龙血竭胶囊治疗药物流产后异常子宫出血的研究

目的观察龙血竭胶囊用于治疗药物流产后异常子宫出血的临床效果并探讨其机理。方法将符合药物流产指征的160例早孕妇女随机分为两组,观察组服用龙血竭胶囊,对照组服用安慰剂,比较两组药物流产效果和出血量及出血时间;采用硝酸酶还原法、放射免疫法测定服药后血中一氧化氮(NO)、内皮素(ET-1)浓度。结果①观察组与对照组完全流产率无显著差异(P>0.05);②完全流产后出血量及平均出血时间观察组显著少于对照组(P<0.05);③血中NO浓度观察组显著低于对照组,而ET-1浓度观察组显著高于对照组(P<0.05)。结论药物流产时加服龙血竭胶囊可明显减少流产后出血量及时间。其作用机理可能是使血中的NO含量进一步降低,从而减弱NO舒张血管作用,增大子宫局部血流阻力,加速绒毛细胞的变性、坏死;减弱NO对血小板聚集的抑制作用,达到止血效果;增加血中ET-1的浓度,加强子宫血管的收缩,减少出血。

Longxuejie Capsule in Treatment of Abnormal Bleeding after Medical Abortion

Objective: To investigate the effect of Chinese traditional drug Longxuejie Capsule on abnormal uterine bleeding after medical abortion. Methods:160 cases of early pregnant women were randomly divided into two groups. Women in the experimental group took orally Longxuejie capsule. Those in the control group took placebos at the process of medical abortion.Effect of medical abortion, durations and amount of bleeding were compared in two groups. The contents of nitric oxide (NO) and endothelin-1(ET-1) in blood were measured by the method of NO3-/NO2-,radioimmunoassay after the treatment in each group. Results:The rate of complete abortion was not significantly different in two groups(P>0.05). The concentration of serum NO, durations and amount of bleeding after complete abortion in the control group were significantly higher than those in the experimental group (P<0.05), while the concentration of serum endothelin-1 in the experimental group was significantly higher than that in the control group. (P<0.05) Conclusion:Longxuejie capsule at the process of medical abortion can reduce durations and amount of bleeding. Its mechanism is possibly as follows:it can reduce the concentration of serum NO further which enhance the resistance of uterine regional blood flow, then weaken the restraining effect of platelet aggregation, therefore, accelerate denaturalization and putrescence of chorionic cells. It can increase the concentration of serum Endothelin-1 and enhance constriction of the uterus blood vessels to reduce bleeding.