基于“火郁发之”理论自拟盆腔炎方联合抗菌药物治疗湿热瘀结型盆腔炎的临床观察

Clinical Observation on Self-designed Pelvic Inflammatory Disease Prescription Based on Dispersing Fire-stagnation Theory Combined with Antibiotics in Treatment of Pelvic Inflammatory Disease with Damp-Heat Stasis Syndrome

目的:探究基于“火郁发之”理论自拟盆腔炎方联合抗菌药物治疗湿热瘀结型盆腔炎性疾病(Pelvic inflammatory disease,PID)的疗效及安全性。方法:将132例PID患者随机分为对照组和治疗组各66例。对照组给予头孢地尼胶囊及甲硝唑片口服,治疗组在对照组基础上加用自拟盆腔炎方口服,疗程均为14 d。比较2组患者治疗前后的有效率、中医证候评分、腹痛视觉模拟评分表(VAS)评分、C-反应蛋白(CRP)、白细胞介素-2(IL-2)水平、盆腔积液量、盆腔包块直径及治疗期间不良反应情况。结果:因用药期间出现不良反应,最终纳入统计分析129例,对照组64例,治疗组65例。治疗后,治疗组有效率为93.85%,高于对照组有效率81.25%(P<0.05);治疗后,中医证候评分、腹痛VAS评分、CRP、IL-2水平均较治疗前改善,盆腔积液量减少,盆腔包块直径减小,且治疗组优于对照组(均P<0.05)。治疗期间,治疗组不良反应发生率低于对照组(P<0.05)。结论:基于“火郁发之”理论自拟盆腔炎方联合抗菌药物治疗湿热瘀结型PID有较好的临床疗效,可改善患者症状,改善CRP及IL-2水平、盆腔积液量及盆腔包块直径,安全性高。

Objective:To investigate the efficacy and safety of a self-designed pelvic inflammatory disease prescription based on the theory of dispersing fire-stagnation combined with antibiotics in the treatment of pelvic inflammatory disease(PID)with damp-heat stasis syndrome.Methods:A total of 132 PID patients were randomly divided into a control group(66 patients treated with cefdinir and metronidazole)and a treatment group(66 patients treated with cefdinir,metronidazole,and the self-designed pelvic inflammatory disease prescription).The control group received oral cefdinir capsules and metronidazole tablets,while the treatment group received the self-designed pelvic inflammatory disease prescription orally in addition to the control group's treatment.The course of treatment was 14 days for both groups.The effective rate,traditional Chinese medicine(TCM)syndrome score,visual analog scale(VAS)score for abdominal pain,levels of C-reactive protein(CRP)and interleukin-2(IL-2),pelvic fluid volume,pelvic mass diameter,and adverse reactions during treatment were compared between the two groups before and after treatment.Results:Due to adverse reactions during medication,a total of 129 patients were ultimately included in the statistical analysis,with 64 in the control group and 65 in the treatment group.After treatment,the effective rate in the treatment group was 93.85%,which was higher than the 81.25%effective rate in the control group(P<0.05).After treatment,the TCM syndrome score,VAS score for abdominal pain,CRP and IL-2 levels were all improved compared to those before treatment,with a reduction in pelvic fluid volume and pelvic mass diameter.The treatment group performed better than the control group in all these aspects(P<0.05).During the treatment period,the incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05).Conclusion:The self-designed pelvic inflammatory disease prescription based on the theory of dispersing fire-stagnation combined with antibiotics has good clinical efficacy in the treatment of PID with damp-heat stasis syndrome.It can improve patients'symptoms,CRP and IL-2 levels,pelvic fluid volume,and pelvic mass diameter,with high safety.