Effect of Modified Shenghua Decoction Combined with Carbetocin in the Prevention of Postpartum Hemorrhage Caused by Uterine Fatigue and Its Influence on Stress Indexes/WANG Jun，XU Ying，LI Pingmei.//Medical Innovation of China，2025，22（20）： 065-068

[Abstract] Objective：To investigate the effect of Modified Shenghua Decoction combined with Carbetocin in the prevention of postpartum hemorrhage （PPH） caused by uterine fatigue and its influenceon stress indexes.Method：A total of 102 patients uterine fatigue who hospitalized in the Department of Obstetrics and Gynecology of Shangrao Maternal and Child Health Hospital from February 2O2O to February 2024 were selected as the study objects，and they were divided into two groups based on diferent medication regimen.The control group （ n =47）was treated with conventional western medicine Carbetocin，and the experimental group （ n =55）was treated with Modified Shenghua Decoction combined with Carbetocin.The amount of postpartum hemorrhage，coagulation function，stress indexand clinical eficacy werecompared between twogroups.Result：There was no statistically significant difference in the amount of bleeding at2h after delivery between two groups （ P 0.05）;the amount of bleeding in the experimental group at 12 and24 h after delivery were less than those in the control group （ P lt;0.05）. After treatment，TT，PT，APTTandFIB in two groups were improved，and those inthe experimental group were better than those in the control group （Plt;0.05） .After treatment， the levels of epinephrine （E），aldosterone （ALD） and angiotensin II （AngII） in two groups were decreased，and those in the experimental group were lower than the control group Plt;0.05） .After treatment， the total effective rate of the experimental group was 96.36% ，whichwashigher than 82.98% of the control group （Plt;0.05） . Conclusion： The effect of Modified Shenghua Decoction combined with Carbetocin in the preventionof PPHcaused byuterine inertiais definite，which can effectivelyimprove the symptoms，and can improve the coagulation function and stress response.

[KeyWords]Modified Shenghua DecoctionCarbetocinPostpartum hemorrhage caused byuterine fatigue Coagulation function Stress response

First-author's address：Department of Obstetrics and Gynecology，Shangrao Maternal and Child ealthHospital，Shangrao334ooo，China

doi：10.3969/j.issn.1674-4985.2025.20.015

产后出血（postpartum hemorrhage，PPH）是一种严重分娩并发症，指在胎儿娩出后 24h 内，阴道分娩者出血量 ⩾500mL ，剖宫产者出血量 ≥1 000mL 其不仅降低产妇免疫功能，增加感染风险，甚至威胁生命，极端状态下可能实施子宫切除术，导致患者永久丧失生育能力[。现有研究表明，PPH诱因较多，宫缩乏力为最关键的因素，其致PPH的占比达 75%～90%^[2] 。临床上以缩宫素治疗为主，可有效促进宫缩恢复，控制和改善PPH症状。卡贝缩宫素是一种新型药物，是人工合成的一种多肽类激素，能有效防治PPH。但临床上单独使用时，其药效持续时间较短，难以确保子宫维持收缩状态。近年来，随着中医药学研究的不断进步，其在PPH治疗中展现出显著疗效。尤其是中药生化汤加味，作为传统中医药理论中理血剂，具有养血化瘀、温经止痛的功效，被广泛用于产后血崩之气虚血瘀证，有着良好的疗效[3。本文探讨了中西医结合预防宫缩乏力性PPH的效果，通过对照研究深入分析生化汤加味与西药卡贝缩宫素联用的可行性和有效性，现报道如下。

1资料与方法

1.1一般资料

以2020年2月—2024年2月在上饶市妇幼保健院妇产科住院的102例宫缩乏力患者作为研究对象。纳入标准：（1）均存在宫缩乏力，可能因宫缩乏力导致产后出血4；（2）足月单胎妊娠；（3）近期未服用影响本研究药效的药物；（4）无妊娠期糖尿病等合并症。排除标准：（1）过敏体质；（2）既往产道创伤史及手术史；（3）合并生殖系统肿瘤；（4）合并其他导致PPH的高危因素，如产道裂伤等；（5）合并精神、意识障碍；（6）合并凝血功能异常。……