【目的】 探究复方生化方（由生化汤演化而成）辅助氨甲环酸治疗产后出血的临床疗效及其对血浆抗凝血酶Ⅲ（AT-Ⅲ）、 D-二聚体（D-D）、纤维蛋白原（FIB）水平的影响。【方法】 选取2023年1月～2024年3月石家庄市妇幼保健院收治的216例产 后出血患者，采用随机数字表法将患者随机分为常规组和试验组，每组各108例。2组患者均给予补血、抗休克、补液、缩 宫等产后常规治疗，在此基础上，常规组给予氨甲环酸治疗，试验组给予复方生化方辅助氨甲环酸治疗，疗程为3 d。观察 2组患者治疗前后中医证候积分、凝血因子、炎症-应激因子的变化情况，比较2组患者的症状改善时间、住院时间、临床疗 效及不良反应发生率。【结果】（1）治疗 3 d 后，试验组的总有效率为 98.15%（106/108），常规组为 91.67%（99/108），组间比 较，试验组的疗效明显优于常规组（P＜0.05）。（2）试验组的出血症状持续时间、止血时间、血性恶露消失时间及住院时间均 明显短于常规组（P＜0.01）。（3）治疗3 d后，2组患者的中医证候主症、次症、舌脉积分均较治疗前明显降低（P＜0.05），且试 验组的降低幅度均明显优于常规组（P＜0.01）。（4）治疗 3 d 后，2 组患者的血浆 D-D、FIB 水平均较治疗前明显降低（P＜ 0.05），血浆 AT-Ⅲ水平均较治疗前明显升高（P＜0.05），且试验组对血浆 D-D、FIB水平的降低幅度及对血浆 AT-Ⅲ水平的 升高幅度均明显优于常规组（P＜0.01）。（5）治疗3 d后，2组患者的血清C反应蛋白（CRP）、脂质过氧化物（LPO）、白细胞介素 8（IL-8）水平均较治疗前明显降低（P＜0.05），血清超氧化物歧化酶（SOD）水平均较治疗前明显升高（P＜0.05），且试验组对 血清CRP、LPO、IL-8水平的降低幅度及对血清SOD水平的升高幅度均明显优于常规组（P＜0.01）。（6）试验组的不良反应发 生率为8.33%（9/108），常规组为10.19%（11/108），组间比较，差异无统计学意义（P＞0.05）。【结论】 复方生化方辅助氨甲环 酸治疗产后出血患者疗效显著，能有效缩短出血时间，缓解临床症状，改善凝血功能，抑制炎症-应激因子表达。

Objective To investigate the clinical efficacy of Compound Shenghua Prescription （derived from Shenghua Decoction） assisting tranexamic acid in the treatment of postpartum hemorrhage and to observe its effect on plasma antithrombin Ⅲ（AT-Ⅲ），D-dimer （D-D） and fibrinogen （FIB） levels. Methods A total of 216 patients with postpartum hemorrhage admitted to Shijiazhuang Maternal and Child Health Hospital from January 2023 to March 2024 were selected. The patients were randomly divided into conventional group and trial group by random number table method， with 108 cases in each group. Two groups of patients were given postpartum routine treatment of blood transfusion，anti-shock，fluid infusion，and promoting uterine contraction. Additionally，the conventional group was given tranexamic acid treatment， and the trial group was given Compound Shenghua Prescription assisting tranexamic acid treatment. The course of treatment for the two groups covered 3 days. Before and after treatment，the changes of traditional Chinese medicine （TCM） syndrome scores and levels of coagulation factors and inflammation-stress factors in the two groups were observed. Time for the symptom improvement， hospitalization time，clinical efficacy and incidence of adverse reactions were compared between the two groups. Results （1） After 3 days of treatment，the total effective rate of the trial group was 98.15%（106/108） and that of the conventional group was 91.67%（99/108）. The curative effect of the trial group was significantly superior to that of the conventional group （P＜0.05）.（2） The duration of bleeding symptoms， hemostasis time， time for the bloody lochia disappearance and hospitalization time in the trial group were significantly shorter than those in the conventional group（P＜0.01）. （3）After 3 days of treatment， the scores of primary symptoms， secondary symptoms，and tongue and pulse manifestations in the two groups were significantly lowered compared with those before treatment（P＜0.05）， and the decrease in the trial group was significantly superior to that in the conventional group （P＜0.01）.（4）After 3 days of treatment，the levels of plasma D-D and FIB in the two groups were significantly decreased compared with those before treatment （P＜0.05），and the level of plasma AT-Ⅲ was significantly increased compared with that before treatment （P＜0.05）. The decrease of plasma D-D and FIB levels and the increase of plasma AT-Ⅲ level in the trial group were significantly superior to those in the conventional group （P＜0.01）.（5） After 3 days of treatment，the levels of serum C-reactive protein （CRP），lipid peroxide （LPO） and interleukin 8（IL-8） in the two groups were significantly decreased compared with those before treatment （P＜0.05），and the level of serum superoxide dismutase （SOD） was significantly increased compared with that before treatment （P＜0.05）. The decrease of serum CRP，LPO and IL-8 levels and the increase of serum SOD level in the trial group were significantly superior to those in the conventional group （P＜0.01）.（6）The incidence of adverse reactions in the trial group was 8.33%（9/108），and that in the conventional group was 10.19% （11/108）. There was no significant difference between the two groups （P＞0.05）. Conclusion Compound Shenghua Prescription assisting tranexamic acid is effective in the treatment of postpartum hemorrhage. It can effectively shorten the bleeding time， relieve clinical symptoms， improve coagulation function and inhibit the expression of inflammation-stress factors.

R271.9

河北省重点研发计划项目（编号：22200110812D