金刚藤咀嚼片辨证治疗湿热蕴结证慢性盆腔炎性包块的临床效果评价

Research on the Clinical Effect and Its Possible Mechanism for Treating Syndrome of Damt-heat Ftagnation Chronic Pelvic Inflammatory Disease with Jingangteng Chewable Tablets

目的:探讨金刚藤咀嚼片辨治湿热瘀结证慢性盆腔炎性包块的临床效果。方法:选取200例湿热蕴结证慢性盆腔炎性包块患者,随机分为对照组和观察组各100例。对照组给予抗生素治之;观察组联合给予金刚藤咀嚼片口服,连续治疗2周。治疗前后对比两组的有效率,评价中医证候积分,观察盆腔包块直径大小变化,检测血液流变学指标,监测血清细胞因子CRP、TNF-α、IL-6水平及宫颈黏液中s Ig A水平变化。结果:观察组的有效率为90%,较对照组的79%明显增高,差异具有统计学意义(P <0. 05);治疗后观察组患者的中医证候积分与对照组相比显著降低,差异具有统计学意义(P <0. 05);观察组的盆腔包块直径相比对照组明显缩小,差异具有统计学意义(P <0. 05);观察组的血液流变各指标显著低于对照组,差异具有统计学意义(P <0. 05);治疗后观察组患者的血清CRP、TNF-α、IL-6水平均显著低于对照组,而宫颈黏液中s Ig A水平经治疗后则显著高于对照组,差异具有统计学意义(P <0. 05)。结论:金刚藤咀嚼片辨治湿热瘀结证慢性盆腔炎性包块疗效确切,利于改善临床症状,促进盆腔包块的消退,其机制与改善血液流变学指标以利于血液微循环及调控因子水平以提高宫颈黏膜对病原微生物反复上行感染的防御能力、减轻免疫损伤有一定相关性,值得深入进一步探究。

Objective： To discuss the clinical efficacy and its possible mechanism for treating syndrome of damt-heat ftagnation chronic pelvic inflammatory disease with jingangteng chewable tablets. Methods： 200 cases were randomly divided into a control group of 100 cases and an observation group of 100 cases. Patients in the control group were treated with antibiotics; while patients in the observation group were treated with jingangteng chewable tablets,2 weeks for treatment. The paper was aimed at comparing the effectiveness,evaluating its syndrome integral,observing the changes of bag piece diameter,testing the blood rheological indexes and monitoring the levels change of inflammatory factors. Results： The efficiency of observation group was 90%,which was higher than control group 79%（ P〈0. 05）; The TCM syndrome integrals of observation group were lower than that control group（ P〈0. 05）; The patients＇ pelvic inflammatory mass decreased,the degree of change in the observation group was more pronounced（ P〈0. 05）; The blood rheological indexes for patients in the observation group were lower than that of the control group（ P〈0. 05）; The levels of hs-CRP,TNF-α and IL-6 for patients in the observation group were lower than that of the control group after treatment; while the level of s Ig A for patients in the observation group was higher than that of the control group after treatment（ P〈0. 05）; Conclusions： Treating syndrome of damt-heat ftagnation chronic pelvic inflammatory disease with jingangteng chewable tablets has satisfactory clinical effect. It can improve the patients＇ clinical symptoms and promote the fade of pelvic mass. The mechanism may be associated with the improvement of blood rheological indexes to be good for blood circulation and regulation of cytokines levels to improve cervical mucosa defense ability against pathogenic microorganisms repeatedly uplink infection and reduce im-mune injury,is worthy of further research and development.