公英败酱汤联合抗生素治疗急性子宫内膜炎湿热瘀结证临床观察

Clinical Observation of Gongying Baijiang Tang Combined with Antibiotics for Acute Endometritis with Damp-Heat and Blood Stasis Syndrome

目的:观察公英败酱汤联合抗生素治疗急性子宫内膜炎湿热瘀结证的临床疗效,及对患者基质金属蛋白酶-9(MMP-9)、炎症因子的影响。方法:将138例急性子宫内膜炎湿热瘀结证患者随机分为2组,对照组69例采用抗生素治疗,研究组69例采用公英败酱汤联合抗生素治疗。比较2组临床疗效,记录患者治疗前后的子宫内膜厚度,检测血清MMP-9和炎症因子[肿瘤坏死因子(TNF)-α、C-反应蛋白(CRP)、白细胞介素-2(IL-2)和白细胞介素-10(IL-10)]水平,观察不良反应情况,统计复发率。结果:研究组总有效率92.75%,对照组总有效率88.41%,2组比较,差异无统计学意义(P>0.05)。治疗后,2组子宫内膜均较治疗前增厚(P<0.05),研究组子宫内膜比对照组厚(P<0.05)。治疗后,2组MMP-9水平均较治疗前降低(P<0.05),研究组MMP-9水平低于对照组(P<0.05)。治疗后,2组TNF-α和CRP水平均较治疗前降低(P<0.05),IL-2和IL-10水平均较治疗前升高(P<0.05);研究组TNF-α和CRP水平均低于对照组(P<0.05),IL-2和IL-10水平均高于对照组(P<0.05)。2组治疗期间均未发生明显不良反应。对照组复发率19.67%(12/61),研究组复发率6.25%(4/64),2组比较,差异有统计学意义(P<0.05)。结论:公英败酱汤联合抗生素治疗急性子宫内膜炎湿热瘀结证疗效显著,能有效改善患者的MMP-9和炎症因子,促进子宫内膜恢复,降低复发率。

Objective： To observe the clinical effect of Gongying Baijiang tang combined with antibiotics for acute endometritis with damp-heat and blood stasis syndrome and its effect on matrix metalloproteinase-9（MMP-9） and inflammatory factors of patients. Methods：Divided 138 cases of patients with acute endometritis with damp-heat and blood stasis syndrome into the control group and the study group randomly,69 cases in each group. The control group was given antibiotics for treatment,while the study group was given Gongying Baijiang tang combined with antibiotics. Compared the clinical effect in the two groups, recorded the endometrial thickness of patients before and after treatment and detected levels of serum MMP-9 and inflammatory factors including tumor necrosis factor-α（TNF-α）, C-reactive protein（CRP）,interleukins-2（IL-2） and interleukins-10（IL-10）. Observed adverse reactions and calculated the recurrence rate. Results：The total effective rate was 92.75% in the study group and was 88.41% in the control group,there was no significance in the difference（P〈0.05）. After treatment,the endometrial thickness of patients in the two groups were increased when compared with those before treatment（P〈0.05）,and the endometrial thickness of patients in the study group were thicker than those in the control group（P〈0.05）. After treatment,MMP-9 levels in the two groups were decreased when compared with those before treatment（P〈0.05）,and MMP-9 levels in the study group were lower than those in the control group（P〈0.05）. After treatment,levels of TNF-α and CRP in the two groups were decreased when compared with those before treatment（P〈0.05）,while levels of IL-2 and IL-10 were increased when compared with those before treatment（P〈0.05）; levels of TNF-α and CRP in the study group were lower than those in the control group（P〈0.05）,while levels of IL-2 and IL-10were higher than those in the control group（P〈0.05）. No obvious adverse reaction was found in the two groups during the treatment. The recurrence ratewas 19.67%（12/61） in the control group and was 6.25%（4/64） in the study group,the difference being significant（P〈0.05）. Conclusion：The therapy of Gongying Baijiang tang combined with antibiotics has significant effect in treating acute endometritis with damp-heat and blood stasis syndrome,which can effectively improve levels of serum MMP-9 and inflammatory factors of patients,promote the recovery of endometrium and decrease the recurrence rate.