生化湯運用於自然產、剖腹產與人工流產產後調理之差異－－34位臺灣中醫婦科專家經驗之分析

THE DIFFERENCES OF SHENG-HUA-TANG ON THE POSTPARTUM RECOVERY AMONG NORMAL SPONTANEOUS DELIVERY, CESAREAN SECTION AND ARTIFICAL ABORTION － THE ANALYTIC STUDIES OF 34 GYNECOLOGICAL EXPERTS’ EXPERIENCES IN TRADITIONAL CHINESE MEDICINE

生化湯在台灣運用於產後調理甚為普遍。本研究之目的主要是探討生化湯在台灣地區使用於自然產、剖腹產與人工流產產後調理之劑量、組成與服用時機之差異。本研究邀請34 位台灣地區中醫婦科臨床專家，以半開放式問卷探討研究主題。研究結果顯示，運用生化湯於產後調理時，自然產之當歸劑量比值及服用帖數均高於剖腹產，而人工流產的當歸、川芎劑量比值與服用帖數也明顯低於自然產。不管是自然產、剖腹產或人工流產，認為「產後一天以上」再服用生化湯之專家佔最多數，且建議生化湯運用時需加味，產後餵哺母乳則不需另外加味。在煎煮法之要求上，除剖腹產以純水煎煮者最多外，自然產及人工流產均以「無特殊要求」佔多數。在受訪的專家之中，有18 位曾見過因服用生化湯所造成的藥物不良反應，建議生化湯運用於產後調理仍應經中醫師處方後再行服用。Sheng-Hua-Tang is commonly used for the postpartum recovery in Taiwan. To understand the differences in the dosage, composition and initial timing of Sheng-Hua-Tang on the normal spontaneous delivery (NSD), cesarean section (C/S) and artificial abortion (AA), 34 Chinese medicine gynecologic experts were enrolled for analysis of the semi-open questionnaire. The results show that the dosage ratio of Radix Angelicae Sinensis and the duration of administration prescribed for NSD were higher than C/S. The dosage ratio of Radix Angelicae Sinensis, Rhizoma Li Chuanxiong and the duration of decoction prescribed for AA were lower than NSD. The initial timing in taking Sheng-Hua-Tang was more than 24 hours after delivery in the opinions of most experts. Sheng-Hua-Tang required additional drugs when prescribed for postpartum recovery of the patient. No additional drugs were necessary for breast-feeding mothers. Concerning the preparation of Sheng-Hua-Tang, there were no special requirements for NSD and AA, except extracting with pure water for C/S. Eighteen experts have met the adverse effects induced by Sheng-Hua-Tang. We suggest that Sheng-Hua-Tang should be prescribed by Chinese medicine doctors for postpartum recovery.