高压氧联合药物治疗慢性盆腔炎的临床疗效与作用机制研究

Clinical effects of hyperbaric oxygen combined with drug therapy in the treatment of chronic pelvic inflammatory disease and the possible mechanism involved

目的：探讨高压氧联合药物治疗慢性盆腔炎的临床效果与机制。方法经患者知情同意，并经医院伦理委员会批准，将124例慢性盆腔炎患者分为联合组（高压氧联合药物治疗，62例）和对照组（单纯药物治疗，62例）。治疗前后，根据患者症状、体征和B超检查判定疗效，采集患者血清检测C反应蛋白（CRP）和炎症细胞因子[肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6和IL-1β]。结果经3个疗程治疗后，联合组和对照组患者的治疗总有效率分别为90．3％和74．2％，差异有统计学意义（P＜0．05）；治疗后半年的复发率联合组（12．9％）显著低于对照组（35．5％），差异有统计学意义（P＜0．05）。2组患者治疗后血清CRP均明显下降，联合组的CRP的水平显著低于对照组，差异有统计学意义（P＜0．01）；2组患者治疗后血清TNF-α、IL-6和IL-1β均显著下降，联合组的下降比对照组更显著，差异有统计学意义（P＜0．01）。结论高压氧联合药物治疗慢性盆腔炎的效果显著优于单纯药物治疗，高压氧通过下调CRP和炎症细胞因子水平发挥其效应，高压氧有望成为慢性盆腔炎的重要辅助治疗手段。

Objective To investigate the clinical effects of HBO combined with drug therapy in the treatment of chronic pelvic inflammatory disease and the underlying mechanism.Methods One hundred and twenty-four patients with chronic pelvic inflammation were randomly divided into the combined therapy group （HBO coupled with drug therapy）and the control group （pure drug therapy）,each consisting of 62 patients. Before and after treatment,therapeutic efficacy was assessed in accordance with the symptoms,vital signs and ultrasonography examination.Blood samples were collected for the detection of C-reactive protein （CRP）and inflammatory cytokines（TNF-α,IL-6 and IL-1β）.Results After 3 courses of treatment,total effective rates for the patients in the combined therapy group and the control group were respectively 90.3%and 74.2%,and statistical significance could be noted,when comparisons were made between the 2 groups （P〈0.05）.After 6 months of treatment,the recurrence rate of the patients in the combined therapy group （12.9%）was significantly lower than that of the patients in the control group （35.5%）（P ＆lt;0.05 ）,and statistical significance could be seen,when comparisons were made between them （P〈0.05）.Following treatment,the levels of serum CRP in the patients of both groups were all significantly decreased,with the serum CRP level of the combined therapy group being obviously lower than that of the control group （P〈0.01 ）,and statistical significance could be found,when comparisons were made between the 2 groups （P ＆lt;0.01 ）.Following treatment,the levels of serum TNF-α,IL-6 and IL-1βin both groups declined significantly,with the levels of＆amp;nbsp;the combined therapy group declining more prominently,as compared with those of the control group,and statistical significance could also be seen,when comparisons were made between them （P ＆lt;0.01 ）. Conclusions The efficacy of HBO coupled with drug therapy was superior to that of pure drug therapy for the treatment of chronic pelvic inflammation.HBO exerted its effects by regulating the expression levels of CRP and inflammatory cytokines,and hopefully it might become an important accessory method for the treatment of chronic pelvic inflammation.