【目的】 研究新生化颗粒联合麦角新碱在促进产后子宫复旧方面的应用效果及其对产妇血液流变学、血清激素与缺氧 诱导因子1α（HIF-1α）、基质金属蛋白酶9（MMP-9）水平的影响。【方法】 选取2022年8月至2024年9月郑州大学第三附属医 院收治的 120例剖宫产产妇为研究对象，采用随机数字表法将产妇随机分为观察组和对照组，每组各 60例。对照组产妇给 予麦角新碱结合缩宫素宫体注射治疗，观察组在对照组基础上给予新生化颗粒口服治疗，连续服药4 d。比较2组产妇的产 后出血情况、子宫复旧情况、血性恶露量及恶露、血性恶露持续时间，观察2组产妇产前和产后第4天血液流变学、血清激 素[促黄体生成素（LH）、雌二醇（E2）、促卵泡激素（FSH）]和 HIF-1α、MMP-9水平的变化情况，并记录 2组产妇不良反应情 况。【结果】（1）产后第 1天，2组产妇的子宫底下降程度比较，差异无统计学意义（P＞0.05）；产后第 4天，观察组产妇的子 宫底下降程度明显优于对照组（P＜0.01）。（2）与对照组相比，观察组产妇产后的血性恶露量更少，恶露及血性恶露持续时间 均更短（P＜0.05）。（3）2组产妇产后 2 h、24 h出血量及出血发生率（产后 24 h出血量＞1 000 mL）比较，差异均无统计学意义 （P＞0.05）。（4）产后第 4天，2组产妇的全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数均较产前明显降低（P＜ 0.05）；且观察组对各项血液流变学指标的降低幅度均明显优于对照组（P＜0.01）。（5）产后第4天，2组产妇的血清LH、E2水 平均较产前升高（P＜0.05），血清FSH水平均较产前降低（P＜0.05），且观察组对血清LH、E2水平的升高幅度及对血清FSH 水平的降低幅度均明显优于对照组（P＜0.01）。（6）产后第 4 天，2 组产妇的血清 HIF-1α、MMP-9 水平均较产前降低（P＜ 0.05），且观察组对血清 HIF-1α、MMP-9 水平的降低幅度均明显优于对照组（P＜0.01）。（7）观察组的不良反应总发生率为 5.00%（3/60），对照组为8.33%（5/60），组间比较，差异无统计学意义（χ2 =0.134，P＞0.05）。【结论】 新生化颗粒联合麦角新碱 可有效促进产妇产后子宫复旧和恶露排出，改善机体血液流变学指标，促进局部血液循环，并可调节性激素水平及血清MMP-9、 HIF-1α水平，加速子宫恢复，并具有较高的安全性。

Objective To investigate the efficacy of Xinshenghua Granules combined with ergometrine in promoting postpartum uterine involution， and to observe their effects on hemorheology， serum hormones， and levels of hypoxia-inducible factor-1α（HIF-1α） and matrix metalloproteinase-9（MMP-9）. Methods A total of 120 women undergoing cesarean section at the Third Affiliated Hospital of Zhengzhou University from August 2022 to September 2024 were randomized into two groups using a random number table method：the observation group （n=60） and the control group （n=60）. The control group received ergometrine combined with oxytocin via uterine body injection， while the observation group received additional oral administration of Xinshenghua Granules for 4 consecutive days.Postpartum hemorrhage， uterine involution， volume of lochia rubra， and durations of lochia and lochia rubra were compared between the two groups. Changes in hemorheology，serum hormones [luteinizing hormone （LH）， estradiol （E2）， follicle-stimulating hormone （FSH）]， HIF-1α， and MMP-9 levels were assessed before delivery and on postpartum day 4. Adverse reactions were recorded. Results （1） On postpartum day 1， no significant difference was observed in the descent of the uterine fundus between the two groups （P＞0.05）. By postpartum day 4，the observation group showed significantly greater uterine fundal descent than the control group （P＜0.01）.（2） The observation group exhibited significantly less lochia rubra volume and shorter durations of both lochia and lochia rubra compared to the control group （P＜0.05）.（3） No significant differences were found between the two groups in blood loss at 2-hour and 24-hour postpartum or in the incidence of postpartum hemorrhage （blood loss＞1 000 mL within 24 hours）（P＞0.05）.（4） On postpartum day 4，both groups showed significant reductions in high-shear whole blood viscosity， low-shear whole blood viscosity， plasma viscosity， and erythrocyte aggregation index compared to pre-delivery levels （P＜0.05）， with the observation group demonstrating significantly greater improvements in all hemorheological parameters than the control group （P＜ 0.01）.（5） On postpartum day 4， both groups exhibited increased serum LH and E2 levels （P＜0.05） and decreased serum FSH levels （P＜0.05） compared to pre-delivery levels. The observation group showed significantly greater increases in LH and E2 and a greater decrease in FSH than the control group （P＜0.01）. （6）On postpartum day 4，both groups demonstrated decreased serum HIF-1α and MMP-9 levels compared to pre-delivery levels （P＜0.05）， with the observation group exhibiting significantly greater reductions than the control group （P＜0.01）.（7） The total incidence of adverse reactions was 5.00% （3/60） in the observation group and 8.33% （5/60） in the control group， with no statistically significant difference （χ2 = 0.134， P＞0.05）. Conclusion Xinshenghua Granules combined with ergometrine effectively promote uterine involution and lochia discharge，improve hemorheological parameters，enhance local blood circulation，regulate sex hormone levels， and reduce serum MMP-9 and HIF-1α levels in postpartum women，thereby accelerating uterine recovery with a favorable safety profile.

R271.9

河南省医学科技攻关计划联合共建立项项目（编号：LHGJ20200750）