针刺联合血府逐瘀汤治疗慢性盆腔炎瘀毒内结证临床研究

Clinical Study on Acupuncture Combined with Xuefu Zhuyu Decoction for Chronic Pelvic Inflammatory Disease with Stasis-Toxin Internal Accumulation Syndrome

目的:观察针刺联合血府逐瘀汤治疗慢性盆腔炎(CPID)瘀毒内结证的临床疗效。方法:122例CPID患者按随机数字表法分为对照组与观察组各61例。对照组给予替硝唑治疗,观察组在对照组基础上加针刺联合血府逐瘀汤治疗。比较2组治疗前后视觉模拟评分法(VAS)评分、焦虑自评量表(SAS)评分、中医证候评分、炎症因子[C-反应蛋白(CRP)、白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子-α (TNF-α)]、氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)]、血液流变学指标,比较2组临床疗效及不良反应发生情况。结果:对照组总有效率为75.41%,观察组总有效率为91.80%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组VAS评分、SAS评分、中医证候评分均较治疗前降低(P<0.05),且观察组治疗后降低幅度大于对照组(P<0.05)。治疗后,2组CRP、IL-6、IL-8、TNF-α、血浆黏度、全血高切黏度、红细胞压积、全血低切黏度水平均较治疗前降低(P<0.05),且观察组治疗后降低幅度大于对照组(P<0.05)。治疗后,2组GSH-Px、SOD水平均较治疗前升高(P<0.05),MDA水平降低(P<0.05),且观察组上述指标改善优于对照组(P<0.05)。观察组不良反应发生率为4.92%,低于对照组18.03%(P<0.05)。结论:针刺联合血府逐瘀汤治疗瘀毒内结证CPID疗效确切,能够有效提高患者抗氧化能力,减轻炎症反应,改善血液循环,安全性较高。

Objective:To observe the clinical effect of acupuncture combined with Xuefu Zhuyu Decoction for chronic pelvic inflammatory disease(CPID) with stasis-toxin internal accumulation syndrome.Methods:A total of 122 cases of patients with CPID were divided into the control group and the observation group according to the ransom number table method,with 61 cases in each group.The control group was treated with Tinidazole,and the observation group was additionally treated with acupuncture combined with Xuefu Zhuyu Decoction based on the treatment of the control group.Before and after treatment,Visual Analogue Scale(VAS) scores,Self-rating Anxiety Scale(SAS) scores,traditional Chinese medicine(TCM) syndrome scores,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)],oxidative stress indexes[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD) and malondialdehyde(MDA)],and hemorheology indexes were compared between the two groups;the clinical effects and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 75.41%in the control group and 91.80% in the observation group,the difference being significant(P<0.05).After treatment,VAS scores,SAS scores and TCM syndrome scores in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the reduction in the observation group was greater than that in the control group(P<0.05).After treatment,the levels of CRP,IL-6,IL-8,TNF-α,plasma viscosity,whole blood high shear viscosity,hematocrit,and whole blood low shear viscosity in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was greater than that in the control group(P<0.05).After treatment,the levels of GSH-Px and SOD in the two groups were increased when compared with those before treatment(P<0.05),and the levels of MDA were decreased(P<0.05);the improvement of the above indexes in the observation group was better than that in the control group(P<0.05).The incidence of adverse reactions was 4.92% in the observation group,lower than that of 18.03% in the control group(P<0.05).Conclusion:The therapy of acupuncture combined with Xuefu Zhuyu Decoction for CPID with stasis-toxin internal accumulation syndrome can effectively enhance the antioxidant capacity of patients,reduce inflammatory responses and improve blood circulation,with high safety.