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生化湯用於產後子宮復舊之文獻探析

Sheng-Hua-Tang Used for Uterine Involution in Postpartum Physical Condition

摘要


產褥期定義為胎兒及胎盤分娩後至生殖道恢復到原來狀態的時間,平均需要六至八週的時間。其間惡露排出、子宮內膜新生、子宮體恢復至原來的體積和重量的過程,稱為產後子宮復舊。產褥期的變化,在產後一周內變化較為急速,惡露排出量多色紅,多數在產後四週內完全排出;非胎盤附著處的子宮內膜約在七至十天逐漸新生完畢, 而胎盤附著處的子宮內膜至少需十四天後才會完全恢復;子宮體約在產後六周恢復至未懷孕的狀態。目前世界衛生組織並無建議在娩出胎盤後使用子宮收縮劑預防子宮收縮不良導致的產後出血,但是需要更多的臨床研究證實中醫藥有助於產後子宮復舊。台灣地區約有八成以上產後婦女服用生化湯,從目前文獻顯示生化湯有助於子宮體收縮、子宮恢復至前傾位,服用生化湯並不會延長惡露天數。但對於生化湯「養血活血,去瘀生新」的作用,有待前瞻性的研究評估,以提供臨床醫師使用上的依據。

關鍵字

生化湯 產褥期 子宮復舊

並列摘要


"Puerperium", from delivery of fetus and placenta to recovery of the reproductive tract, takes about six to eight weeks. The process of lochia discharge, endometrium regeneration, and uterus recovery was named "uterine involution". During the first week of puerperium, the physical condition changes rapidly. Lochia excreted and may completely discharged within four weeks. Placental attached endometrium might be fully recovered at least fourteen days. Uterus returned to normal size in about six weeks. Nowadays, the World Health Organization did not recommend the regular use of medication to improve uterine contraction during puerperium. In Taiwan, more than eighty percent women takes sheng hua tang for uterine involution. In this article, it revealed consumption of sheng hua tang was correlated with anteverted uterus, and the contractile activity of the uterus. There was no difference between consumption of sheng hua tang and duration of lochia. However, more biopharmacological research and clinical trials to investigate the mechanism, named "eliminate blood stasis and promote tissue regeneration", of sheng-hua-tang are warranted in the future.

並列關鍵字

Sheng-Hua Tang Postpartum Uterine involution

參考文獻


李祥雲: 產後服生化湯述評─李祥雲教授婦科系列經驗(10)。遼寧中醫雜誌2005 ; 31387.
Chang PJ, Tseng YC, Chuang CH, et al.: Use of sheng-hua-Tang and health-related quality life in postpartum women: a population-based cohort study in Taiwan. International Journal Nursing of Studies 2010;47(1): 13-9.
Charles R.B. Beckmann, William Herbert, et al.: Obstetrics and Gynecology. Seventh Edition. Philadelphia: Lippincott Williams & Wilkins,2013; 129-136.
王馨世: 婦產科學(第一版)。台北縣新店市:藝軒出版社,2004:224-237。
Mulic-Luctiva A: Postpartum ultrasound. Donald school Journal of Ultrasound Obstetrics and Gynecology.2012 ; 6(1):76-92.

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