行气化瘀消癥汤联合西药治疗慢性盆腔炎临床研究

Clinical Study on Xingqi Huayu Xiaozheng Decoction Combined with Western Medicine for Chronic Pelvic Inflammatory Disease

目的:观察行气化瘀消癥汤联合西药治疗慢性盆腔炎(CPID)气滞血瘀证的临床疗效。方法:选取106例CPID气滞血瘀证患者,以随机数字表法分为对照组和研究组各53例。对照组给予盐酸左氧氟沙星片和甲硝唑片治疗,研究组在对照组基础上给予行气化瘀消癥汤治疗,2组均治疗4周,随访6个月。比较2组临床疗效,中医证候评分,炎症指标[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)]水平,血流动力学指标[盆腔搏动指数(PI)、阻力指数(RI)、最大血流速度(Vmax)]及复发率。结果:治疗后,研究组总有效率94.34%,高于对照组81.13%(P<0.05)。治疗后,2组腰骶胀痛、下腹刺痛或胀痛、带下量多、情志抑郁、乳房胀痛、经量增多、经色暗红或有血块评分均较治疗前降低(P<0.05),研究组上述7项中医证候评分均低于对照组(P<0.05)。治疗后,2组血清IL-6、TNF-α、hs-CRP水平均较治疗前降低(P<0.05),血清IL-10水平均较治疗前升高(P<0.05);研究组血清IL-6、TNF-α、hs-CRP水平均低于对照组(P<0.05),血清IL-10水平高于对照组(P<0.05)。治疗后,2组PI、RI均较治疗前降低(P<0.05),Vmax均较治疗前升高(P<0.05);研究组PI、RI均低于对照组(P<0.05),Vmax高于对照组(P<0.05)。随访6个月,研究组复发率4.00%,低于对照组16.28%(P<0.05)。结论:在西药基础上加用行气化瘀消癥汤治疗CPID气滞血瘀证可提高疗效,缓解临床症状,控制炎症反应,改善盆腔血流,降低复发率。

Objective:To observe the clinical effect of the therapy of Xingqi Huayu Xiaozheng Decoction combined with western medicine on chronic pelvic inflammatory disease(CPID)with syndrome of qi stagnation and blood stasis.Methods:A total of 106 cases of CPID patients with syndrome of qi stagnation and blood stasis were selected and divided into the control group and the study group according to the random number table method,with 53 cases in each group.The control group was treated with Levofloxacin Hydrochloride Tablets and Metroidazole Tablets,and the study group was additionally treated with Xingqi Huayu Xiaozheng Decoction based on the treatment of the control group.The two groups were treated for 4 weeks and followed up for 6 months.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,levels of inflammation indexes[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)],levels of hemodynamics indexes[pulsitility index(PI),resistance index(RI)and maximum blood flow velocity(Vmax)of pelvic cavity]and recurrence rates were compared between the two groups.Results:After treatment,the total effective rate was 94.34%in the study group,higher than that of 81.13%in the control group(P<0.05).After treatment,the scores of distending pain in lumbosacral spine,sharp or distending pain in lower abdomen,large leukorrhea amount,emotional depression,distending pain in breasts,increased ovarian volume and dark red menses or with clotted blood in the two groups were decreased when compared with those before treatment(P<0.05),and the above seven TCM syndrome scores in the study group were lower than those in the control group(P<0.05).After treatment,the levels of serum IL-6,TNF-αand hs-CRP in the two groups were decreased when compared with those before treatment(P<0.05),and the serum IL-10 levels were increased when compared with those before treatment(P<0.05);the levels of serum IL-6,TNF-αand hs-CRP in the study group were lower than those in the control group(P<0.05),and the serum IL-10 level was higher than that in the control group(P<0.05).After treatment,the PI and RI in the two groups were decreased when compared with those before treatment(P<0.05),and the Vmax was increased when compared with that before treatment(P<0.05);the PI and RI in the study group were lower than those in the control group(P<0.05),and the Vmax was higher than that in the control group(P<0.05).After follow-up of 6 months,the recurrence rate was 4.00%in the study group,lower than that of 16.28%in the control group(P<0.05).Conclusion:The therapy of Xingqi Huayu Xiaozheng Decoction combined with western medicine can enhance the curative effect on CPID with syndrome of qi stagnation and blood stasis,mitigate the clinical symptoms,control the inflammatory responses,improve the blood flow of pelvic cavity and decrease the recurrence rate.