Objective  To observe the clinical efficacy of modified Qingre Tiaoxue decoction combined with oxytocin on postpartum malignant dew with damp-heat and stasis obstruction, and its effects on anemia and coagulation function indices.

Methods  110 patients with damp-heat and stagnant dew were randomly divided into the experimental group (modified Qingre Tiaoxue decoction combined with oxytocin) and the control group (oxytocin alone) with 55 cases in each group for a treatment period of 7 d. The total clinical efficiency, the time to drain the dew, and the changes in the indices of Chinese medicine symptoms, the sum of the three diameters of the uterus, hematocrit, hemoglobin, fibrinogen and D-dimer levels before and after the treatment were compared between two groups. The incidence of adverse reactions between two groups during the treatment period was recorded.

Results  The total clinical efficiency of the experimental group was significantly higher than that of the control group, and the time to clear the malignant dew was significantly shorter than that of the control group (P<0.05). After treatment, the case distribution of TCM symptoms scores in the two groups was significantly better than before, and the total score was significantly lower (P<0.01). Hemoglobin and hematocrit were significantly higher than before, and the sum of blood fibrinogen, D-dimer levels and uterine triple diameter were significantly lower than before (P<0.01). All the above indices in the experimental group were better than those in the control group (P<0.01). The difference of the incidence of adverse reactions between two groups was not statistically significant (P>0.05).

Conclusion  The combination of modified Qingre Tiaoxue decoction and oxytocin can further improve the clinical symptoms of patients with damp-heat and stasis obstruction of postpartum malignant dew, promote the recovery of the uterus after delivery, and correct the symptoms of anemia and blood hypercoagulation, with significant efficacy and without increasing the safety risk of patients with the drug.

1.靳蕊蕊, 许晓英, 杨德花, 等. 中西医结合治疗产后恶露不绝的临床观察[J]. 中国中西医结合杂志, 2021, 41(12): 1441-1444. [Jin RR, Xu XY, Yang DH, et al. Clinical observation of combined traditional Chinese and western medicine in the treatment of persistent postpartum dew[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2021, 41(12): 1441-1444.] DOI: 10.7661/j.cjim.20211011.377.

2.王志琼, 彭继蓉. 应用普林格尔——多系统治疗仪治疗产后42天子宫复旧不良的效果观察[J].中国计划生育和妇产科, 2018, 10(2): 49-51. [Wang ZQ, Peng JR. Observation of the effect of applying Pringles--multi-system therapeutic instrument for the treatment of poor uterine regeneration at 42 days after delivery[J]. Chinese Journal of Family Planning & Gynecotokology, 2018, 10(2): 49-51.] DOI: 10.3969/j.issn.1674-4020.2018.02.14.

3.蔡颖超, 谷灿灿, 何珏, 等. 朱南孙教授辨治产后恶露不绝[J]. 吉林中医药, 2017, 37(5): 453-456. [Cai YC, Gu CC, He J, et al. Professor Zhu Nansun's identification and treatment of postpartum malignant dew that does not stop[J]. Jilin Traditional Chinese Medicine, 2017, 37(5): 453-456.] DOI: 10.13463/j.cnki.jlzyy.2017.05.007.

4.李宁, 张红. 清热调血汤加减治疗慢性盆腔炎湿热瘀结证40例[J]. 长春中医药大学学报, 2008, 24(1): 90. [Li N, Zhang H. Modified Qingre Tiaoxue decoction for the treatment of 40 cases of chronic pelvic inflammation with damp heat stasis syndrome[J]. Journal of Changchun University of Traditional Chinese Medicine, 2008, 24(1): 90.] DOI: CNKI:SUN:CZXX.0.2008-01-067.

5.吴芳, 杨冬梅, 李鹏利. 清热调血汤联合穴位埋线对湿热瘀结型痛经患者镇痛效应、子宫动脉血流动力学及前列腺素E2、前列腺素F2α、β内啡肽的影响[J]. 环球中医药, 2021, 14(3): 525-527. [Wu F, Yang DM, Li PL. Analgesic effect of Qingre Tiaoxue decoction combined with acupoint catgut implantation on dysmenorrhea patients with damp-heat stasis type, uterine arterial hemodynamics, prostaglandin E2, prostaglandin F2α、β the effect of endorphins[J]. Global Traditional Chinese Medicine, 2021, 14(3): 525-527.] DOI: 10.3969/j.issn.1674-1749.2021.03.041.

6.谢幸, 主编. 妇产科学, 第9版[M]. 北京: 人民卫生出版社, 2018: 218.

7.张土珍, 主编. 中医妇产科学, 第2版[M]. 北京: 中国中医药出版社, 2008: 291-293.

8.郑筱萸, 主编. 中药新药临床研究指导原则[M]. 北京:中国医药科技出版社, 2002: 184-257.

9.闵羡蕙, 陈慧娜, 王柳. 伊血安颗粒与新生化冲剂治疗产后恶露不绝的临床随机对照研究[J]. 辽宁中医杂志, 2020, 47(12): 93-95. [Min XH, Chen HN, Wang L. A clinical randomized controlled study of Ixuean granules and Xinshenghua punch for the treatment of unrelenting postpartum malignant dew[J]. Liaoning Journal of Traditional Chinese Medicine, 2020, 47(12): 93-95.] DOI: 10.13192/j.issn.1000-1719.2020.12.027.

10.王伟. 产后恶露不净的原因及治疗[J]. 中国妇幼保健, 2011, 26(1): 156-157. [Wang W. Causes and treatment of postpartum ooze[J]. China Maternal and Child Health, 2011, 26(1): 156-157.] DOI: CNKI:SUN:ZFYB.0.2011-01-085.

11.尹小兰, 魏绍斌. 产后恶露不绝中医药治疗进展[J]. 辽宁中医药大学学报, 2015, 17(12): 219-222. [Yin XL, Wei SB. Advances in the treatment of postpartum malignant dew with Chinese medicine[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2015, 17(12): 219-222.] DOI: 10.13194/j.issn.1673-842x.2015.12.075.

12.郭静, 王建军, 童晓文, 等. 缩宫素联合鲜益母草胶囊及缩宫素联合五加生化胶囊治疗产后子宫复旧不良的临床疗效比较[J]. 中国性科学, 2018, 221(6): 128-131.[Guo J, Wang JJ, Tong XW, et al. Comparison of clinical efficacy of uterotonin combined with fresh motherwort capsule and uterotonin combined with Wujia biochemical capsule for postpartum poor uterine regeneration[J]. Chinese Journal of Human Sexuality, 2018, 221(6): 128-131.] DOI: 10.3969/j.issn.1672-1993.2018.06.037.

13.陈幸, 王晓莉, 陈琳. 新生化颗粒联合缩宫素对产后子宫复旧不良患者的临床疗效[J]. 中成药, 2020, 42(2): 536-538. [Chen X, Wang XL, Chen L. Clinical efficacy of new biochemical granules combined with uterine shrinkage in patients with poor postpartum uterine regeneration[J]. Chinese Traditional Patent Medicine, 2020, 42(2): 536-538.] DOI: 10.3969/j.issn.1001-1528.2020.02.055.

14.和作珍, 杨桥玉, 和萍, 等. 丽江纳西族妇女产后恶露情况的临床研究[J]. 中国生育健康杂志, 2008, 19(5): 297, 299. [He ZZ, Yang QY, He P, et al. Clinical study of postpartum dew in Naxi women in Lijiang[J]. Chinese Journal of Reproductive Health, 2008, 19(5): 297, 299.]DOI: 10.3969/j.issn.1671-878X.2008.05.009.

15.吕建利, 王占伟. 慈航胶囊联合桂枝茯苓胶囊治疗产后恶露不尽的疗效观察[J]. 药物评价研究, 2021, 44(5): 1037-1040. [Lyu JL, Wang ZW. The efficacy of Cixiang capsule combined with Guizhi Fuling capsule in the treatment of incomplete postpartum malignant dew[J]. Drug Evaluation Research, 2021, 44(5): 1037-1040.] DOI: 10.7501/j.issn.1674-6376.2021.05.020.

16.黎小莉, 王桂, 符永燕, 等. 生化汤联合失笑散治疗初产妇产后恶露不尽临床疗效观察[J]. 四川中医, 2020, 38(10): 175-179. [Lai XL, Wang G, Fu YY, et al. Clinical efficacy of biochemistry soup combined with loss of smile in the treatment of incomplete postpartum dew in primiparous women[J]. Sichuan Traditional Chinese Medicine, 2020, 38(10): 175-179.] http://www.cnki.com.cn/Article/CJFDTotal-SCZY202010057.htm.

17.吴芳, 李鹏利, 杨冬梅. 热敏灸联合清热调血汤对湿热蕴结型痛经患者疗效、镇痛效应及子宫动脉血流影响[J]. 辽宁中医药大学学报, 2020, 22(5): 130-133. [Wu F, Li PL, Yang DM. Efficacy, analgesic effect and uterine artery blood flow of thermal moxibustion combined with clearing heat and regulating blood soup on patients with damp-heat-embedded dysmenorrhea[J]. Journal of Liaoning University of Chinese Medicine, 2020, 22(5): 130-133.] DOI: 10.13194/j.issn.1673-842x.2020.05.032.

18.朱巧贞, 曾慧璇. 产妇产后血性恶露时间影响因素及访视对于产褥期疾病的影响研究[J]. 中国妇幼保健, 2020, 35(13): 2490-2492. [Zhu QZ, Zeng HX. Study on the factors influencing the duration of postpartum bloody malignant dew and the impact of visits on puerperal diseases[J]. Maternal and Child Health Care of China, 2020, 35(13): 2490-2492.] DOI: 10.19829/j.zgfybj.issn.1001-4411.2020.13.044.

19.蒋一逍, 李力, 刘宿, 等. 纤维蛋白原在产后出血中的临床应用研究进展[J]. 解放军医学杂志, 2021, 46(5): 498-503. [Jiang YZ, Li L, Liu S, et al. Research progress of clinical application of fibrinogen in postpartum hemorrhage[J]. Medical Journal of Chinese People's Liberation Army, 2021, 46(5): 498-503.] DOI: 10.11855/j.issn.0577-7402.2021.05.12.

20.柴韩飞, 叶银才, 黄跃跃, 等. D-二聚体/纤维蛋白原/血小板计数比值预测妊娠晚期孕妇产后出血的价值[J]. 医学研究杂志, 2019, 48(8): 54-57, 69. [Chai HF, Ye YC, Huang YY, et al. The value of D dimer/fibrinogen/platelet count ratio in predicting postpartum hemorrhage in pregnant women with late pregnancy[J]. Journal of Medical Research, 2019, 48(8): 54-57, 69.] DOI: 10.11969/j.issn.1673-548X.2019.08.013.

21.尹艳, 左冬冬, 侯淑峰, 等. 灸疗联合刮痧对气虚血瘀体质者凝血功能状态的影响[J]. 中医药信息, 2017, 34(6): 84-86. [Yin Y, Zuo D, Hou S, et al. Effect of moxibustion therapy combined with gua sha on coagulation status in patients with qi deficiency and blood stasis[J]. Information of Traditional Chinese Medicine, 2017, 34(6): 84-86.] DOI: 10.3969/j.issn.1002-2406.2017.06.022.