大黄芒硝腹部外敷联合抗生素治疗盆腔炎性肿块疗效观察
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摘要
目的:探讨大黄芒硝外敷结合抗生素治疗盆腔炎性肿块的临床疗效。方法:以2014年9月—2015年3月期间我院收治的68例盆腔炎性肿块患者为研究对象,将其随机分为对照组(34例)和实验组(34例)。两组均采用左氧氟沙星0.5 g 1次/d+甲硝唑0.5 g 1次/8 h静脉滴注治疗,临床症状改善后改口服持续至少14 d;实验组在此基础上加用大黄芒硝袋敷下腹,1次/d,经期停药,15 d为1个疗程。观察两组临床治疗效果,统计停药两个月后两组复发率,记录治疗前后两组患者中医症候总积分的改善情况,B超测定治疗后两组盆腔炎性肿块体积的变化。结果:实验组总有效率(97.06%)明显高于对照组(79.41%),差异具有统计学意义(P=0.027);实验组患者复发率为2.94%,对照组复发率为11.76%,差异不具有统计学差异(P=0.178);两组患者治疗过程中均无明显不良反应;实验组治疗后中医症候总积分为(10.03±6.37)分,对照组为(20.98±3.75)分,两组对比差异有统计学意义(P=0.000);实验组治疗后盆腔炎性肿块体积缩小至(5.21±4.98)cm~2,对照组为(15.49±6.83)cm~2,两组盆腔炎性肿块体积经统计学检验差异有统计学意义(P=0.000)。结论:大黄芒硝腹部外敷联合抗生素治疗盆腔炎性肿块临床疗效显著,治愈率高,具有重要的临床研究价值。
Objective: To investigate the clinical curative effect of external application of rhubarb and mirabilite combined with antibiotics in the treatment of pelvic inflammatory lump. Methods: A total of 68 patients with pelvic inflammatory lump who were treated in the hospital during September 2014 to March 2015 were selected as the research objects. The patients were randomly divided into the control group( 34 cases) and the experimental group( 34 cases). The two groups were treated with levofloxacin 0. 5 g once a day and metronidazole 0. 5 g once every 8 h for intravenous injection. After the clinical symptoms were improved,oral administration lasted for at least 14 days. Based on this,the experimental group was additionally treated with rhubarb and mirabilite applied in the lower abdomen,once a day,drug withdrawal during menstrual period and 15 d was a course of treatment. The clinical curative effect in the two groups was observed. After two months of drug withdrawal,the recurrence rates in the two groups were statistically analyzed. The improvements of total integral of TCM symptoms in the two groups were recorded before and after the treatment. After the treatment,B ultrasound was used to determine the volumetric changes of pelvic inflammatory lump in the two groups. Results: In the experimental group,the total efficiency( 97. 06%) was significantly higher than that in the control group( 79. 41%). The difference was statistically significant( P = 0. 027). The relapse rate in the experimental group was 2. 94% and in the control group was 11. 76%,was without statistical difference( P = 0. 178). There was no obvious adverse reaction in the two groups during the course of treatment. In the experimental group,the total score of TCM symptoms was( 10. 03 ±6. 37) points and in the control group's was( 20. 98 ± 3. 75) points. The difference was statistically significant( P =0. 000). In the experimental group,the volume of pelvic inflammatory lump was reduced to( 5. 21 ± 4. 98) cm~2 and the control group's was( 15. 49 ± 6. 83) cm~2. Tested by statistics,the difference in the volume of pelvic inflammatory lump between the two groups was statistically significant( P = 0. 000). Conclusion: The clinical curative effect of external application of rhubarb and mirabilite combined with antibiotics in the treatment of pelvic inflammatory lump is remarkable andthe cure rate is high. It is of important value in clinical research.
Objective: To investigate the clinical curative effect of external application of rhubarb and mirabilite combined with antibiotics in the treatment of pelvic inflammatory lump. Methods: A total of 68 patients with pelvic inflammatory lump who were treated in the hospital during September 2014 to March 2015 were selected as the research objects. The patients were randomly divided into the control group( 34 cases) and the experimental group( 34 cases). The two groups were treated with levofloxacin 0. 5 g once a day and metronidazole 0. 5 g once every 8 h for intravenous injection. After the clinical symptoms were improved,oral administration lasted for at least 14 days. Based on this,the experimental group was additionally treated with rhubarb and mirabilite applied in the lower abdomen,once a day,drug withdrawal during menstrual period and 15 d was a course of treatment. The clinical curative effect in the two groups was observed. After two months of drug withdrawal,the recurrence rates in the two groups were statistically analyzed. The improvements of total integral of TCM symptoms in the two groups were recorded before and after the treatment. After the treatment,B ultrasound was used to determine the volumetric changes of pelvic inflammatory lump in the two groups. Results: In the experimental group,the total efficiency( 97. 06%) was significantly higher than that in the control group( 79. 41%). The difference was statistically significant( P = 0. 027). The relapse rate in the experimental group was 2. 94% and in the control group was 11. 76%,was without statistical difference( P = 0. 178). There was no obvious adverse reaction in the two groups during the course of treatment. In the experimental group,the total score of TCM symptoms was( 10. 03 ±6. 37) points and in the control group's was( 20. 98 ± 3. 75) points. The difference was statistically significant( P =0. 000). In the experimental group,the volume of pelvic inflammatory lump was reduced to( 5. 21 ± 4. 98) cm~2 and the control group's was( 15. 49 ± 6. 83) cm~2. Tested by statistics,the difference in the volume of pelvic inflammatory lump between the two groups was statistically significant( P = 0. 000). Conclusion: The clinical curative effect of external application of rhubarb and mirabilite combined with antibiotics in the treatment of pelvic inflammatory lump is remarkable andthe cure rate is high. It is of important value in clinical research.
引文
[1]廖秦平.重视盆腔炎性疾病的诊断及规范化治疗[J].中国实用妇科与产科杂志,2008,24(4):249-251.
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[3]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:243-253.
[4]Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service[J].American Journal of Obstetrics and Gynecology,2012,206(6):476.
[5]叶志玲.妇炎汤联合抗生素与单用抗生素对盆腔炎性疾病患者疗效、抗炎及血液流变学对照研究[J].中国医师进修杂志,2011,34(21):44-45.
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[8]张丽洁.中西医结合治疗盆腔炎性疾病疗效观察[J].现代中西医结合杂志,2010,19(14):1759-1760.
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[10]张师前,张月存,刘德山.中药灌肠联合微波治疗残留卵巢综合症49例[J].中国中西医结合杂志,2007,28(7):657-659.
[11]聂昌平,蒋文雯,王兴远.民族药材土大黄中α-葡萄糖苷酶抑制剂的初步研究[J].时珍国医国药,2013,24(6):1399-1401.
[12]李燕,隋峰,刘亮亮.大黄各炮制品提取物泻下作用的比较研究[J].中国实验方剂学杂志,2011,17(17):151-154.
[13]师广红,唐兴广,张守江.大黄炮制品及配伍应用[J].中国现代药物应用,2010,4(8):216.
[14]王新力,咸晓靖,龚英英.大黄和芒硝外敷预防腹部切口脂肪液化效果观察[J].现代中西医结合杂志,2011,20(17):2191-2192.
[15]王斌,唐志书,周永学.矿物类中药研究现状与思考[J].陕西中医学院学报,2010,33(6):94-95.
[16]杨安娜.中药保留灌肠联合中药熨烫治疗盆腔炎的临床研究[J].中医学报,2013,28(7):1032-1033.
[17]赵福玲.不同中医方法治疗盆腔积液合并慢性盆腔炎疗效观察[J].西部中医药,2013,12(8):109-110.
[18]朱玉叶,何贵翔.盆腔炎后遗症慢性盆腔痛的中医药治疗[J].吉林中医药,2012,32(12):1222-1224.
[19]赵倩睿,魏绍斌.魏绍斌教授治疗盆腔炎反复发作经验[J].河北中医,2013,21(12):1767-1768.
[20]殷燕云,周春祥,谈勇,等.盆腔炎颗粒治疗盆腔炎后遗症性不孕患者145例临床观察[J].中医杂志,2014,55(13):1117-1119.
[21]易蕾,孟凤云.温经通络隔姜灸法治疗盆腔炎性疾病的临床研究[J].针灸临床杂志,2015,31(1):42-44.
[2]乐杰,谢幸,丰有吉.妇产科学[M].6版.北京:人民卫生出版社,2004:274-275.
[3]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:243-253.
[4]Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service[J].American Journal of Obstetrics and Gynecology,2012,206(6):476.
[5]叶志玲.妇炎汤联合抗生素与单用抗生素对盆腔炎性疾病患者疗效、抗炎及血液流变学对照研究[J].中国医师进修杂志,2011,34(21):44-45.
[6]侯玉华.中西医结合治疗盆腔炎性疾病50例[J].中医研究,2010,23(7):41-42.
[7]Lee SH.,Lin CY.,Wang PH,et al.Significant Association of Elevated Concentration of Plasma YKL-40 with Disease Severity in Patients With Pelvic Inflammatory Disease[J].Journal of clinical laboratory analysis,2012,26(3):136-142.
[8]张丽洁.中西医结合治疗盆腔炎性疾病疗效观察[J].现代中西医结合杂志,2010,19(14):1759-1760.
[9]吴少祯.常见疾病的诊断与疗效判定(标准)[S].北京:中国中医药出版社,1999:533-534.
[10]张师前,张月存,刘德山.中药灌肠联合微波治疗残留卵巢综合症49例[J].中国中西医结合杂志,2007,28(7):657-659.
[11]聂昌平,蒋文雯,王兴远.民族药材土大黄中α-葡萄糖苷酶抑制剂的初步研究[J].时珍国医国药,2013,24(6):1399-1401.
[12]李燕,隋峰,刘亮亮.大黄各炮制品提取物泻下作用的比较研究[J].中国实验方剂学杂志,2011,17(17):151-154.
[13]师广红,唐兴广,张守江.大黄炮制品及配伍应用[J].中国现代药物应用,2010,4(8):216.
[14]王新力,咸晓靖,龚英英.大黄和芒硝外敷预防腹部切口脂肪液化效果观察[J].现代中西医结合杂志,2011,20(17):2191-2192.
[15]王斌,唐志书,周永学.矿物类中药研究现状与思考[J].陕西中医学院学报,2010,33(6):94-95.
[16]杨安娜.中药保留灌肠联合中药熨烫治疗盆腔炎的临床研究[J].中医学报,2013,28(7):1032-1033.
[17]赵福玲.不同中医方法治疗盆腔积液合并慢性盆腔炎疗效观察[J].西部中医药,2013,12(8):109-110.
[18]朱玉叶,何贵翔.盆腔炎后遗症慢性盆腔痛的中医药治疗[J].吉林中医药,2012,32(12):1222-1224.
[19]赵倩睿,魏绍斌.魏绍斌教授治疗盆腔炎反复发作经验[J].河北中医,2013,21(12):1767-1768.
[20]殷燕云,周春祥,谈勇,等.盆腔炎颗粒治疗盆腔炎后遗症性不孕患者145例临床观察[J].中医杂志,2014,55(13):1117-1119.
[21]易蕾,孟凤云.温经通络隔姜灸法治疗盆腔炎性疾病的临床研究[J].针灸临床杂志,2015,31(1):42-44.