自拟红藤汤联合针灸治疗慢性盆腔炎疗效及对血清IL-4、TGF-β1水平的影响

Efficacy of self-made Hongteng decoction combined with acupuncture and moxibustion on patients with chronic pelvic inflammatory disease and effects on levels of serum IL-4and TGF-β1

目的:探讨自拟红藤汤联合针灸对慢性盆腔炎(CPID)患者疗效及血清白细胞介素-4(Interleukin-4,IL-4)、转化生长因子-β1(Transforming growth factor-β,TGF-β1)水平的影响。方法:选取2021年3月~2022年5月期间我院妇产科收治的CPID患者86例作为研究对象,按随机数字表法分为对照组(n=43)和观察组(n=43),对照组采用常规西药治疗,观察组在对照组基础上加用自拟红藤汤保留灌肠联合针灸治疗。比较两组治疗效果、治疗前后的中医症状评分、炎症因子水平、血液流变学参数变化以及不良反应发生情况。结果:治疗后观察组的有效率(93.02%)明显优于对照组(74.42%)(P<0.05);治疗前两组下腹部疼痛、白带异常、腰骶疼痛各症状积分无明显差异(P>0.05),经过治疗后各症状积分均有明显降低(P<0.01),且观察组的下腹部疼痛、白带异常、腰骶疼痛评分均低于对照组,两组有统计学差异(P<0.01);治疗前两组患者血清中IL-4、TGF-β1含量无明显差异(P>0.05),治疗结束后IL-4、TGF-β1含量较治疗前均有明显升高(P<0.01),且观察组的炎症因子水平明显高于对照组(P<0.01);治疗前两组患者纤维蛋白原、血浆黏度、红细胞压积无显著差异(P>0.05),治疗结束后纤维蛋白原和血浆黏度较治疗前均有明显下降(P<0.01),且观察组指标参数明显低于对照组(P<0.05),而红细胞压积在观察组及对照组治疗前后均无显著差异(P>0.05);治疗期间对照组的不良反应总发生率(6.98%)与观察组(11.63%)无明显差异(P>0.05)。结论:自拟红藤汤保留灌肠联合针灸治疗能够改善CPID主要症状,减轻盆腔炎症反应,改善血液流变学水平,其疗效优于单纯西医治疗,且不增加安全风险,值得临床推广。

Objective:To explore the efficacy of self-made Hongteng decoction combined with acupuncture and moxibustion in the treatment of patients with chronic pelvic inflammatory disease(CPID)and the effects on levels of serum interleukin-4(IL-4)and transforming growth factor-β1(TGF-β1).Methods:86patients with CPID who were treated in department of Obstetrics and Gynecology of our hospital from March 2021to May 2022were selected as the research subjects,and were divided into control group(n=43)and observation group(n=43)by the random number table method.The control group was treated with conventional western medicine,while the observation group was treated with self-made Hongteng decoction retention enema combined with acupuncture and moxibustion on the basis of control group.The therapeutic effect,TCM symptoms scores,inflammatory factor levels and hemorheological parameters,occurrence of adverse reactions were compared between the two groups before and after treatment.Results:After treatment,the effective rate of the observation group(93.02%)was significantly better than that of control group(74.42%)(P<0.05).Before treatment,there were no significant differences in the scores of symptoms such as lower abdominal pain,abnormal vaginal discharge and lumbosacral pain between the two groups(P>0.05),the above scores were significantly decreased after treatment(P<0.01),and the scores of observation group were lower than those of control group(P<0.01).There were no significant differences in serum IL-4and TGF-β1levels between the two groups before treatment(P>0.05),the levels of IL-4and TGF-β1were significantly higher at the end of treatment than before(P<0.01),and the levels in observation group were significantly higher than those in control group(P<0.01).There was no significant difference in fibrinogen,plasma viscosity and hematocrit between the two groups before treatment(P>0.05).the parameters of fibrinogen and plasma viscosity were significantly reduced after treatment(P<0.01),and the parameters in observation group were significantly lower than those in control group(P<0.05),however,here was no significant difference in erythrocyte pressure volume before and after treatment between the two groups(P>0.05).The total incidence rate of adverse reactions during treatment had no significant difference between control group(6.98%)and observation group(11.63%)(P>0.05).Conclusion:Self-made Hongteng decoction retention enema combined with acupuncture and moxibustion can improve the main symptoms of CPID,reduce the pelvic inflammatory response and improve the level of hemorheology.Its efficacy is better than simple western medicine,and it does not increase the safety risk.