宫血宁胶囊治疗人工流产术后阴道出血

李　婷

(张家口市第六医院妇产科，河北 张家口 075000)



宫血宁胶囊治疗人工流产术后阴道出血

李婷

(张家口市第六医院妇产科，河北 张家口 075000)

摘要：目的探讨宫血宁胶囊用于人工流产术后阴道出血的临床效果。方法选择行人工流产术孕妇150例为研究对象，随机分为观察组和对照组，各75例。2组均在行人工流产术前2 d空腹口服米非司酮，上午8∶00 50 mg，晚上20∶00 25 mg，服药前后禁食2 h，共服用2 d；术后给予口服奥硝唑胶囊0.5 g/次，2次/d，盐酸左氧氟沙星0.2 g/次，3次/d。观察组在此基础上口服宫血宁胶囊0.26 g/次，3次/d。2组连续服用7 d，于流产后7、14、30 d复查。于治疗7 d后测定凝血功能4项，观察2组用药后阴道出血情况及出血持续时间。结果观察组PT、TT、APTT水平低于对照组，FIB水平高于对照组(P<0.05)；观察组出血量小于月经量占80.0%，等同于月经量占17.3%，大于月经量占2.7%，与对照组的48.0%、40.0%、2.7%比较，差异有统计学意义(P<0.05)；观察组阴道出血时间≤ 7 d占77.3%，8～14 d占20.0%，15～30 d占2.7%，与对照组的52.0%、33.3%、14.7%比较，差异有统计学意义(P<0.05)。结论流产后服用宫血宁胶囊可有效促进流产后子宫复旧，减少阴道出血天数及出血量。

关键词：人工流产术；宫血宁胶囊；阴道出血

终止早期妊娠的人工流产方法包括手术流产和药物流产[1]。但流产后易出现腹痛、阴道出血量多、出血时间长、月经紊乱等现象，严重者还需行二次清宫术，从而增加患者痛苦[2-3]。本研究对人工流产术后孕妇给予宫血宁胶囊口服，观察阴道出血情况。现报道如下。

1资料与方法

1.1一般资料选择2014年8月—2015年8月在我院行人工流产术的孕妇150例为研究对象，随机分为观察组和对照组，各75例，所有受试者平素月经周期均规律，尿HCG(+)，经彩色B超确诊为宫内早期妊娠，并自愿接受终止妊娠，且无人工流产术禁忌证。2组孕妇年龄、孕周、体质量等一般资料比较，差异无统计学意义(P>0.05)。

1.2治疗方法2组均在行人工流产术前2 d空腹口服米非司酮，上午8∶00 50 mg，晚上20∶00 25 mg，服药前后禁食2 h，共服用2 d。术后给予口服奥硝唑胶囊0.5 g/次，2次/d，盐酸左氧氟沙星0.2 g/次，3次/d。观察组在此基础上口服宫血宁胶囊0.26 g/次，3次/d。2组连续服用7 d。于流产后7、14、30 d复查。

2结果

2.12组凝血功能4项比较见表1。

表1　2组凝血功能4项比较

注：与对照组比较，#P<0.05

2.22组阴道出血情况比较见表2。

表2　2组阴道出血情况比较(n=75)　例(%)

注：与对照组比较，#P<0.05

2.32组阴道出血时间比较见表3。

表3　2组阴道出血时间比较(n=75)　例(%)

注：与对照组比较，#P<0.05

3小结

流产术后阴道出血原因[4-6]较多，宫血宁胶囊主要成分为重楼皂甙，其药理作用[7-8]：1)收缩子宫平滑肌，促进子宫复旧和止血；促进细胞钙离子内流，动员细胞内钙使其浓度升高，促进前列腺素合成，促进及加强子宫平滑肌收缩。2)止血作用：缩短出凝血时间，诱导血小板聚集，促进血小板内容物释放。3)抗炎作用：增加毛细血管通透性，促进血管内皮细胞增殖，增加外周白细胞和吞噬细胞数量，加强末梢血管收缩，炎性物质渗出，调节系统的功能应答。本研究结果提示，流产后服用宫血宁胶囊可有效促进流产后子宫复旧，减少阴道出血天数及出血量，且服药安全方便。

参考文献：

[1]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2014:383.

[2]辛华,郑定容,周伟.米非司酮与米索前列醇配伍宫血宁胶囊在终止妊娠中的临床观察[J].中国医药导报,2010,7(12):99-100.

[3]赖放颖,张晓燕.缩宫素与米非司酮对人工流产术后阴道出血的效果及不良反应比较[J].中国当代医药,2015,22(1):114-116.

[4]徐怡,卢雨莲,石宝珠.宫血宁胶囊用于药物流产后出血孕妇的临床疗效分析[J].抗感染药学,2015,12(3):423.

[5]朱慧玲,程利南.药物流产后阴道出血的原因分析和治疗现状[J].中国计划生育学杂志,2006,14(9):569-571.

[6]程慧玲,赵秋萍.分析药物流产后阴道出血相关因素及药物治疗疗效[J].中外医疗,2014,14(24):3-4.

[7]庞蓉蓉.逐瘀胶囊治疗产后恶露不绝临床疗效观察[J].亚太传统医药,2014,10(3):97-98.

[8]王淼,陆智义.产后宫清汤防治药物流产后阴道出血气虚血瘀型临床观察[J].吉林中医药,2012,32(10):1033.

Gongxuening capsule in treatment of vaginal bleeding after artificial abortion

LI Ting

(Department of Gynecology and Obstetrics,The Sixth Hospital of Zhangjiakou City in Hebei Province, Zhangjiakou 075000,Hebei Province,China)

Abstract：ObjectiveTo explore the clinical effect of Gongxuening capsule in the treatment of vaginal bleeding after artificial abortion.MethodsA total of 150 pregnant women were randomized into the observation group and the control group.The pregnant women in the two groups were orally took mifepristone 2 d before artificial abortion,50 mg at 8 am,25 mg at 8 pm,fasting for 2 h before and after taking medicine,for 2 d.After operation,they were orally given ornidazole capsule 0.5 g,twice/d,levoflxacin hydrochloride 0.2g,three times a day.On this basis,the pregnant women in the observation group were orally given Gongxuening capsule 0.26g,three times a day.The pregnant women in the two groups were given a continuous 7 day treatment.The patients were told to recheck 7 d,14 d,1 month after abortion.The coagulation function 7 d after treatment was determined.The vaginal bleeding and bleeding duration after medication in the two groups were observed.ResultsPT,TT,and APTT levels in the observation group were significantly lower than those in the control group,FIB level was significantly higher than that in the control group (P<0.05).After medication,the amount of bleeding in 80.0% was less than,17.3% equal to,and 2.7% greater than the menstrual blood volume in the observation group,while in the observation group were 48.0%,40.0%,2.7%,respectively,and the comparison between the two groups was statistically significant (P<0.05).In the observation group,77.3% patients had vaginal bleeding time ≤7 d,20.0% 8-14 d,2.7% 15-30 d,while in the control group were 52.0%,33.3%,14.7%,respectively,and the comparison between the two groups was statistically significant (P<0.05).ConclusionTaking Gongxuening capsule after abortion can effectively promote the uterine involution,reduce the vaginal bleeding days and amount with a safety and convenience;therefore,it deserves to be widely recommended in the clinic.

Keywords：artificial abortion;Gongxuening capsule;vaginal bleeding

收稿日期:(本栏责任编辑：张海洋2015-11-02)

文章编号：2095-6258(2016)02-0367-02

中图分类号：R271.9

文献标志码：A

作者简介：李婷(1973-)，女，大学本科，副主任医师，主要从事妇产科疾病研究。

基金项目：张家口市科学技术研究与发展指导计划项目(1021057D)。

DOI:10.13463/j.cnki.cczyy.2016.02.053