安盆清带方保留灌肠经肠道微生态调节机制对湿热瘀结型盆腔炎患者的治疗作用

Therapeutic Effect of Anpen Qingdai Prescription with Retained Enema on Damp-heat Stasis Type Pelvic Inflammation and Its Regulation Mechanism on Intestinal Microecology

目的探讨安盆清带方保留灌肠经肠道微生态调节机制对湿热瘀结型盆腔炎患者的治疗作用。方法选取2020年1月—2022年1月期间张家港市中医医院收治的118例盆腔炎患者作为研究对象,按随机数字表法分为对照组和研究组,每组各59例。对照组采取常规西医治疗,研究组在对照组基础上采取安盆清带方保留灌肠,共治疗3个月经周期。观察比较两组患者临床疗效、不良反应发生情况,治疗前后中医证候积分、血清炎性因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、单核细胞趋化蛋白-1(Monocyte chemoattractant protein-1,MCP-1)]水平、肠道菌群水平。结果治疗后研究组临床总有效率94.92%(56/59)高于对照组83.05%(49/59),差异有统计学意义(P<0.05)。治疗后两组患者腰骶胀痛、下腹疼痛、神疲乏力、白带异常分值较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CRP、TNF-α、MCP-1水平较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者酵母菌、肠杆菌水平较治疗前降低,拟杆菌、乳杆菌、双歧杆菌水平较治疗前升高,差异有统计学意义(P<0.05);且研究组酵母菌、肠杆菌水平低于对照组,拟杆菌、乳杆菌、双歧杆菌水平高于对照组,差异有统计学意义(P<0.05)。治疗期间,研究组不良反应发生率(3.39%)与对照组(6.78%)比较,差异无统计学意义(P>0.05)。结论在西医治疗基础上采取安盆清带方保留灌肠治疗湿热瘀结型盆腔炎可有效缓解患者临床症状,减轻炎性反应,调节肠道微生态环境,提高疾病治疗效果,且具有安全性。

Objective To explore the therapeutic effect of Anpen Qingdai Prescription with retained enema on damp-heat stasis type pelvic inflammatory disease and its mechanism of regulating intestinal microecology.Method A total of 118 patients with pelvic inflammatory disease admitted to Zhangjiagang Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were enrolled and randomly divided into a control group and a research group according to the random number table method,with 59 patients in each group.The control group was treated with conventional western medicine,while the research group was treated with Anpen Qingdai Prescription with retained enema on the basis of the control group treatment,for 3 menstrual cycles.The therapeutic effect,adverse reactions,traditional Chinese medicine symptom scores,serum inflammatory factors[C-reactive protein(CRP)and tumor necrosis factor before and after treatment of the two groups were statistically analyzed-αtumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1)]level,and intestinal flora levels were compared before and after treatment.Results After treatment,the research group showed a significantly higher clinical total effective rate(94.92%,56/59)compared to the control group(83.05%,49/59)after treatment(P<0.05).After treatment,both groups exhibited reduced scores for lumbosacral pain,lower abdominal pain,mental fatigue and abnormal leucorrhea(P<0.05),with the research group showing lower scores compared to the control group(P<0.05).Serum CRP,TNF-αand MCP-1 levels in both groups decreased significantly after treatment(P<0.05),with the research group showing lower levels compared to the control group(P<0.05).After treatment,both groups exhibited reduced levels of yeast and Escherichia coli,and increased levels of Bacteroides,Lactobacillus and Bifidobacterium(P<0.05).The research group had lower levels of yeast and enterobacteria and higher levels of Bacteroides,Lactobacillus and Bifidobacterium compared to the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the research group(3.39%)and the control group(6.78%)(P>0.05).Conclusion On the basis of western medicine,Anpen Qingdai Prescription with retained enema can effectively relieve the clinical symptoms and reduce inflammatory reactions of patients with damp-heat stasis type pelvic inflammation.It also regulates the intestinal microecological environment,improves the disease treatment outcomes,and is considered safe.