摘要
目的观察中药化瘀止痛方对气滞血瘀型盆腔炎性疾病后遗症(Sequelae of pelvic inflammatory disease,SPID)的临床疗效以及对其免疫功能和盆腔炎(Pelvic inflammatory disease,PID)复发的影响。方法选取2019年10月—2020年9月期间北京中医医院平谷医院收治的气滞血瘀型SPID患者68例,按随机数字表法分为对照组和治疗组,每组各34例。对照组给予甲硝唑维B6片联合盐酸左氧氟沙星口服,治疗组给予化瘀止痛方口服,两组患者均连续治疗21 d。治疗后观察比较两组患者临床疗效,治疗前后中医证候量化评分、临床体征量化评分、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、不良反应及复发情况。结果治疗后治疗组总有效率91.18%(31/34)明显高于对照组69.70%(23/33),差异有统计学意义(P<0.05)。治疗后两组患者下腹刺痛或胀痛、腰骶疼痛、月经异常、带下异常4项中医证候量化评分均低于治疗前,差异有统计学意义(P<0.05);且治疗组均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者子宫活动度、宫体压痛、附件区压痛、附件增厚4项体征量化评分均低于治疗前,差异有统计学意义(P<0.05);且治疗组均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CD4^(+)、CD4^(+)/CD8^(+)水平均高于治疗前,治疗组CD8^(+)水平均低于治疗前,差异有统计学意义(P<0.05);且治疗组CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,差异有统计学意义(P<0.05);治疗后对照组CD8^(+)水平与治疗前比较、治疗组CD8^(+)水平与对照组比较,差异无统计学意义(P>0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后3个月内,治疗组PID复发率5.88%明显低于对照组27.27%,差异有统计学意义(P<0.05)。结论化瘀止痛方治疗气滞血瘀型SPID疗效显著,明显优于常规西药治疗,能有效改善患者临床症状体征,并可增强患者免疫功能,降低盆腔炎复发概率,且安全性好,值得临床推广应用。
Objective To explore the efficacy of Huayu Zhitong Prescription in the sequelae of pelvic inflammatory disease(SPID)with qi stagnation and blood stasis and its influence on immune function and recurrence rate of PID.Methods Sixty-eight patients with SPID with qi stagnation and blood stasis diagnosed and treated in Pinggu Hospital,Beijing Hospital of Traditional Chinese Medicine from October 2019 to September 2020 were included and divided into a control group and a treatment group according to the random number table,with 34 cases in each group.The control group was given metronidazole B6 tablets combined with levofloxacin hydrochloride orally,and the treatment group was given Huayu Zhitong Prescription.Both groups were treated for 21 days.After treatment,the clinical efficacy of the two groups was observed and compared.The scores of traditional Chinese medicine(TCM)syndromes,the scores of clinical signs,and immune function(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+))before and after treatment between the two groups were compared,and the occurrence of adverse reactions during the treatment and the recurrence rate of PID within 3 months after treatmentwere recorded.Results After treatment,the total effective rate was 91.18%(31/34)in the treatment group,which was higher than that[69.70%(23/33)]in the control group(P<0.05).After treatment,the quantitative scores of four TCM syndromes of lower abdomen tingling or pain,lumbosacral pain,menstrual abnormalities,and abnormal vaginal discharge in the two groups were lower than those before treatment(P<0.05),and the scores of the treatment group were lower than those of the control group(P<0.05).After treatment,the scores of four clinical signs of uterine mobility,uterine body tenderness,adnexa tenderness,and adnexa thickening in the two groups were all lower than those before treatment(P<0.05),and the scores of the treatment group were lower than those of the control group(P<0.05).After treatment,the CD4^(+)and CD4^(+)/CD8^(+)levels in both groups were higher than those before treatment,and the CD8^(+)levels in the treatment group were lower than those before treatment(P<0.05).The CD4^(+)and CD4^(+)/CD8^(+)levels in the treatment group were higher than those in the control group(P<0.05).After treatment,the differences between the CD8^(+)levels in the control group and those before treatment and the CD8^(+)levels in the treatment group and those in the control group had no statistical significance(P>0.05).During the treatment period,there was no statistical difference in adverse reactions between the two groups(P>0.05).Within 3 months after treatment,the recurrence rate of PID in the treatment group was 5.88%,which was lower than that of the control group[27.27%,(P<0.05)].Conclusion Huayu Zhitong Prescription has a significant effect on the treatment of SPID with qi stagnation and blood stasis,which is significantly better than conventional western medicine.It can effectively improve the patient′s clinical symptoms and signs,enhance the patient′s immune function,reduce the probability of PID recurrence,and is safe and worth clinical promotion.
作者
权玉巧
秦丽莉
王世艳
陈海荣
QUAN Yu-qiao;QIN Li-li;WANG Shi-yan;CHEN Hai-rong(Department of Gynecology,Pinggu Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101200;Department of Ultrasound,Pinggu Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101200)
出处
《世界中西医结合杂志》
2022年第10期2067-2071,2076,共6页
World Journal of Integrated Traditional and Western Medicine
基金
北京市平谷区卫生健康委科研项目(pgwjw2020-04)。
关键词
盆腔炎性疾病后遗症
化瘀止痛方
气滞血瘀
免疫功能
复发率
Sequelae of Pelvic Inflammatory Disease
Huayu Zhitong Prescription
Qi Stagnation and Blood Stasis
Immune Function
Recurrence Rate
