穴位注射加温针灸配合中药灌肠治疗慢性盆腔炎临床研究

Clincal research on the integrative treatment of point injection, warm acupuncture and Chinese medicine enema for the chronic pelvic inflammatory disease

目的 评价穴位注射加温针灸配合中药灌肠治疗慢性盆腔炎的疗效.方法 将符合入选标准的86例慢性盆腔炎患者,按随机数字表法分为2组,每组43例.对照组采用温针灸配合中药灌肠治疗,治疗组在对照组基础上联合穴位注射治疗.采用ELISA法检测治疗前后血清CRP、IL-1β和IL-6水平,采用全自动血流变测试仪检测血浆黏度及红细胞压积,比较2组患者治疗前后症状积分,评价临床疗效,观察复发率.结果 治疗组总有效率为97.7%（42/43）、对照组为81.4%（35/43）,2组比较差异有统计学意义（χ2=6.081,P=0.014）.治疗后,治疗组血清CRP[（7.53±3.44）mg/L比（10.11±3.02）mg/L,t=-3.696]、IL-1β[（26.37±13.98）pg/mL比（36.33±4.02）pg/mL,t=-4.490]和IL-6[（23.31±10.11）pg/mL比（29.56±4.27）pg/mL,t=-3.734]水平低于对照组（P〈0.05）;治疗组腹痛[（2.13±0.55）分比（2.71±0.62）分,t=-4.589]、疲乏无力[（1.07±0.98）分比（2.53±0.52）分,t=-8.630]、肢体寒冷[（1.51±0.51）分比（2.21±0.67）分,t=-5.451]、月经期间症状[（1.27±0.97）分比（2.29±0.78）分,t=-5.374]评分及总分[（6.13±3.94）分比（8.55±1.82）分,t=-3.656]均低于对照组（P〈0.05）;治疗组血浆黏度[（1.13±0.25）mPa＆#183;s比（1.41±0.32）mPa＆#183;s,t=-4.521]及红细胞压积[（0.27±0.08）%比（0.41±0.07）%,t=-8.636]均低于对照组（P〈0.05）.对照组复发率为11.4%（4/35）、治疗组未见复发病例,2组复发率比较,差异有统计学意义（χ2=5.063,P=0.024）.结论 穴位注射加温针灸配合中药灌肠可降低慢性盆腔炎患者炎性细胞因子水平,改善血液微循环,降低复发率.

Objective To evaluatethe curative effect of the integrative treatment of point injection, warm acupuncture and Chinese medicine enema for the chronic pelvic inflammatory disease.Methods A total of 86 patients with chronic pelvic inflammatory diseasewere divided into control group and treatment group, 43 patients in each group , according to the random number table. The control group was treated by warm acupuncture combined with Chinese medicine enema, while the treatment group was treated with point injection plus the basis of control group. The levels of serum CRP, IL-1 and IL-6 were detected by enzyme linked immunosorbent assay,the plasma viscosity and hematocrit were detected by automatic blood rheological test instrument,the symptom scores of 2 groups were compared before and after treatment, the clinical efficacy was evaluated and the recurrence rate was observed. Results The clinical effective rate of treatment group patients was 97.7% （42/43）, and the control group 81.4% （35/43）. The difference between two groups was significant （χ2=6.081,P=0.014）. After treatment, the levels of CRP （7.53 ± 3.44 mg/L vs. 10.11 ± 3.02 mg/L,t=-3.696）, IL-1β （26.37 ± 13.98 pg/mL vs. 36.33 ± 4.02 pg/mL,t=-4.490） and IL-6 （23.31 ± 10.11 pg/mlvs. 29.56 ± 4.27 pg/ml,t=-3.734）in the treatment group were significant lower than those in control group （P〈0.05）. The scores of pain （2.13 ± 0.55vs.2.71 ± 0.62,t=-4.589）, tiredness （1.07 ± 0.98 vs. 2.53 ± 0.52,t=-8.630）, Body cold （1.51 ± 0.51 vs. 2.21 ± 0.67,t=-5.451）, menstrual symptoms （1.27 ± 0.97 vs. 2.29 ± 0.78, t=-5.374） and total points （6.13 ± 3.94vs. 8.55 ± 1.82,t=-3.656） in the treatment group were significant lower than those in control group （P〈0.05）. The plasma viscosity （1.13 ± 0.25 mPa？svs. 1.41 ± 0.32 mPa？s,t=-4.521） and the red blood cells deposited （0.27% ± 0.08% vs. 0.41% ± 0.07%,t=-8.636） in the treatment group were significant lower than those in control group （P〈0.05）. The recurrence rate of treatment group was none, while 11.43% （4/35） in control group. Thus, the recurrence rate of treatment group was significantly lower than the control group （χ2=5.063,P=0.024）. Conclusions The integrative treatment of point injection, warm acupuncture and Chinese medicine enema can reduce the level of inflammatory factors in patients with chronic pelvic inflammatory disease, improve the blood microcirculation, and reduce the recurrence rate.