红藤汤保留灌肠对慢性盆腔炎患者疗效及对免疫-炎症因子的调节作用

Effect of Retention Enema of Hongteng Decoction on CPID and Its Regulation on Immune Inflammatory Factors

目的:探讨红藤汤保留灌肠对慢性盆腔炎(CPID)患者疗效及对免疫-炎症因子的调节作用。方法:选择2018年1月—2018年12月期间于陕西中医药大学第二附属医院确诊并接受治疗的77例CPID患者作为研究对象,按照随机数字表法分为灌肠组39例和常规组37例。常规组采用左氧氟沙星和甲硝唑治疗,灌肠组在此基础上给予红藤汤保留灌肠治疗,连续治疗2个疗程;对比两组疗效差异及治疗前后血流动力学、血液流变学、免疫因子、炎症因子等变化情况。结果:灌肠组总有效率高于常规组,差异有统计学意义(P<0.05)。治疗后灌肠组白细胞和中性粒细胞计数低于常规组,差异有统计学意义(P<0.05),灌肠组搏动指数(PI)、阻力指数(RI)低于常规组,最大峰值流速(Vs)高于常规组,差异有统计学意义(P<0.05);灌肠组血浆黏度(PV)、红细胞沉降率(ESR)、红细胞比容(Hct)低于常规组,差异有统计学意义(P<0.05);灌肠组CD3^+、CD4^+、CD4^+/CD8^+高于常规组,CD8^+低于常规组,差异有统计学意义(P<0.05);灌肠组白细胞介素-4(IL-4)、白细胞介素-10(IL-10)高于常规组,肿瘤坏死因子-β(TNF-β)、γ干扰素(IFN-γ)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)低于常规组,差异有统计学意义(P<0.05),灌肠组中医证候积分低于常规组,差异有统计学意义(P<0.05)。结论:红藤汤保留灌肠可显著改善CPID患者盆腔血流动力学和血液流变学,促进血液微循环,有效抑制炎症反应,增强免疫功能,提高治疗效果。

Objective:To explore the therapeutic effect of retention enema of Hongteng Decoction on chronic pelvic inflammatory disease(CPID)and its regulatory effect on immune inflammatory factors.Methods:77 patients with CPID were randomly divided into the enema group(n=39)and the conventional group(n=37).The conventional group was treated with Levofloxacin and Metronidazole,and the enema group was treated with retention enema of Hongteng Decoction for two consecutive courses.The difference of therapeutic effect was compared between the two groups.The changes of hemodynamics,hemorheology,cellular immune factors and inflammatory factors were observed before and after the treatment in the two groups.Results:The total effective rate of the enema group was significantly higher than that in the conventional group(P<0.05).The amounts of leukocyte and neutrophil were lower in the enema group than those in the conventional group(P<0.05).Compared to those in the conventional group,the pulsatility index(PI)and resistance index(RI)were lower and the maximum peak flow rate(VS)was higher in the enema group(P<0.05).The plasma viscosity(PV),erythrocyte sedimentation rate(ESR)and hematocrit(Hct)were lower in the enema group than those in the conventional group(P<0.05).The levels of CD3^+,CD4^+and CD4^+/CD8^+were higher,and the level of CD8^+was lower in the enema group than those in the conventional group(P<0.05).The contents of interleukin-4(IL-4)and interleukin-10(IL-10)were higher,and the levels of tumor necrosis factor-β(TNF-β),interferon-γ(IFN-γ)and granulocyte macrophage-colony stimulating factor(GM-CSF)were lower in the enema group than those in the conventional group(P<0.05).TCM syndrome scores were lower in the enema group than those in the conventional group(P<0.05).Conclusion:Retention enema of Hongteng Decoction can significantly improve the pelvic hemodynamics and hemorheology of patients with CPID.It can promote blood microcirculation,effectively inhibit inflammatory response,enhance immune function,and improve the treatment effect.