catalogue
Basic information of 1
2 practice
3 pharmacological action
Contraindications of drug treatment
5 Clinical application
postpartum care
Postpartum placental residue
uterine contraction pain
hysteromyoma
ectopic/extrauterine pregnancy
6 arguments of various schools of thought
7 experimental research
8 outlook
9 preventive measures
10 efficacy
1 basic information editing
Shenghua decoction
[Composition] Eight pieces of Angelica sinensis [24g] each, Ligusticum chuanxiong San Qian [9g], fourteen pieces of peach kernel [6g] each, dried ginger with black powder [2g] and fried licorice root [2g].
[Usage] Yellow rice wine and baby excrement are fried in half.
[Fang Ge] Shenghua Decoction is a postpartum prescription, which belongs to bear peach grass wine and ginger. He is good at removing blood stasis and promoting blood circulation, and has the effects of relieving pain and warming menstruation.
Indications: Abdominal pain due to postpartum blood stasis. The lochia is endless, and the abdomen is cold and painful.
【 Function 】 Removing blood stasis, promoting tissue regeneration, warming channels and relieving pain.
【 Precautions 】 If there is postpartum blood stasis, this prescription is not suitable.
Shenghua decoction
Source of prescription: Quanshu 6 1 Juan Yin Qian Fang.
Efficacy of prescription: removing blood stasis and promoting tissue regeneration.
[Fiona Fang] The first volume of Gynecology Postpartum should not be confined to the ancient prescriptions, but use Su Shu, Peng and Leng in vain, so as to belittle people's lives. All its blood-dispersing prescriptions and blood-breaking drugs are prohibited. Hawthorn is slow, but it can also kill people, so it should not be used indiscriminately, but biochemical soup is the holy medicine for blood clots.
[use]
1. If the abdominal pain is not very good, you can reduce the peach kernel; If there is still blood stasis and severe abdominal pain, Pollen Typhae, Oletum Trogopterori and Rhizoma Corydalis can be added to remove blood stasis and relieve pain; If the abdomen is cold and painful, cinnamon can be added to warm the meridians and dispel the cold.
【 Precautions 】 If there is postpartum blood stasis, this prescription is not suitable.
Add 2.4 grams of cinnamon within seven days after delivery, or the food is cold and caking is very painful. Postpartum hemorrhage, pain or swelling after half a month, or body heat, eating less and being very tired, adding Rhizoma Sparganii, Rhizoma Pinelliae, Cortex Cinnamomi, etc. , attack and supplement at the same time, the lump disappears on its own.
In the prescription, angelica is reused to enrich blood and promote blood circulation, and remove blood stasis to give birth to a new monarch; Chuanxiong promotes qi in blood, and peach kernel promotes blood circulation and removes blood stasis as a minister; Black ginger enters the blood to dispel cold, and warms the interior to relieve pain; Roasted licorice. It is made by mixing a variety of drugs.
2 practice editing
material
One day: 40 grams of Angelica sinensis (whole), 30 grams of Chuanxiong, 25 grams of peach kernel (heart-removed), 25 grams of fried ginger and 25 grams of fried grass (honey licorice).
working methods
1) 700 ml of yellow rice wine water (the alcohol has volatilized after boiling), add medicinal materials, simmer for about 1 hour, leaving about 200 ml, which is 1 hour, and pour out the medicinal liquor for later use.
[ 1]
2) Add 350 ml of rice wine water for the second time, which is the same as 1 cooking method, and the remaining is about 100 ml.
3) Mix 300 ml of No.65438+No.0 and No.2 medicinal liquor together and mix them evenly.
Tips:
Function: According to ancient records, the advantages of Shenghua Decoction are nourishing blood and activating blood, replenishing blood after delivery and eliminating lochia. Drink biochemical soup after giving birth, whether it is caesarean section or natural delivery. During the first week after birth, the baby should drink biochemical soup six times a day, seven days after delivery and 14 days after caesarean section. It is helpful to discharge the dirty blood in the uterus, prevent congestion and restore the function of the uterus. [2]
3 Pharmacological Action Editor
It mainly affects the weight of uterus and enhances the contraction of uterine smooth muscle. It has effects on uterine tissue morphology, and has antithrombotic, blood enriching, anti-inflammatory and analgesic effects.
Effect on uterine weight
(1) Female mature mice were subcutaneously injected with diethylstilbestrol oil 1 .65μ g10g once a day for 3 days. 2g crude drug /ml Jiawei Shenghua Decoction (adding Herba Leonuri and fried Herba Schizonepetae) was given to the stomach for 7 days. The experiment shows that Jiawei Shenghua Decoction can obviously reduce the wet weight and dry weight of uterus compared with the control group. The warm weight and dry weight of uterus in the medication group were 322 29.3 mg/100g body weight and 64.9 3.4 mg/100g body weight respectively. The control group was 656 86 mg/100g and 65438 016.6 23.1mg/100g respectively.
(2) Two ovaries of female mice were removed, and after 7 days of recovery, diethylstilbestrol 1. 1μg/kg was injected subcutaneously. After continuous injection for 3 days, take Jiawei Shenghua Decoction for 7 days. The average uterine weight in the control group was 330 mg/100g; The weight of the drug group was 383mg/ 100mg. It shows that this prescription can not only resist the effect of exogenous estrogen after ovariectomy, but also promote uterine weight gain.
(3) The formula of Jiawei recipe was analyzed by orthogonal design. The results showed that although the dosage of processed ginger and roasted licorice was small, it had obvious effect on preventing estrogen from gaining weight in uterus. Motherwort alone has little effect, but it has obvious effect after combined medication, and fried Schizonepeta tenuifolia has negative effect.
(4) 24 hours after delivery, mice were given Shenghua Decoction 1.23 and 4.92g/kg daily 1 time, which obviously promoted the involution of postpartum uterus. After 7 days of administration, the weight of uterus in mice was obviously reduced and the placental point disappeared rapidly. But it has no obvious effect on the weight of postpartum mice.
2. Shenghua Decoction can enhance the contraction of uterine smooth muscle by 0.2-5 1.2mg/ml, and can obviously enhance the contraction amplitude and frequency of isolated rabbit uterine smooth muscle. Oral administration of 1.23, 3.69 and 7.38g/kg Shenghua Decoction can obviously enhance the contraction amplitude and frequency of rabbit uterine smooth muscle in vivo.
3. Effect on the morphology of uterus. The medicine can reduce the degree of endometrial hyperplasia caused by diethylstilbestrol, reduce the number of cells and gradually eliminate multilayer arrangement. The endometrium of most animals basically returned to normal, the hyperemia and edema of uterine wall and the secretion of submucosal glands also basically disappeared, the simple hypertrophy of muscular layer gradually disappeared, and the glycogen content was close to normal.
4. Anti-thrombosis
1) was injected into two silicified polyethylene tubes of 0. 1 mg/ml biochemical soup and 0, 1ml physiological saline respectively, and 1ml anticoagulant whole blood of healthy adults was injected into the two tubes at the same time. Put them on the disk of the thrombometer and rotate for 20 minutes, then pour out the thrombus and measure its length, weighing the wet weight and dry weight. It shows that Shenghua decoction has obvious inhibitory effect on thrombosis in vitro.
(2) Oral administration of Shenghua Decoction 4.92g/kg can obviously reduce the whole blood viscosity of acute "blood stasis" model rats caused by ice water and adrenaline, and reduce the trend of erythrocyte aggregation index, thus improving the blood viscosity, concentration and pathological state of coagulation.
5. Blood-supplementing mice were given1.23,4.92 g/kg Shenghua Decoction; It can obviously increase the contents of red blood cells and hemoglobin in mice with blood deficiency.
6. Anti-inflammatory and analgesic effects
(1)4.92g/kg Shenghua Decoction can obviously inhibit the foot swelling induced by egg white in rats. 0.05ml croton oil mixed inflammatory solution was dripped into the left ear of all mice, and 0. 1ml(0.2 15g/ml) of Shenghua decoction was injected intraperitoneally. The ear swelling of mice was significantly lower than that of the control group.
(2) Oral administration of 4.92g/Kg Shenghua Decoction can obviously inhibit the writhing reaction induced by acetic acid in mice.
4 drug taboo editor
Shenghua decoction promotes blood circulation and removes blood stasis, and it is appropriate to have pain in the pillow. With the constitution of liver deficiency and blood dryness, the hyperactivity of liver yang is often known at ordinary times. Shenghua decoction is pungent and warm and should not be taken. Anyone who has tasted this convulsion must know; Slippery stool caused by weakness of spleen and stomach, palpitation and palpitation caused by hyperactivity of heart fire, dizziness and hypochondriac pain caused by hyperactivity of liver yang, dry mouth and throat caused by internal heat due to yin deficiency, blood clots caused by rushing to Ren and consolidating the body, and the mother's feeling of exogenous heat due to summer heat are all contraindications.
5 clinical application editor
postpartum care
60 parturients were given the original prescription of Shenghua Decoction, daily 1 dose, divided into three doses after delivery, and compared with the control group (without Shenghua Decoction). Results: Compared with the control group, the incidence of postpartum discomfort in the medication group decreased by 65438 06.6%, of which the pathological change rate in the control group was 28.33% and that in the medication group was 65438 00%. It is considered that the postpartum conditioning effect of Shenghua Decoction is mainly manifested in preventing puerperal infection (the ratio of taking medicine to control group is 1: 3) and promoting lactation function (the ratio of taking medicine to control group is 1: 4). In addition, the pain of postpartum uterine contraction in the medication group increased, indicating that Shenghua Decoction can strengthen uterine contraction and is also beneficial to prevent puerperal diseases.
Postpartum placental residue
22 cases of postpartum placental residue were treated with Shenghua decoction to remove licorice, and Leonurus japonicus, Radix Rehmanniae Preparata, Cortex Moutan, Carthami Flos and Folium Artemisiae Argyi were added. Among them, 3 cases were hospitalized for curettage more than 2 times, and no effect was found. A few patients took 2 doses, and most patients took 6 doses, that is, the residual placenta was discharged, bleeding and abdominal pain were eliminated. All 22 cases were cured, and no clinical symptoms were found during the follow-up for half a year.
uterine contraction pain
59 cases of postpartum uterine involution were treated with Shenghua Decoction and Honghua Decoction, and postpartum uterine contraction pain was 4 1 case. At the same time, 50 cases of postpartum uterine involution were treated with ergonovine. Results: Postpartum uterine involution was bad: The average uterine fundus decreased by 0.59 cm 24 hours before treatment and by 3.28 cm 24 hours after taking the medicine, which was more than five times faster than before treatment. In the western medicine treatment group, the average uterine fundus decreased by 65438±0.40cm 24 hours after medication. Compared with the western medicine group, the uterine fundus in the Chinese medicine group decreased rapidly 1 times. B. Postpartum uterine contraction pain: 465,438+0 cases were treated with biochemical decoction and safflower, 35 cases were markedly effective, 3 cases were ineffective, and 3 cases were unknown. C. A total of 100 patients in the two groups took Shenghua Decoction. Among them, 47 patients had blood clots in the vagina after taking the medicine, and some patients felt contractions after taking the medicine. It is believed that the effects of Shenghua Decoction and Carthamus tinctorius can strengthen uterine contraction rhythmically, and then promote postpartum uterine involution and postpartum uterine contraction pain to disappear.
hysteromyoma
70 cases of hysteromyoma and uterine obesity were treated with Jiawei Shenghua Decoction (fried Shenghua Decoction of Herba Leonuri and Herba Schizonepetae) as the main medicine, and decocted with water, with 65,438+0 doses per day and 30 doses for 65,438+0 courses. Among them, there were 24 cases of hysteromyoma, 8 cases were cured, 3 cases were effective/kloc-0, and 3 cases were ineffective. Of 46 cases in uterine hypertrophy, 25 cases were cured, 8 cases were effective/kloc-0, and 3 cases were ineffective. The minimum dose is 10, and the maximum dose is 84, with 30 to 60 doses accounting for 75%.
ectopic/extrauterine pregnancy
Based on the pathogenesis of ectopic pregnancy, it belongs to the syndrome of blood stasis and deficiency of abdomen. Although it is necessary to promote blood circulation and remove blood stasis in treatment, it should not be too rash. Therefore, Shenghua Decoction (Radix Angelicae Sinensis, Rhizoma Chuanxiong, Semen Persicae, Ramulus Cinnamomi, Poria, Radix Paeoniae Rubra and Cortex Moutan) was selected to treat 2 cases of ectopic pregnancy, 2 cases of shock type 10 and 2 cases of unstable type. Results: 2/kloc-0 cases of ectopic pregnancy were treated with Shenghua decoction, and all of them were cured. The shortest hospitalization days were 7 days and the longest was 75 days, with an average of 48 days.
6 discussion editors
"Medical Forest Compilation": When a woman gives birth, her qi and blood are greatly broken, but her strength is exhausted and her qi is exhausted, so postpartum is mostly cold. There are lochia, pillow pain, and all diseases are due to insufficient qi, so it is appropriate to treat this with warming and activating qi. Angelica sinensis nourishes its new blood, Ligusticum chuanxiong nourishes blood and benefits qi, dried ginger warms it up, roasted grass warms it up, and peach kernel uses it slightly. This is the best way to treat residual blood pain.
Usage and dosage: Upper (oral) mouth. Water for 2 minutes, add 2 jujubes, fry for 8 minutes, and take it warm.
Note: There is no rehmannia root in Fu Qingzhu Gynecology Postpartum. Half of the coat is fried in yellow wine and half in children's stool.
7 experimental research editor
Experimental research method of Shenghua decoction
1. Take 5 12g (including 372g Angelica and 0/40g Chuanxiong) according to the ratio of Radix Angelicae Sinensis and Rhizoma Ligustici Chuanxiong in the prescription of Shenghua Decoction, and determine the content of volatile oil according to the method of volatile oil determination in China Pharmacopoeia.
2. Take 403g medicinal materials according to the proportion of each medicinal material in the prescription of Shenghua Decoction, add water for two hours, filter and quantify 1000ml. The content of ferulic acid was determined by HPLC according to China Pharmacopoeia.
3. Effect of oral Shenghua Decoction on uterus weight of mice: Female mice were divided into 4 groups according to their body weight, each group had 10 mice. Subcutaneous injection of diethylstilbestrol 0.065438±00g ml (containing 65438 06 μ g), once a day/kloc-0, for 3 days. The negative control group, positive control group and Shenghua decoction group were given normal saline and Shenghua decoction respectively from the day of injection of diethylstilbestrol for 8 days. The mice were killed 2 hours after the last administration, and the uterus was taken out and weighed on the electronic balance, and then converted into the weight per 100g uterus (mg/ 100g). Statistical results were tested by t test.
4. Oral "Shenghua Decoction" analgesia test (writhing method in mice): 60 NIH mice, weighing 18-22g, half male and half female, were equally divided into 5 groups according to their weight and sex, with 12 mice in each group. 45 minutes after administration, 0.2 ml of 0.6% acetic acid solution was injected intraperitoneally, and the number of writhing within 65438 00 minutes after injection of acetic acid solution was observed. T test statistical results. Results The average yield of volatile oil was 85%, and that of ferulic acid was 84.8%. 3. Oral administration of Shenghua Decoction to mice in dose group (50g/kg) and middle dose group (20g/kg) can reduce the weight of uterus increased by estrogen (P < 0.0 1), and can resist the hyperemia, hyperplasia and hypertrophy of uterus caused by estrogen, and obviously reduce the weight of uterus.
5. A large dose of Shenghua Decoction (50g/kg) was taken orally by mice once, which significantly inhibited the writhing reaction caused by intraperitoneal injection of acetic acid, indicating that Shenghua Decoction has a certain analgesic effect. Conclusion The average yield of effective components in Shenghua Decoction can reach 85% by using volatile oil extraction technology and water extraction technology. It shows that the traditional decoction method of Shenghua Decoction is reasonable. Shenghua decoction can resist the hyperemia, hyperplasia and hypertrophy of uterus caused by estrogen, obviously reduce the weight of uterus, obviously inhibit the writhing reaction caused by intraperitoneal injection of acetic acid, and has certain analgesic effect. This pharmacological experiment provides a basis for the traditional medicine of Shenghua Decoction in treating postpartum blood deficiency, cold lochia and abdominal cold pain.
Toxicity test
(1) Acute toxicity: The maximum tolerated dose of Shenghua decoction after decoction and alcohol precipitation is 49.2 g/kg. The maximum tolerance of intraperitoneal injection was 32.8g/kg.
(2) Long-term toxicity: Rats were given Shenghua Decoction by gavage, the dose was 1.23.24.6g/kg/kg, for a total of 14 days. Experiments show that Shenghua Decoction has no obvious toxic damage to the growth, weight, liver function, renal function and blood routine of animals, but has no obvious toxic damage to the shape of heart, liver, spleen, lung, kidney, adrenal gland, ovary and uterus. [2]
8 Outlook editor
In the past, the clinical application of Shenghua Decoction was limited to postpartum diseases, especially gynecological diseases. However, it is limited to clinical efficacy observation or experience summary, and the results lack comparability, repeatability and advancement.
Some observed cases are too few, some lack objective indicators, some lack strictly controlled prospective scientific research design, and some lack basic experimental research, thus affecting the selection and development of effective prescriptions. However, the compound prescription of traditional Chinese medicine seems to be a natural combinatorial chemical library with multi-targets, multi-levels and multi-interference factors, which also brings some difficulties to the pharmacological research of compound Shenghua Decoction of traditional Chinese medicine.
We should learn from the research methods of modern pharmacology and combine the theoretical characteristics of traditional Chinese medicine to study the material basis and compatibility theory of traditional Chinese medicine and the correlation between pharmacodynamics and pharmacokinetics from the aspects of drugs (compound and medicinal materials), effective parts and effective levels (whole, animal experiments, organs and tissues, molecular biology). Only by screening out fixed, effective and safe drugs, with controllable drug quality standards and modern dosage forms and packaging, can we realize the modernization of traditional Chinese medicine and better meet the clinical needs.
9 note editor
Biochemical soup must be diagnosed by traditional Chinese medicine and used according to one's own constitution. If the parturient has symptoms such as cold, postpartum fever, postpartum infection and inflammation, abnormal bleeding, cough, sore throat, etc., she should return to the clinic as soon as possible, and it is not advisable to continue to use Shenghua Decoction. If you have diarrhea after taking biochemical soup, you must also ask Chinese medicine to make adjustments. [ 1]
Blood-heat-stasis is forbidden to use biochemical soup.
This prescription is specially designed for postpartum patients with abdominal cold pain caused by blood deficiency, cold blood stasis and uterine obstruction, and cannot be used as a routine postpartum medicine. In the Qing Dynasty, the book Jin Jing Yi Zong also
According to records, Shenghua Decoction is composed of Angelica sinensis, Chuanxiong, Salvia miltiorrhiza, peach kernel, safflower and ginger charcoal, which has a strong effect of promoting blood circulation and removing blood stasis and is used to treat postpartum abdominal pain and fever caused by blood stasis. Different from Fu Shan Shenghua Decoction in treating postpartum abdominal pain due to blood deficiency and cold coagulation, its clinical application needs to be distinguished.
remind
In the early postpartum period, women will have mild pain in the lower abdomen and waist, and at the same time, some blood, necrotic tissue and mucus will be discharged from the vagina, which is called lochia. This is a normal phenomenon. If there is no abnormality in lochia discharge, it is not necessary for the parturient to take biochemical soup.
If the postpartum lochia cannot be discharged or the amount is small, or there is a black and purple blood clot, or there are symptoms such as abdominal pain and fever, Chinese medicine calls it "lochia can't be discharged". At this time, we should go to the hospital in time, find out the reasons and do targeted treatment.
If the parturient has no other organic diseases, blood deficiency and blood stasis with cold postpartum abdominal pain, it can be treated with Shenghua Decoction. Shenghua decoction is mild in nature, so it should be added and subtracted according to the syndrome and applied according to the syndrome under the guidance of a doctor. It is not advisable for pregnant women to blindly take biochemical soup regardless of cold and heat.
10 efficacy editing
First of all, let's look at the ingredients of biochemical soup: angelica, Ligusticum chuanxiong, peach heart, roasted ginger and roasted licorice. Among them, Angelica sinensis can nourish blood and replenish blood, Chuanxiong can promote blood circulation, and Tao Xin can break blood and remove blood stasis. The purpose of the whole prescription is to nourish blood and promote blood circulation, replenish blood after delivery and eliminate lochia.
From the perspective of western medicine, after the delivery of fetal and placental tissues, the uterus compresses blood vessels to stop bleeding through muscle contraction. If the contraction is not good, these blood vessels will continue to open, causing bleeding. If a blood clot is formed in the uterine cavity, the contraction of the myometrium will be more severe and the bleeding will be more serious. Therefore, it is most important to maintain the contraction of uterine myometrium. In natural delivery and caesarean section, the treatment method of western medicine is the same, relying on uterine massage and drugs to help uterine contraction. Whether or not to give uterine contraction drugs depends on the quality of uterine contraction, about 2 ~ 3 days after delivery.
Next, it is necessary to reconstruct and regenerate the endometrial layer, which is related to future pregnancy. This process begins 2-3 days after delivery. Except for the part where the placenta was implanted, the rest of endometrial regeneration was completed in 7 ~ 10 days after delivery. However, the endometrial regeneration of placenta implantation is more complicated. This part of the thrombus needs to be peeled off before the new endometrium can grow completely. Generally, the peeling process takes about 2 weeks, sometimes even 6 weeks. It was during this period that biochemical soup really played its role.
Shenghua decoction
Let the thrombus in the endometrium at the placenta implantation site peel off (promote blood circulation and remove blood stasis), and the new endometrium can be reconstructed. Therefore, the drinking time of Shenghua Decoction starts from about 2 ~ 3 days after delivery (before that, the uterus is contracted by uterine massage or uterine contraction drugs, of course, I have no objection to drinking it immediately after delivery), about 7 ~ 10 days.
In short, do not exceed 2 weeks after delivery, because after that, Shenghua Decoction will have a negative impact on endometrial regeneration, which will make the newborn endometrium unstable, but it will not stop bleeding. This is also the most common side effect of biochemical soup. In the outpatient department, some people complained about the continuous bleeding. When asked, most of them were caused by drinking biochemical soup for a whole month.
Drink biochemical soup
After understanding the principle of endometrial rejuvenation, whether you want to drink biochemical soup depends on your own understanding. In Taiwan Province Province, most hospitals do not prohibit drinking biochemical soup (in fact, there is no need to be hospitalized after delivery, because uterine contraction is very important in these two to three days). We just object to drinking biochemical soup for a whole month (because after two weeks, biochemical soup is not good for reconstructed endometrium, but easy to bleed. If you don't want to drink, don't drink, and there is nothing in western medicine that can replace medicine. Just have a good rest.
After drinking the biochemical soup, it is time to start eating sesame-oil chicken, because at this time, the endometrium has been reconstructed and most wounds (natural perineal wounds and laparotomy wounds) have completely healed; You can only use sesame oil and wine. If you choose not to eat biochemical soup, please start eating sesame chicken wine at this time (at least postpartum 12 days).
Drink sesame chicken wine after delivery
The most important significance of drinking sesame-oil chicken wine in confinement is that the status of ancient women in the family is often the lowest, and most of them are in a state of malnutrition for a long time. Confinement is an opportunity for mother and child to rest and replenish blood. However, modern people often have excessive calories. I am very much in favor of regulating qi and blood by confinement, but blindly supplementing calories will only lead to obesity.
A balanced diet and proper rest are necessary, but calories are not equal to nutrition. Therefore, I often "warn" my parturient to know the nutrients and calories contained in food and choose what you eat carefully. Don't eat a pile of food with no nutritional value but calories, which will burden your body.
Basic introduction
Dashi pharmacy shenghuatang
Ingredients: Angelica sinensis; Chuanxiong; Peach kernel; Canned ginger; Fried licorice
Indications: tonifying postpartum deficiency, removing blood stasis and dispelling cold; Promoting blood circulation and removing blood stasis, living without hurting blood. It has the functions of accelerating uterine recovery, relieving abdominal pain and promoting milk secretion.
Usage and dosage: one pair for each bottle, put the medicinal materials in the bottle into the filter paper bag attached with the bottle, add 2 liters of water and fry for 2-3 hours, and take it twice or three times.