加味补中益气汤治疗气虚血瘀证盆腔炎性疾病后遗症疗效及对中医证候评分、体征评分和复发率的影响

Curative effect of modified Buzhong Yiqi Decoction on sequelae of pelvic inflammatory disease of qi-deficiency blood stasis syndrome and its influences on scores of TCM syndromes,sign and recurrence rate

目的:探讨加味补中益气汤治疗气虚血瘀证盆腔炎性疾病后遗症(SPID)疗效及对中医证候评分、体征评分和复发率的影响。方法:选取2022年2月~2023年2月在本院收治的气虚血瘀证SPID患者80例,据简单随机法将其分为观察组与对照组,各40例。对照组给予常规药物治疗,观察组在对照组基础上给予加味补中益气汤治疗,均持续用药三个疗程。评估两组临床疗效,对比中医证候评分、体征评分、盆腔疼痛症状积分及炎症因子[白细胞介素(IL)-10、IL-2、肿瘤坏死因子-α(TNF-α)]和血液流变学指标[全血高切、全血中切、全血低切、血浆黏度值、红细胞压积]水平变化,记录两组治疗期间不良反应发生率。于治疗结束后3个月随访,观察两组复发率。结果:观察组临床总有效率为95.00%,显著高于对照组的80.00%(P<0.05)。治疗后观察组下腹坠胀或刺痛、腰骶酸痛、带下量多积分均低于对照组(P<0.05)。治疗后,两组患者六点行为评分法(BRS-6)、盆腔体征量表(Mc-Cormack)评分均下降,且观察组低于对照组(P<0.05)。治疗后观察组IL-2、IL-10水平均高于对照组,TNF-α水平低于对照组(P<0.05)。治疗后,两组患者全血高切、全血中切、全血低切、血浆黏度值、红细胞压积均降低,且观察组低于对照组(P<0.05)。两组不良反应发生率对比明显差异(P>0.05),但观察组复发率低于对照组(P<0.05)。结论加味补中益气汤治疗气虚血瘀证SPID疗效确切,可降低患者中医证候评分、体征评分及复发率,改善炎症反应和血液流变学,缓解疼痛。

Objective:To explore the curative effect of modified Buzhong Yiqi Decoction on sequelae of pelvic inflammatory disease(SPID)of qi-deficiency blood stasis syndrome and its influences on scores of TCM syndromes,sign and recurrence rate.Methods:A total of 80patients with SPID of qi-deficiency blood stasis syndrome in the hospital were enrolled between February 2022and February 2023.According to simple randomizationmethod,they were divided into observation group and control group,40cases in each group.The control group was treated with routine drugs,while observation group was additionally treated with modified Buzhong Yiqi Decoction for 3courses.The clinical curative effect in the two groups was evaluated.The scores of TCM syndromes,physical signsand pelvic pain symptoms,levels of inflammatory factors[interleukin(IL)-10,IL-2,tumor necrosis factor-α(TNF-α)]and hemorheology indexes(whole blood high-shear viscosity,middle-shear viscosity,low-shear viscosity,plasma viscosity,hematocrit)in the two groups were compared.The incidence of adverse reactions during treatment in the two groupswas recorded.All were followed up for 3months after treatment to observe recurrence ratesin the two groups.Results The total clinical response rate of observation group was significantly higher than that of control group(95.00%vs 80.00%,P<0.05).After treatment,scores of TCM syndromes(lower abdominal distension or tingling pain,lumbosacral pain,increased leucorrhea)in observation group were lower than those in control group(P<0.05).After treatment,scores of the 6-point behavioral rating scale(BRS-6)and pelvic sign scale(Mc-Cormack)were decreased in both groups,which were lower in observation group than control group(P<0.05).After treatment,levels of IL-2and IL-10in observation group were higher than those in control group,while TNF-αwas lower than that in control group(P<0.05).After treatment,whole blood high-shear viscosity,middle-shear viscosity,low-shear viscosity,plasma viscosity and hematocritwere all decreased in both groups,which were lower in observation group than control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05),but the recurrence rate in observation group was lower than that in control group(P<0.05).Conclusion Curative effect of modified Buzhong Yiqi Decoction is significant in patients with SPID of qi-deficiency blood stasis syndrome,which can reduce scores of TCM syndromes,physical signs and recurrence rate,improve inflammatory responseand hemorheology,and relieve pain.