标题：益母缩宫颗粒防治早孕患者药流后异常出血的效果分析

      作者：刘燕，陈艳    (十堰市妇幼保健院西院区妇科，湖北 十堰 442000)

      卷次： 2017年28卷12期

      【摘要】 目的 观察益母缩宫颗粒防治早孕患者药流后异常出血的效果。方法 选择2013年3月至2016年2月于我院进行药流的84例早孕女性，按照随机数字表法分为对照组和观察组各42例，两组均采用米非司酮、米索前列醇药物流产，对照组在孕囊排出2 h后予肌注缩宫素+口服诺氟沙星预防感染，观察组在对照组基础上加用益母缩宫颗粒，比较两组药流前后雌二醇(E2)、孕酮(P)、人绒毛膜促性腺激素(HCG)水平的变化，观察两组流产结局，记录两组阴道出血、月经恢复时间和阴道出血量。结果 药流 1周，观察组患者的P、HCG下降水平高于对照组[(6.11±1.22) μg/L、(425.22±221.23) IU/L vs (7.87±1.01) μg/L、(745.36±201.76) IU/L]，差异均有统计学意义(P<0.05)；观察组患者完全流产率为78.57%，高于对照组的 54.76%，流产失败率及清宫率分别为 7.14%、9.52%，均低于对照组的 23.81%、26.19%，差异均有统计学意义(P<0.05)；观察组患者的阴道出血时间、月经恢复时间及经期持续时间均短于对照组[(9.31±4.26) d、(29.85±5.23) d、(5.48±1.26) d vs (13.15±5.17)d、(36.67±7.44) d、(6.23±1.11) d]，差异均有统计学意义(P<0.05)；观察组阴道出血量大所占比例为 7.14%，低于对照组的 23.81%，差异有统计学意义(P<0.05)。结论 在早孕药流后阴道异常出血的防治中，采用益母缩宫颗粒可下调孕激素表达，缩短阴道流血时间，减少出血量，促进患者月经恢复。
      【关键词】 早孕；药物流产；益母缩宫颗粒；阴道出血
      【中图分类号】 R714.21 【文献标识码】 A 【文章编号】 1003—6350（2017）12—2031—03

Effects of Yimu Suogong Granules in prevention and treatment of abnormal bleeding in patients with earlypregnancy after medical abortion.
LIU Yan, CHEN Yan. Department of Gynecology, Western Branch of Shiyan Maternaland Child Health-Care Hospital, Shiyan 442000, Hubei, CHINA
【Abstract】 Objective To observe the effects of Yimu Suogong Granules in prevention and treatment of abnor-mal bleeding in patients with early pregnancy after medical abortion. Methods A total of 84 women with early pregnan-cy, who underwent medical abortion in our hospital from March 2013 to February 2016, were divided into the controlgroup and the observation group by the random number table method, with 42 cases in each group. Both groups under-went medical abortion with mifepristone and misoprostol. The control group was treated with intramuscular injection ofoxytocin and oral administration of norfloxacin for preventing infection at 2 h after sac discharge; the observation groupwas additionally treated with Yimu Suogong Granules based on the treatment of the control group. Changes of estradiol(E2), progesterone (P) and human chorionic gonadotropin (HCG) levels before and after medical abortion of the twogroups were compared, and abortion outcomes in two groups were observed. The time of vaginal bleeding, menstruationrecovery time and vaginal bleeding volume were recorded. Results One week after medical abortion, the levels of Pand HCG in the observation group were respectively (6.11±1.22) μg/L and (425.22±221.23) IU/L, which were signifi-cantly lower than corresponding (7.87±1.01) μg/L and (745.36±201.76) IU/L in the control group (P<0.05). The com-plete abortion rate of the observation group was 78.57% , which was significantly higher than 54.76% of the controlgroup (P<0.05); while the failure rate of abortion and clearance rate of uterus in the observation were respectively 7.14%and 9.52%, which were significantly lower than corresponding 23.81% and 26.19% in the control group (P<0.05). Thetime of vaginal bleeding time, menstrual recovery time and menstrual duration of the observation group were respective-ly (9.31±4.26) d, (29.85±5.23) d, (5.48±1.26) d, which were significantly shorter than corresponding (13.15±5.17) d,(36.67±7.44) d, (6.23±1.11) d of the control group (P<0.05). The proportion of massive vaginal bleeding in the observa-tion group was 7.14%, which was significantly lower than 23.81% in the control group (P<0.05). Conclusion The ap-plication of Yimu Suogong Granules in prevention and treatment of abnormal bleeding in patients with early pregnancyafter medical abortion can down-regulate the expression of progesterone, shorten the time of vaginal bleeding, reducebleeding volume, and promote the recovery of patients with menstruation.
      【Key words】 Early pregnancy; Medical abortion; Yimu Suogong Granules; Vaginal bleeding·临床经验·doi:10.3969/j.issn.1003-6350.2017.12.047