护盆消癥饮协定方灌肠联合微波理疗对盆腔炎性疾病后遗症的疗效及Th1/Th2平衡的影响

The effect of the Hupen Xiaozheng Yin prescription enema plus microwave physiotherapy on sequelae of pelvic inflammatory disease and Th1/Th2 balance

目的:观察护盆消癥饮协定方灌肠联合微波理疗治疗盆腔炎性疾病后遗症的效果。方法:将112例盆腔炎性疾病后遗症患者按照随机数字表法分为观察组(56例)和对照组(56例)。观察组给予护盆消癥饮协定方灌肠联合微波理疗,对照组给予西药常规治疗。比较两组治疗的临床总有效率、盆腔McGill疼痛量表评分、中医证候总积分、子宫动脉血流动力学指标、外周血中辅助性T细胞(Helper T Cell,Th)1、Th2占CD4^(+)T细胞比例、血清中Th1/Th2平衡相关指标[干扰素(Interferon,IFN)-γ、白细胞介素(Interleukin,IL)-2、肿瘤坏死因子(Tumor Necrosis Factor,TNF)-α、IL-10]变化。结果:观察组的总有效率高达94.64%(53/56),明显高于对照组的总有效率[82.14%(46/56)](P<0.05);治疗后,观察组的McGill疼痛量表评分、中医证候总积分均明显低于对照组(P<0.05),子宫动脉血流动力学指标阻力指数(Resistive Index,RI)、搏动指数(Pulsatility Index,PI)明显低于对照组,收缩期最大流速(Vmax)明显高于对照组(P<0.05);观察组的Th1细胞升高较对照组更明显,Th2比例降低较对照组更明显,Th1/Th2明显高于对照组(P<0.05);观察组的血清中IFN-γ、TNF-α含量明显低于对照组,IL-2、IL-10含量明显高于对照组(P<0.05);从不良反应发生率、复发率来看,两组患者差异无统计学意义(P>0.05)。结论:护盆消癥饮协定方灌肠联合微波理疗治疗有利于减轻盆腔炎性疾病后遗症患者的盆腔痛感,改善临床症状,增强盆腔血液微循环,调节Th1/Th2平衡,改善免疫-炎症状态,安全性好,不易复发,值得推广。

Objective:To observe the effect of the Hupen Xiaozheng Yin prescription(护盆消癥饮协定方)plus microwave physiotherapy on the sequelae of pelvic inflammatory disease.Methods:A total of 112 sequelae of pelvic inflammatory disease patients were divided into the observation group(56 cases)and the control group(56 cases)according to random number table method.The observation group was given enema plus microwave physiotherapy,and the control group was given conventional westernO medicine.The total clinical effective rate,and the changes of pelvic McGill pain scale suore,TCM syndrome total score,uterine arterial hemodynamics indexes,the proportion of Th1 and Th2 in CD4^(+)T cell in peripheral blood,and serum Th1/Th2 balance related indexes(IFN-γ,IL-2,TNF-α,IL-10)were compared between the two groups.Results:The total effective rate in the observation group was 94.64%(53/56),which was significantly higher than 82.14%(46/56)in the control group(P<0.05).After treatment,the McGill pain scale score and the total score of TCM syndrome in the observation group were significantly lower than those in the control group(P<0.05),the hemodynamic indexes RI and PI of uterine arterial blood flow were significantly lower than those in the control group,and the Vmax was significantly higher than the control group(P<0.05).The proportion of Th1 cells in the observation group was increased more significantly than that in the control group,the proportion of Th2 cells was decreased more significantly than that in the control group,and Th1/Th2 was significantly higher than that in the control group(P<0.05).The contents of IFN-γand TNF-αin serum in the observation group were significantly lower than those in the control group,and the contents of IL-2 and IL-10 were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions and recurrence between two groups(P>0.05).Conclusion:The combination of enema with the Hupen Xiaozheng Yin prescription and microwave physio therapy can alleviate pelvic pain in patients with sequelae of pelvic inflammatory disease,ameliorate clinical symptoms,enhance pelvic blood microcirculation,regulate Th1/Th2 balance,and ameliorate immune-inflammation state.It has good safety and is not prone to recurrence,which is worthy of promotion.