克林霉素磷酸酯联合安宫黄体酮治疗子宫内膜炎的效果观察

Therapeutic effect of clindamycin phosphate combined with medroxyprogesterone acetate on endometritis

目的探讨克拉霉素磷酸酯联合安宫黄体酮治疗子宫内膜炎的临床效果及安全性。方法抽取2020年5月至2022年5月开封市祥符区中医院收治的子宫内膜炎患者86例,按随机数字表法分为对照组与观察组,每组43例。对照组予以克林霉素磷酸酯治疗,观察组在对照组基础上加用安宫黄体酮治疗,两组均持续用药2周。比较两组患者的临床疗效、症状及体征消失时间、炎症因子水平[肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞计数(WBC)]、免疫功能(CD4、CD38、CD138)及不良反应发生情况。结果观察组总有效率(95.35%,41/43)高于对照组(81.40%,35/43),P<0.05;观察组症状及体征消失时间短于对照组,(P<0.05);治疗后,观察组CRP、TNF-α、IL-6、WBC水平分别为(5.63±1.12)mg/L、(30.41±3.25)pg/ml、(36.52±3.48)pg/ml、(7.32±1.17)×10^(9)/L,低于对照组的(7.28±1.23)mg/L、(35.18±3.42)pg/ml、(41.24±3.89)pg/ml、(8.96±1.22)×10^(9)/L,差异有统计学意义(P<0.05);治疗后,观察组CD4、CD38、CD138水平分别为(15.63±1.82)%、(3.25±0.42)%、(1.36±0.25)%,低于对照组的(18.92±2.04)%、(4.36±0.57)%、(1.68±0.29)%,差异有统计学意义(P<0.05);两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论克林霉素磷酸酯联合安宫黄体酮可提高子宫内膜炎患者的治疗效果,促进疾病症状及体征消失,减轻炎症反应,纠正免疫异常,且安全可靠。

Objective To investigate the clinical effect and safety of clindamycin phosphate combined with medroxyprogesterone acetate in the treatment of endometritis.Methods A total of 86 patients with endometritis admitted to Xiangfu District Hospital of Traditional Chinese Medicine from May 2020 to May 2022 were selected,and they were divided into control group and observation group according to the random number table method,with 43 patients in each group.The control group was treated with clindamycin phosphate,and the observation group was treated with medroxyprogesterone acetate based on the treatment of the control group,both groups were treated for 2 weeks continuously.The clinical efficacy,disappearance time of symptoms and signs,levels of inflammatory factors,including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)and white blood cell count(WBC),immune function assessed by cluster of differentiation 4(CD4),cluster of differentiation 38(CD38)and cluster of differentiation 138(CD138),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group(95.35%,41/43)was higher than that of the control group(81.40%,35/43),P<0.05.The disappearance time of symptoms and signs in the observation group was shorter than that in the control group(P<0.05).After treatment,the levels of CRP,TNF-α,IL-6,and WBC in the observation group were(5.63±1.12)mg/L,(30.41±3.25)pg/ml,(36.52±3.48)pg/ml,(7.32±1.17)×10^(9)/L,respectively,which were lower than the(7.28±1.23)mg/L,(35.18±3.42)pg/ml,(41.24±3.89)pg/ml,and(8.96±1.22)×10^(9)/L in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CD4,CD38,and CD138 in the observation group were(15.63±1.82)%,(3.25±0.42)%,and(1.36±0.25)%,respectively,which were lower than the(18.92±2.04)%,(4.36±0.57)%,and(1.68±0.29)%in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Clindamycin phosphate combined with medroxyprogesterone acetate can improve the therapeutic effect on endometritis,accelerate the disappearance of disease symptoms and signs,reduce the inflammatory reaction,regulate immune abnormalities,which is safe and reliable.