盆炎平方内服联合蒲地方保留灌肠治疗慢性盆腔炎的临床研究

Clinical Study of Penyanping Decoction Taken Orally with Pudi Decoction Retention Enema in the Treatment of Chronic Pelvic Inflammatory Disease

目的:观察盆炎平方内服联合蒲地方保留灌肠治疗慢性盆腔炎(湿热瘀结型)的临床疗效及血液流变与血清C-反应蛋白的影响。方法:将120例患者随机按数字表分为对照组和观察组各60例。对照组采用黄藤素分散片,4片/次,3次/d,自月经干净后开始服用,一个疗程20 d;苦参栓,1粒/次,1次/d,自月经干净后3 d开始用直肠给药,1个疗程连续使用10d。观察组采用盆炎平方,1剂/d,常规水煎,每次约200 mL,从月经干净后分早晚服用,一个疗程20 d;蒲地灌肠方,1剂/d,自月经干净后3 d开始保留灌肠,1个疗程连续使用10 d。两组均连续观察3个月经周期。记录治疗前后湿热瘀结证候评分,检测治疗前后血液流变学指标及血清C-反应蛋白(CRP)水平,用世界卫生组织生活质量测定简表(WHOQOL-BREF)进行评价患者生活质量。结果:观察组总有效率为91.66%,优于对照组的78.33%(P<0.05);治疗后第4、8和12周,观察组热瘀结证候评分低于对照组(P<0.01);治疗后观察组全血黏度及全血还原黏度(低、中、高切)、红细胞聚集指数和血浆黏度均明显改善(P<0.01),观察组的改善均优于对照组(P<0.01);观察组血清CRP明显下降,并低于对照组(P<0.01);治疗后观察组生存质量、健康状况、日常活动及自我感觉4个维度评分及总分均高于对照组(P<0.01)。结论:盆炎平方内服联合蒲地方保留灌肠治疗慢性盆腔炎,能改善临床症状和局部体征,提高患者生活质量;并能改善患者血液的浓、黏、凝、滞状态,减轻了炎症反应,提高了临床疗效,值得临床推广使用。

Objective： The purpose is to observe the curative effect of Penyanping decoction taken orally with Pudi decoction retention enema treatment on chronic pelvic inflammatory disease（hot and damp stasis junction） and the influence on blood rheological and serum C reactive protein（CRP）. Method： One hundred and twenty patients were randomly divided into control group （60 cases） and observation group （60 cases）by numeric table. Patients in control group were given daemonorops margaritae dispersible tablets, 4 pieces/time, 3 times/day, orally.Take the pills after the menstruation is end,treatment course 20 days;sophora suppository, 1 grain/time,1 times/day,after three days from the menstruation is clean,rectal administration,treatment course 10 days.Patients in observation group were given Penyanping decoction,1 dose/day,orally,2 times/day, conventional water frying about 200 mL each time and take it in the morning and evening.Taking it after the menstrual to be clean,treatment course 20 days.Pudi decoction retention enema：1 agent/day,after three days from the menstruation is clean,treatment course 10 days.Observe the both groups for three consecutive menstrual cycle.Record the humid heat and blood stasis syndrome score before and after the treatment.Detect the level of blood rheology indexes and CPR before and after the treatment.Evaluate the patients life quality with the world health organization quality of life measurement profile （WHOQOL-BREF）. Result： The total effective rate of observation group on pain reduction index （91.66%） were superior to the control group （78.33%） （P〈0.05）. The heat and blood stasis syndrome score of observation group is lower than control group（P〈0.01）at the fourth,eighth and twelfth week after treatment.The whole blood viscosity,whole blood reductive viscosity（high, medium and low）,red blood cell aggregation index and plasma viscosity got obvious improvement after the treatment（P〈0.01）.The improvement of the observation group were better than the control group（P〈0.01）.Serum CRP significantly decreased in observation group is less than control group（P〈0.01）. The dimension score and total score in life quality,health, daily activities and feel,the observation group is higher than control group（P〈0.01）. Conclusion： The treatment of Penyanping decoction taken orally with Pudi fang retention enema treatment on chronic pelvic inflammatory disease can improve clinical symptoms and local signs and improve the quality of life of patients,and improve the patient＇s blood state of thick, sticky, coagulation and sluggish,reduce inflammatory response,improve clinical curative effect, which deserves promoting in the clinical.