丹萸饮内服联合红藤汤保留灌肠、消癥散热敷治疗盆腔炎性疾病后遗症湿热瘀结型临床观察

Clinical observation of oral Danyu Decoction combined with Hongteng Decoction enema and Xiaozheng Powder hot compress on pelvic inflammatory sequelae of damp-heat stagnation

目的观察丹萸饮内服联合红藤汤保留灌肠、消癥散热敷治疗盆腔炎性疾病后遗症(SPID)湿热瘀结型的临床疗效。方法将SPID湿热瘀结型患者72例按照随机数字表法分为2组。对照组36例予注射用头孢替唑钠联合左奥硝唑氯化钠注射液治疗,治疗组36例予丹萸饮内服联合红藤汤保留灌肠、消癥散热敷治疗。比较2组临床疗效,以及治疗前后CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平,中医证候评分、妇科检查评分。治疗结束后对2组随访6个月,观察复发率。结果治疗后2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较本组治疗前升高(P<0.05),CD8^(+)、TNF-α、CRP、GM-CSF、MCP-1水平均较本组治疗前降低(P<0.05),且2组组间比较差异也均有统计学意义(P<0.05)。治疗后2组小腹疼痛、腰骶痠胀、带下量多、月经不调评分及总积分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后2组妇科检查宫颈触痛、宫体及附件压痛、子宫活动受限、附件增粗、宫腔积液评分及总积分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗组总有效率94.44%(34/36),6个月复发率11.76%(4/34),对照组分别为83.33%(30/36)、43.33%(13/30)。治疗组总有效率高于对照组(P<0.05),复发率低于对照组(P<0.05)。结论丹萸饮内服联合红藤汤保留灌肠、消癥散热敷治疗SPID湿热瘀结型疗效显著,能有效抑制炎性反应,增强免疫功能,复发率低。

Objective To observe the clinical effect of oral Danyu Decoction combined with Hongteng Decoction enema and Xiaozheng Powder hot compress on pelvic inflammatory sequelae of damp-heat stagnation.Methods Seventy two patients with pelvic inflammatory sequelae(damp-heat stagnation)were randomly grouped,the clinical efficacy before and after treatment were performed on the two groups which comprised 36 cases of control group(Cefotizole Sodium plus Levo Ornidazole Sodium Chloride),36 cases of treatment group(oral Danyu Decoction plus Hongteng Decoction enema plus Xiaozheng Powder hot compress);before and after treatment CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),tumor necrosis factor-α(TNF-α),C reactive protein(CRP),monocyte chemoattractant protein-1(MCP-1),granular-macrophage colony stimulating factor(GM-CSF),traditional Chinese medicine(TCM)syndrome score,gynecologic examination score were compare;6-month follow-up effective treatment was performed to observe the recurrence rate.Results After treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+) in groups were significantly upregulated(P<0.05),while CD8^(+),TNF-α,CRP,GM-CSF,MCP-1 were obviously downregulated(P<0.05),the difference between groups was statistically significant(P<0.05);TCM syndrome scores including lower abdomen pain,lumbosacral soreness,leucorrhea increasing,irregular menstruation in groups were evidently decreased(P<0.05),treatment group were notably decreased in comparison with control group(P<0.05);gynecologic examination score including cervical tenderness,uterine body and accessory tenderness,limited uterine activity,accessories thickening,endometrial cavity fluid in groups were evidently lower(P<0.05),which in treatment group were significantly decreased(P<0.05).The total effective rates in treatment group and control group were 94.44%(34/36)and 83.33%(30/36),respectively,the curative effect being better in treatment group than control group(P<0.05).The 6-month follow-up recurrence rate in treatment group was lower than that in control group[11.76%(4/34)vs 43.33%(13/30),(P<0.05),respectively].Conclusion For patients wtih pelvic inflammatory sequelae(damp-heat stagnation),oral Danyu Decoction combined with retention enema with Hongteng Decoction and hot compress of Xiaozheng Powder has a significant effect,can effectively inhibit inflammatory response,enhance immune function,and has a low recurrence rate.