催产助生汤对妊娠宫颈结构和张力影响的临床及实验研究

目的观察中药催产助生汤对宫颈成熟因素的影响。方法(1)临床研究对需要引产的足月妊娠孕妇90例,分为3组。治疗组30例,采用催产助生汤每天1剂,水煎300 mL,早饭前30 min顿服(用药过程中若出现宫缩≥3次/h即停药),连续3天;对照组30例,采用催产素1U加在5%葡萄糖注射液500 mL中静脉滴注,6 h滴完,每天1次,连续3天。空白组30例,采用催产助生汤安慰剂,每天1剂300 mL,早饭前30 min顿服,连续3天。观察用药当日及72 h或临产时阴道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。(2)实验研究用体外宫颈张力仪测定妊娠大鼠的宫颈张力,取大鼠宫颈组织作病理检查,观察其宫颈组织形态学变化。结果促宫颈成熟总有效率治疗组为96.67%,对照组为83.33%;治疗组促宫颈成熟总有效率明显优于对照组及空白组(P<0.05)。宫颈成熟度评分治疗组与空白组比较差异有统计学意义(P<0.05)。动物实验研究结果显示:用药后大鼠宫颈组织疏松,胶原纤维明显减少、肿胀、卷曲、断裂、呈疏松网状,排列紊乱,胶原纤维发生降解,血管扩张充血并有大量炎性细胞浸润,基质成分增多,间质中出现大量白细胞及成纤维细胞。结论中药催产助生汤可改变宫颈组织形态结构,降低宫颈张力,从而达到促宫颈成熟,诱发产兆。

英文摘要:

Objective To observe the effect of Cuichan Zhusheng Decoction(CZD)on cervical maturation factors.Methods Ninety women with full-term pregnancy and indication for labor inducing were assigned to three groups equally.The treated group was treated by water decoction of CZD,one dose(300 mL)daily,taken orally in the morning 30 min before breakfast,for successive 3 days,the administration would be discontinued if uterine contraction occurred for over 3 times/hour in the course.The control group was treated with pitocin by adding 1 U into 500 mL 5% glucose for intravenous dripping in 6 h,once every day for 3 successive days.The blank group was treated by placebo of CZD,administrated in same way as that in the treated group.The length and width of cervix and diameter of neck tube in all the women were measured on the very day of medication and 72 h later or parturient time by vaginal B-ultrasonography,and the cervical maturation degree was scored referring to the clinical Bishop scale.In the experimental study,the cervical tension of pregnant rats was measured with an in vitro cervical tension-meter,rats’ cervical tissues were taken for pathologic examination to observe its morphological change.Re- suits The total effective rate for promoting cervical maturation was 96.67% in the treated group and 83.33% in the control group.It was significantly superior in the treated group to that in the control group and the blank group (P<0.05).Moreover,the cervical score in the treated group was higher in comparing with that in the blank group showing statistical significance(P<0.05).Animal experiments displayed that after medication,the cervical tissue of rat loosened with significantly lessened,swollen,convoluted and ruptured collagen fiber,showing sparse disor- derly fined-up reticular status.Degradation of collagen fiber,vascular dilatation and congestion with massive a- mount of inflammatory cells infiltration,increased matrix components,and many leucocyte and fibroblast in the stroma could be seen.Conclusion CZD can change the morphorlogic structure of cervical tissue,decrease cervi- cal tension,so as to promote the cervical maturation and induce labor.

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