎(chǔ)上口服益母草膏，10 g/次，2次/d。兩組均連續(xù)治療3 d。觀察兩組臨床療效、出血情況及癥狀改善時(shí)間，比較治療前后宮底高度、血小板計(jì)數(shù)（PLT）、紅細(xì)胞比容（HCT）、纖維蛋白原（FIB）、D二聚體（D-D）水平。結(jié)果 治療后，治療組總有效率是100.00%，顯著高于對(duì)照組的89.83%（P＜0.05）。治療組治療2、12、24 h的出血量顯著少于同期對(duì)照組（P＜0.05）；治療組止血時(shí)間顯著短于對(duì)照組（P＜0.05）。治療后，治療組面色蒼白、無力、頭暈、耳鳴的改善時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組宮底高度和DASS-21評(píng)分均顯著降低（P＜0.05）；治療后，治療組宮底高度和DASS-21評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組PLT、HCT均顯著升高，而FIB、D-D均顯著降低（P＜0.05）；治療后，治療組PLT、HCT、FIB、D-D改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 益母草膏聯(lián)合卡前列素氨丁三醇治療宮縮乏力性產(chǎn)后出血具有較好的臨床療效，止血效果突出，能有效控制出血量，減輕凝血功能異常，加速產(chǎn)婦失血癥狀改善及子宮功能和心理恢復(fù)，值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Yimucao Ointment combined with carboprost tromethamine in treatment of postpartum hemorrhage caused by uterine fatigue. Methods A total of 118 patients with postpartum hemorrhage caused by uterine fatigue admitted to Xianning Central Hospital from March 2020 to December 2023 were selected and divided into control group and treatment group according to random number table method, with 59 cases in each group. Patients in the control group were given a single myometriol injection of Carboprost Tromethamine Injection, 250 μg. Patients in the treatment group were po administered with Yimucao Ointment on the basis of the control group, 10 g/time, twice daily. Both groups were treated continuously for 3 d. The clinical efficacy, bleeding situation and symptom improvement time of the two groups were observed. The height of the posterior fundus, platelet count (PLT), erythrocyte specific volume (HCT), fibrinogen (FIB) and D-dimer (D-D) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 100.00%, which was significantly higher than 89.83% of the control group (P < 0.05). The amount of blood loss in the treatment group at 2, 12, and 24 h was significantly lower than that in the control group (P < 0.05). The hemostatic time of the treatment group was significantly shorter than that of the control group (P < 0.05). After treatment, the improvement time of pallor, weakness, dizziness, and tinnitus in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, fundal height and DASS-21 score were significantly decreased in both groups (P < 0.05). After treatment, the fundal height and DASS-21 score in the treatment group were lower than those in the control group (P < 0.05). After treatment, PLT and HCT were significantly increased, but FIB and D-D were significantly decreased in both groups (P < 0.05). After treatment, the improvement of PLT, HCT, FIB and D-D in the treatment group was better than that in the control group (P < 0.05). Conclusion Yimucao Ointment combined with carboprost tromethamine has good clinical efficacy in treatment of postpartum hemorrhage caused by uterine fatigue, and the hemostatic effect was outstanding, and can effectively control the amount of blood loss, reduce the abnormal coagulation function, accelerate the improvement of maternal blood loss symptoms and uterine function and psychological recovery, which is worthy of clinical application.

R984

廣西壯族自治區(qū)中醫(yī)藥管理局自籌經(jīng)費(fèi)科研項(xiàng)目（GXZYA20220085）