克林霉素联合氨曲南治疗盆腔炎性疾病的疗效及对炎性因子水平的影响

Effect of Clindamycin Combined with Aztreonam in Treatment of Pelvic Inflammatory Disease and the Influence on Inflammatory Factors

目的探讨克林霉素联合氨曲南治疗盆腔炎性疾病的疗效及对炎性因子水平的影响。方法选取2012年12月至2014年12月新疆医科大学第一附属医院诊治的盆腔炎性疾病患者214例为研究对象,采用随机数字表法分为对照组和观察组,各107例。对照组采用左氧氟沙星联合甲硝唑治疗,盐酸左氧氟沙星注射液200 mg+甲硝唑注射液1250 mg,加入到500 m L生理盐水中静脉滴注,每12小时1次,等临床病症改善后改为口服用药;观察组采用克林霉素联合氨曲南治疗,盐酸克林霉素注射液1200 mg+注射用氨曲南1000 mg,加入到500 m L生理盐水中静脉滴注,每12小时1次,等临床病症改善后改为口服用药。两组用药总疗程14 d。于治疗前后行中医证候积分和局部体征积分,比较两组患者治疗前后的炎性因子水平、临床病症改善情况、临床疗效、不良反应发生情况。结果治疗后,观察组白细胞计数、白细胞介素6、高敏C反应蛋白、肿瘤坏死因子α低于对照组[(7.6±0.8)×109/L比(11.2±1.0)×109/L,(66±4)ng/L比(103±13)ng/L,(8.4±1.2)mg/L比(14.0±1.0)mg/L,(2.1±0.5)ng/L比(2.8±0.6)ng/L],差异均有统计学意义(P<0.01)。治疗后,观察组患者中医证候积分、局部体征积分均低于对照组[(2.69±0.54)分比(6.12±0.76)分,(1.80±0.78)分比(3.64±0.95)分],差异均有统计学意义(P<0.01)。观察组患者中医证候积分疗效总有效率、局部体征积分疗效总有效率均高于对照组[99.1%(106/107)比85.0%(91/107),98.1%(105/107)比82.2%(88/107)],差异有统计学意义(P<0.05)。观察组患者总不良反应发生率低于对照组[1.9%(2/107)比10.3%(11/107)],差异有统计学意义(P<0.05)。结论克林霉素联合氨曲南治疗盆腔炎性疾病的效果较好,可明显改善患者的临床病症,显著降低患者的炎性因子水平,疗效显著且安全性高,值得临床推广使用。

ObjectiveTo investigate the clinical effect of clindamycin combined with aztreonam in treatment of pelvic inflammatory disease. Methods Total of 214 patients with pelvic inflammatory disease in the First Affiliated Hospital of Xinjiang Medical University from Dec. 2012 to Dee. 2014 were included in the study, and divided into a control group and an observation group according to the random number table method, 107 cases each. The control group was given levofloxacin combined with metronidazole ： levofloxaein injection 200 mg ＋ metronidazole injection 1250 mg added to 500 mL of normal saline for intravenous infu- sion, once per 12 h, changed into oral administration after clinical conditions improved;the observation group was given clindamyein combined with aztreonam treatment： elindamycin hydroehloride injection 1200 mg＋ aztreonam injection 1000 rag, added to 500 mL normal saline infusion, once per 12 h, changed into oral administration after clinical conditions improved. The total course of treatment for both groups was 14 d. TCM syndromes integral and local signs integral were evaluated before and after treatment. Inflammatory factor levels and dinical symptoms improvement, clinical efficacy and adverse reactions of the two groups were compared. Results After treatment, leucocyte count ,interleukin 6 and high-sensitivity C-reactive protein, tumor necrosis factor-or of the observation group were lower than the control group [ （ 7.6 ± 0. 8 ） × 10^9/L vs （11.2±1.0） × 10^9/L,（66 ±4） ng/L vs （103±13） ng/L,（8.4 ±1.2） mg/L vs （14.0±1.0） mg/L, （2. 1 ± 0. 5 ） ng/L vs （ 2.8 ± 0. 6 ） ng/L ], the differences were statistically significant （ P 〈 0. 01 ）. After treatment, TCM syndrome score,local signs points of the observation group were lower than the control group [ （2.69 ± 0.54） scores vs （6. 12 ± 0. 76 ） scores, （ 1.80 ±0. 78 ） scores vs （ 3.64 ± 0. 95 ） scores ], the differences were statistically significant（ P 〈 0. 01 ）. TCM syndrome score total effective rate,local signs total effective integration of the observation group were higher than the control group [ 99. 1% （106/107） vs 85.0% （91/107）, 98.1% （105/107） vs 82. 2% （88/107） ], the differences were statistically significant （ P 〈 0. 05 ）. The overall incidence of adverse reactions of the observation group was lower than the control group[ 1.9% （ 2/107 ） vs 10. 3% （ 11/107 ） ], the difference was statistically significant （ P 〈 0.05 ）. Conclusion Clindamycin combined with aztreonam in treatment of pelvic inflammatory disease has good effect, which can significantly improve clinical symptoms and reduce inflammatory factor levels, with significant curative effect and high safety,thus is worthy of clinical application and promotion.