催产助生汤对晚期妊娠宫颈成熟的影响

目的观察中药催产助生汤对晚期妊娠宫颈成熟因素的影响。方法选择需要引产的足月妊娠孕妇共90例,分为3组,每组30例。治疗组口服中药催产助生汤,对照组采用催产素1 U加入5%萄萄糖注射液500 mL中静脉滴注,安慰剂组口服大麦茶,均连用3天。观察用药前后采用阴道B超测量孕妇宫颈长度、宫颈宽度及颈管直径,参照临床Bishop评分,进行超声宫颈成熟度评分;测定3组用药前后血液前列腺素E_(2α)(PGE_(2α))、白细胞介素-8(IL-8)及内皮素-1(ET-1)水平。结果促宫颈成熟总有效率治疗组为96.7%(29/30),对照组及安慰剂组分别为83.3%(25/30)及26.7%(8/30),治疗组明显优于对照组及安慰剂组(P0.05)。治疗组和对照组用药前后比较血中PGE_(2α)、IL-8及ET-1水平均升高(P0.05);用药后比较,治疗组血中PGE_(2α)、IL-8及ET-1水平较安慰剂组升高(P0.05),对照组血中PGE_(2α)及IL-8水平均高于安慰剂组(P0.05)。结论中药催产助生汤通过提高血液中PGE_(2α)、IL-8及ET-1水平,改变宫颈组织结构,降低宫颈张力,进而达到促宫颈成熟的作用,增加宫颈评分,诱发产兆,提高阴道分娩率,减少剖宫产率。

Effect of Culchan Zhunsheng Decoction for Promoting Cervical Ripening in Late Pregnancy

Objective To observe the effect of Cuichan Zhunsheng Decoction （CZD） on the cervical ripening factors in late pregnancy. Methods Ninety women with full-term pregnant ready for labor inducing were equally assigned to 3 groups. The treated group was orally treated with CZD, the control group was with pitocin by adding 1 U into 500 mL of 5% glucose for intravenous dripping in 6 h, and the placebo group was orally treated with simulator of CZD as placebo, with the medication lasted for 3 days. Changes of cervical length and width, and neck tube diameter were measured by vaginal B-ultrasonography to estimate the degree of cervical maturation referring to the clinical Bishop scale; meanwhile, changes in blood levels of prostaglandin E2α （PGE2α）, in- terleukin-8 （IL-8） and endothelin-1 （ ET-1 ） were measured. Results The total effective rate on cervical ripening was 96.7% in the treated group, which was significantly superior to those in the control group （83.3%） and the placebo group （26.7%, P〈0.05）. The blood levels of PGE2α, IL-8, and ET-1 after treatment in the treated group were significantly higher than those in the placebo group （P 〈0.05）, and levels of PGE2α and IL-8 were higher in the control group than in the placebo group （P 〈0. 05）. Conclusion CZD can promote the cervical ripening through raising blood levels of PGE2α, IL-8 and ET-1, altering the structure of cervical tissue to reduce the cervical tension, which could increase the maturation of cervix, induce delivery sign, so as to elevate the vaginal delivery rate and reduce the percentage of caesarean birth.