膈下逐瘀汤辅治盆腔炎性疾病后遗症(气滞血瘀)疗效及对血液流变学、炎症状态的影响

Curative Effect of Gexia Zhuyu Decoction Adjuvant Therapy on Sequelae of Pelvic Inflammatory Disease(Qi-stagnation Blood-stasis)and Its Influences on Hemorheology and Inflammation Status

目的:观察膈下逐瘀汤辅治气滞血瘀证盆腔炎性疾病后遗症(SPID)效果及对血液流变学、炎症状态的影响。方法:选取2018年7月~2019年7月南京中医药大学附属南京市中西医结合医院收治的100例气滞血瘀证SPID患者,并用随机数字表法将其分为对照组和观察组各50例,其中对照组给予头孢西丁钠治疗,观察组在对照组的基础上联合给予膈下逐瘀汤辅助治疗;根据两组治疗前、后的中医证候积分计算出中医疗效指数,统计两组的临床治疗效果;比较两组治疗前、后的盆腔包块大小和盆腔积液量变化;测评两组治疗前、后的全血低切粘度(LBV)、全血高切粘度(HBV)以及红细胞沉降率(ESR)血液流变学指标水平变化;记录两组治疗前、后的白细胞介素-2(IL-2)、白细胞介素-6(IL-6)以及肿瘤坏死因子α(TNF-α)炎性细胞因子表达水平;统计两组的不良反应总发生率。结果:观察组的治疗总有效率为92.00%高于对照组的76.00%(P<0.05);观察组治疗后盆腔包块大小和盆腔积液量均低于对照组(P<0.05);观察组治疗后LBV、HBV和ESR三项血液流变学指标水平均低于对照组(P<0.05);观察组治疗后IL-2水平高于对照组(P<0.05),IL-6和TNF-α水平均低于对照组(P<0.05);观察组、对照组的不良反应总发生率分别为8.00%和14.00%,比较差异无统计学意义(P>0.05)。结论:膈下逐瘀汤辅治气滞血瘀证SPID疗效显著,能缩小盆腔包块,促进盆腔积液的吸收和血流动力学的稳定,改善机体炎症状态。

Objective:To explore the curative effect of Gexia Zhuyu Decoction adjuvant therapy on sequelae of pelvic inflammatory disease(SPID)of Qi-stagnation blood-stasis syndrome and its influences on hemorheology and inflammation status.Methods:A total of 100 SPID patients of Qi-stagnation blood-stasis syndrome who were admitted to Nanjing Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from July 2018 to July 2019 were enrolled.They were divided into controlled group and observation group by random number table method,50 cases in each group.The controlled group was treated with Cefoxitin Sodium,while the observation group was additionally given Gexia Zhuyu Decoction adjuvant therapy.According to scores of TCM syndrome before and after treatment,TCM curative effect indexes were calculated in both groups.The clinical curative effect in both groups was statistically analyzed.The changes in pelvic masses and pelvic effusion volume before and after treatment were compared between the two groups.The changes in levels of hemorheology indexes[low blood viscosity(LBV),high blood viscosity(HBV),erythrocyte sedimentation rate(ESR)]before and after treatment in both groups were measured.The expression levels of inflammatory cytokines[interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factorα(TNF-α)]before and after treatment in both groups were recorded.The total incidence of adverse reactions in both groups was statistically analyzed.Results:The total response rate of treatment in the observation group was higher than that in the controlled group(92.00%vs 76.00%)(P<0.05).After treatment,size of pelvic masses and pelvic effusion volume in the observation group were lower than those in the controlled group(P<0.05).After treatment,levels of LBV,HBV and ESR in the observation group were lower than those in the controlled group(P<0.05).After treatment,level of IL-2 in the observation group was higher than that in the controlled group(P<0.05),while IL-6 and TNF-αlevels were lower than those in the controlled group(P<0.05).There was no significant difference in total incidence of adverse reactions between the observation group and the controlled group(8.00%vs 14.00%)(P>0.05).Conclusion:The curative effect of Gexia Zhuyu Decoction adjuvant therapy is significant on SPID of Qi-stagnation blood-stasis syndrome,which can reduce pelvic mass,promote pelvic effusion absorption and hemodynamic stability,and improve inflammatory status.