解毒益气中药联合阿奇霉素治疗围产期沙眼衣原体感染临床观察

The clinical effect of clearing heat and qi-strengthening medicine combined with azithromycin treatment in pregnant woman with Chlamydia trachomatis infection

目的探讨解毒益气中药联合阿奇霉素治疗围产期沙眼衣原体(CT)感染的临床疗效。方法将136例宫颈分泌物CT阳性患者随机分为3组,阿奇霉素组45例,予阿奇霉素1.0g,隔日1次顿服,3次为1个疗程,3周后复查CT,仍阳性者重复下1个疗程,共2个疗程;中西医结合组54例,在阿奇霉素组治疗基础上予解毒益气中药,日1剂,水煎服,14日为1个疗程,停中药2周后复查CT,仍阳性者重复用药,共2个疗程;空白对照组37例,不予任何治疗,观察随诊。3组在2个疗程后统计疗效,待分娩。统计临床疗效、不良妊娠结局的发生率。结果3组治愈率、有效率两两比较差异均有统计学意义(均P<0.05),中西医结合组优于阿奇霉素组、空白对照组,阿奇霉素组优于空白对照组;3组妊娠结局两两比较差异均有统计学意义(P<0.05),3组流产、早产、胎膜早破、胎死宫内、低体质量儿、新生儿结膜炎和新生儿肺炎发生率由高到低依次为空白对照组>阿奇霉素组>中西医结合组。结论孕期CT感染可造成不良妊娠结局,解毒益气中药联合阿奇霉素治疗围产期CT感染疗效确切,并明显改善妊娠结局。

Objective To observe the clinical effect of clearing heat and qi - strengthening medicine combined with azithromycin treatment in pregnant woman with Chlamydia trachomatis （CT） infection. Methods 136 pregnant woman with CT infection were divided into three groups. Patients in azithromycin group （A group, n = 45） accepted oral azithromycin, Patients in combination of TCM and western medicine group （B group, n = 54） accepted oral azithromycin and clearing heat and qi- strengthening medicine, patients in control group （C group, n = 37） accepted no medicine. 3 groups＇ therapeutic effect and incidence rate of bad pregnancy outcome were recorded and compared after two the therapeutic courses. Results Cure rate and effective rate in B group was 90.74% and 96.30%, much higher than A group（66.67%, 75.56% ） and C group（2.70%, 10.81% ）, P 〈 0.05 for all. Sequence of incidence rate of abortion, premature delivery, premature rupture of membrane, dead fetus in uterus, Neonatal conjunctivitis and pneumonia of newborn was C group 〉 A group 〉 B group. Conclusion Pregnant woman with Chlamydia tmchomatis infection could have bad outcome. The effect of clearing heat and qi - strengthening medicine combined with azithromycin treatment is better than azimyocine treatment, and can improve pregnancy outcome.