龙胆泻肝汤联合西药治疗宫颈炎效果及对宫颈分泌液炎性因子的影响

Effect of Longdan xiegan decoction combined with western medicine for treating cervicitis and its influence on the inflammatory level of the cervical secretion

目的:探究龙胆泻肝汤联合阿奇霉素治疗宫颈炎效果及对阴道微生态、宫颈炎性反应的影响。方法:选取2019年1月-2023年10月本院收治的宫颈炎患者80例,数字表法随机分成联合组与西药组各40例,两组均给予阿奇霉素治疗,联合组加龙胆泻肝汤治疗,治疗1个月后观察临床疗效、不良反应发生率,中医症候评分、免疫功能指标、宫颈分泌液炎性因子、阴道菌群相对丰度变化。结果:治疗后联合组总有效率(90.0%)高于西药组(70.0%),白带增多、带下浓稠、小腹坠痛与外阴瘙痒4项中医证候评分低于西药组,CD3^(+)(54.47±1.85)、CD4^(+)(27.84±1.79)均高于西药组(46.19±2.49、23.12±1.37),乳酸杆菌属相对丰度(45.67±0.97)高于西药组(40.95±1.72),加德纳菌属相对丰度(5.10±0.07)低于西药组(5.68±0.05),TNF-α(4.85±0.65ng/L)、CRP(6.70±0.97mg/L)均低于西药组(6.91±0.61ng/L、10.68±1.07mg/L)(均P<0.05);治疗期间不良反应发生率联合组(15.0%)与西药组(17.5%)无差异(P>0.05)。结论:龙胆泻肝汤联合阿奇霉素治疗宫颈炎可提升疗效、减轻炎症反应并控制临床症状,改善阴道微环境,提升患者免疫力,未增加不良反应风险,临床治疗有效、安全。

Objective:To explore the efficacy of Longdan xiegan decoction combined with azithromycin for treating cervicitis of patients,and to study its influence on the vaginal microecology and cervical inflammatory response of the patients.Methods:A total of 80patients with cervicitis treated in hospital were selected and were randomly divided into study group and control group(40cases in each group)according to the numerical table method from January 2019to October 2023.The patients in the two groups were treated with azithromycin,and the patients in the study group were treated with Longdan xiegan decoction additionally.The efficacy,the incidence of adverse reactions,the score of TCM syndrome,the values of immune function index,the inflammatory factors of cervical secretion and the relative abundance change of vaginal flora of the patients in the two groups after 1month of treatment were observed.Results:After treatment,the total effective rate(90.0%)of the patients in the study group was significantly higher than that(70.0%)of the patients in the control group.Four TCM syndrome scores of increased leucorrhea,leucorrhea thickness,lower abdominal pain and vulva pruritus of the patients in the study group were significantly lower than those of the patients in the control group.The levels of CD3^(+)(54.47±1.85),CD4^(+)(27.84±1.79)and the relative abundance of lactobacillus(45.67±0.97)of the patients in the study group were significantly higher than those(46.19±2.49,23.12±1.37and 40.95±1.72)of the patients in the control group.The gardnerella relative abundance(5.10±0.07),and the levels of TNF-α(4.85±0.65ng/L)and CRP(6.70±0.97mg/L)of the patients in the study group were significantly lower than those(5.68±0.05,6.91±0.61ng/L and 10.68±1.07mg/L)of the patients in the control group(all P<0.05).There was no significant difference in the incidence of the adverse reactions(15.0%vs.17.5%)of the patients between the two groups(P>0.05).Conclusion:Longdan xiegan decoction combined with azithromycin for treating cervicitis of the patients can improve the curative effect,can reduce inflammation response and control clinical symptoms,can improve the vaginal microenvironment and enhance the immunity of the patients,and without increasing the risk of adverse reactions,which is an effective and safe clinical treatment for the cervicitis of the patients.