目的:观察独参汤预防产后出血的疗效,研究其对氧化应激指标和凝血功能的影响。方法:纳入住院行剖宫产的产妇108例,随机分为对照组和观察组各54例。所有产妇均予以常规剖宫产手术,术后使用缩宫素肌内注射,观察组在此基础上从术前24 h开始加用独参汤口服。观察两组不同时间出血量、产后出血发生率、其他止血措施使用率、血红蛋白(HGB)水平与红细胞数量(RBC)、超氧化物歧化酶(SOD)和丙二醛(MDA)水平、纤维蛋白原(FIB)和D-二聚体(D-D)水平,以及不良反应发生情况。结果:观察组术中、术后2 h和术后24 h总出血量均少于对照组,差异具有统计学意义(P<0.05)。观察组产后出血发生率1.85%,低于对照组的11.11%(P<0.05)。观察组联合使用其他止血措施率3.70%,低于对照组的14.81%(P<0.05)。术后24 h,两组HGB和RBC水平均较术前下降,但观察组水平均高于对照组(P<0.05)。观察组术后24 h的MDA水平低于对照组,SOD水平高于对照组(均P<0.05)。产妇在术后24 h的FIB和D-D水平,观察组低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:独参汤能够有效减少剖宫产术后阴道出血,减少产后出血的发生率,具有较高安全性,其作用可能是通过抗氧化应激来实现的。

Objective:To observe the effect of Dushen Decoction（独参汤） on preventing postpartum hemorrhage and to study its effect on oxidative stress index and coagulation function. Methods:108 puerperae with cesarean section were randomly divided into the control group and the observation group,with 54 cases in each group. All patients were given routine cesarean section and intramuscular injection of oxytocin after operation. The observation group was given Dushen Decoction orally 24 hour before operation. The amount of bleeding at different time,the incidence of postpartum hemorrhage,the utilization rate of other hemostatic measures,the levels of hemoglobin(HGB) and red blood cell(RBC),the levels of superoxide dismutase(SOD) and malondialdehyde(MDA),the levels of fibrinogen(FIB) and D-Dimer(D-D) in the two groups were observed. Results:The total blood loss in the observation group was significantly less than that in the control group(P<0.05). The incidence of postpartum hemorrhage in the observation group was 1.85%,which was significantly lower than 11.11% of the control group(P<0.05). The rate of combined use of other hemostatic measures in the observation group was 3.7%,which was significantly lower than14.81% in the control group(P<0.05). Twenty-four hours after operation,the HGB and RBC levels of the two groups were lower than those before operation,and the HGB and RBC levels of the observation group were significantly higher than those of the control group(P<0.05). The MDA level in the observation group was significantly lower than that in the control group,and the SOD level in the observation group was significantly higher than that in the control group(P<0.05). The levels of FIB and D-D in the observation group were significantly lower than those in the control group 24 hours after operation(P <0.05). The difference in the incidence of adverse reactions between the two groups was not statistically significont(P >0.05). Conclusions:Dushen Decoction can effectively reduce vaginal bleeding after cesarean section,reduce the incidence of postpartum hemorrhage,and it is of high safety,this effect may be achieved through antioxidant stress.