Xinyu Xue, Xintong Tang, Youping Li, Feng Wan, Jiajie Yu
Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2022 Jul 21;13:916665. doi: 10.3389/fphar.2022.916665. eCollection 2022.
Motherwort injection (MI) is a modern patented injection extracted from motherwort (Leonurus japonicus Hoult). Empirical studies and systematic reviews have shown the benefits of motherwort injection for preventing postpartum hemorrhage after vaginal delivery and cesarean section. This study was conducted to explore the efficacy and safety of motherwort injection for women with the prevention of post-abortion uterine hemorrhage. A comprehensive literature search was conducted to identify RCTs regarding the effect of the use of motherwort injection in women after abortion. Data from trials were pooled by meta-analysis and a random-effects model was used to calculate the summarized relative risks (RRs) and their 95% confidence intervals (CIs). The grading of recommendations assessment, development, and evaluation (GRADE) methodology was used to access the quality of the evidence. Nine trials with a total of 1,675 participants were identified. Overall, motherwort injection combined with oxytocin compared to oxytocin had a significantly lower blood loss within 2 hours (MD = -50.00, 95% CI -62.92 to -37.08, very low quality); lower blood loss within 24 h (MD = -50.00, 95% CI -62.92 to -37.08, very low quality); however, there was no significant difference between motherwort injection and oxytocin (24 h: MD: 0.72, 95% CI -7.76 to 9.20; 48 h: MD: -0.01, 95% CI -11.35 to 11.33; 72 h: MD: -1.12, 95% CI -14.39 to 12.15, very low quality). Compared with oxytocin or no intervention, both motherwort injection and motherwort injection combined with oxytocin had a significantly decreased duration of blood loss (MI vs. O: MD -2.59, 95% CI -4.59 to -0.60, very low quality; MI + O vs. O: MD -2.62, 95% CI -3.02 to -2.22, very low quality; MI + O vs. No intervention: MD: -1.80, 95% CI -2.28 to -1.33, low quality). Seven of nine included trials reported adverse event outcomes. Three cases were found in the motherwort injection group, and five induced abortion syndromes were found in the motherwort injection plus oxytocin group. 29 adverse events were reported in the oxytocin group instead. The recovery time of normal menstruation after abortion was significantly earlier in the group using motherwort injection compared with oxytocin (MDs -3.77, 95% CI -6.29 to -1.25, very low quality), and the endometrial thickness in the motherwort injection group was significantly different from that in the oxytocin group (MD: 2.24, 95% CI 1.58 to 2.90, very low quality). The results of this meta-analysis indicate prophylactic use of motherwort injection may reduce the risk of uterine hemorrhage in women after abortion, and more high-quality research is needed to confirm the efficacy and safety of motherwort injection in preventing uterine hemorrhage after abortion. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=274153, identifier CRD42021274153.
益母草注射液（MI）是一种从益母草（Leonurus japonicus Hoult）中提取的现代专利注射剂。实证研究和系统评价表明，益母草注射液对预防阴道分娩和剖宫产术后产后出血有益。本研究旨在探讨益母草注射液对预防流产后子宫出血女性的疗效和安全性。进行了全面的文献检索，以确定关于流产后女性使用益母草注射液效果的随机对照试验（RCT）。通过荟萃分析汇总试验数据，并使用随机效应模型计算汇总相对风险（RRs）及其95%置信区间（CIs）。采用推荐意见评估、制定与评价（GRADE）方法来评估证据质量。共纳入9项试验，总计1675名参与者。总体而言，与催产素相比，益母草注射液联合催产素在2小时内出血量显著更低（MD = -50.00，95%CI -62.92至-37.08，极低质量）；24小时内出血量更低（MD = -50.00，95%CI -62.92至-37.08，极低质量）；然而，益母草注射液与催产素之间无显著差异（24小时：MD：0.72，95%CI -7.76至9.20；48小时：MD：-0.01，95%CI -11.35至11.33；72小时：MD：-1.12，95%CI -14.39至12.15，极低质量）。与催产素或无干预相比，益母草注射液以及益母草注射液联合催产素均使出血持续时间显著缩短（益母草注射液组与催产素组比较：MD -2.59，95%CI -4.59至-0.60，极低质量；益母草注射液联合催产素组与催产素组比较：MD -2.62，95%CI -3.02至-2.22，极低质量；益母草注射液联合催产素组与无干预组比较：MD：-1.80，95%CI -2.28至-1.33，低质量）。纳入的9项试验中有7项报告了不良事件结果。益母草注射液组发现3例，益母草注射液加催产素组发现5例人工流产综合征。催产素组则报告了29例不良事件。与催产素相比，使用益母草注射液的组流产后月经恢复正常的时间显著更早（MDs -3.77，95%CI -6.29至-1.25，极低质量），且益母草注射液组的子宫内膜厚度与催产素组有显著差异（MD：2.24，95%CI 1.58至2.90，极低质量）。本荟萃分析结果表明，预防性使用益母草注射液可能降低流产后女性子宫出血的风险，需要更多高质量研究来证实益母草注射液预防流产后子宫出血的疗效和安全性。https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=274153，标识符CRD42021274153 。
