大黄牡丹汤加减治疗湿热瘀结证慢性盆腔炎临床研究
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摘要
目的:观察大黄牡丹汤加减治疗慢性盆腔炎湿热瘀结证的临床疗效及对血清单核细胞趋化蛋白(MCP)-1和胰岛素样生长因子(IGF)-1水平的影响。方法:将慢性盆腔炎患者60例随机分为2组各30例,对照组予多西环素联合头孢西丁治疗,治疗组在对照组的基础上加用大黄牡丹汤加减治疗,2组均连续治疗2周;观察比较2组患者湿热瘀结证主症评分、中性粒细胞和白细胞数比例及临床疗效,检测2组治疗前后血清MCP-1、IGF-1水平变化。结果:总有效率治疗组为93.33%,对照组为70.00%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者湿热瘀结证主症下腹胀痛、腰骶胀痛、带下量多、带下色黄等评分均较治疗前明显下降(P <0.05),且治疗组各项评分均明显低于对照组(P <0.05)。治疗后,2组中性粒细胞、白细胞计数及血清MCP-1、IGF-1水平均较治疗前明显下降(P <0.05),且治疗组上述各项指标均明显低于对照组(P <0.05)。结论:在常规治疗的基础上,大黄牡丹汤加减治疗慢性盆腔炎疗效显著,其调节患血清MCP-1、IGF-1水平可能是其发挥疗效的途径之一。
Objective: To observe the clinical effect of the modified Dahuang Mudan tang for chronic pelvic inflammation with damp-heat stasis syndrome and its effect on the levels of monocyte chemoattractant protein-1(MCP-1) in serum and insulin-like growth factor-1(IGF-1). Methods:A total of 60 cases of patients with chronic pelvic inflammation were randomly divided into two groups, 30 cases in each group. The control group was treated with doxycycline and cefoxitin,while the treatment group was additionally treated with modified Dahuang Mudan tang based on the treatment of the control group. Both groups were treated for two weeks. The scores of main symptoms of the damp-heat stasis syndrome,the proportion of neutrophil and leukocyte,as well as the clinical effect in the two groups were observed and compared. The changes in the levels of MCP-1 and IGF-1 in serum in the two groups were detected before and after treatment. Results:The total effective rate was 93.33% in the treatment group and 70.00% in the control group,the difference being significant(P < 0.05). After treatment,the scores of main symptoms of the damp-heat stasis syndrome including distending pain in the lower abdomen,distending pain in the lumbosacral region,excessive leucorrhea and yellowish leucorrhea in the two groups were significantly decreased when compared with those before treatment(P < 0.05), and each score in the treatment group was obviously lower than that in the control group(P < 0.05). After treatment,the neutrophil count, white blood cell count as well as the levels of MCP-1 and IGF-1 in serum in the two groups were obviously decreased when compared with those before treatment(P < 0.05),and the above indexes in the treatment group were obviously lower than those in the control group(P < 0.05). Conclusion:Modified Dahuang Mudan tang has significant curative effect in treating chronic pelvic inflammation based on the routine therapy, whose mechanism is probably the regulation of the levels of MCP-1 and IGF-1 in serum.
Objective: To observe the clinical effect of the modified Dahuang Mudan tang for chronic pelvic inflammation with damp-heat stasis syndrome and its effect on the levels of monocyte chemoattractant protein-1(MCP-1) in serum and insulin-like growth factor-1(IGF-1). Methods:A total of 60 cases of patients with chronic pelvic inflammation were randomly divided into two groups, 30 cases in each group. The control group was treated with doxycycline and cefoxitin,while the treatment group was additionally treated with modified Dahuang Mudan tang based on the treatment of the control group. Both groups were treated for two weeks. The scores of main symptoms of the damp-heat stasis syndrome,the proportion of neutrophil and leukocyte,as well as the clinical effect in the two groups were observed and compared. The changes in the levels of MCP-1 and IGF-1 in serum in the two groups were detected before and after treatment. Results:The total effective rate was 93.33% in the treatment group and 70.00% in the control group,the difference being significant(P < 0.05). After treatment,the scores of main symptoms of the damp-heat stasis syndrome including distending pain in the lower abdomen,distending pain in the lumbosacral region,excessive leucorrhea and yellowish leucorrhea in the two groups were significantly decreased when compared with those before treatment(P < 0.05), and each score in the treatment group was obviously lower than that in the control group(P < 0.05). After treatment,the neutrophil count, white blood cell count as well as the levels of MCP-1 and IGF-1 in serum in the two groups were obviously decreased when compared with those before treatment(P < 0.05),and the above indexes in the treatment group were obviously lower than those in the control group(P < 0.05). Conclusion:Modified Dahuang Mudan tang has significant curative effect in treating chronic pelvic inflammation based on the routine therapy, whose mechanism is probably the regulation of the levels of MCP-1 and IGF-1 in serum.
引文
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[9]薛丽霞.黄藤素分散片联合替硝唑治疗慢性盆腔炎的临床研究[J].现代药物与临床,2017,32(6):1081-1084.
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[11]杨敏,王媛.左炔诺孕酮宫内释放系统对IGF-1的影响及预防盆腔炎疗效分析[J].湖南师范大学学报(医学版),2016,13(6):96-99.
[2]方霞,俞碧霞,顾海燕,等.克拉霉素结合桂枝茯苓胶囊对患者慢性盆腔炎的治疗疗效研究[J].中华医院感染学杂志,2018,28(5):761-767.
[3]贾利平,刘玉珠,周小飞.中西医结合治疗慢性盆腔炎疗效观察及安全性分析[J].中华中医药学刊,2018,36(4):939-941.
[4]宋俊生,薛晓焕,熊俊,等.大黄牡丹汤及其加减方治疗阑尾周围脓肿的系统评价[J].辽宁中医杂志,2010,37(12):2273-2277.
[5]谢辛.妇产科学[M].8版.北京:人民卫生出版社,2013:242.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:243-253.
[7]杨兰,杨明末.益气消积汤内服和解毒化癥汤灌肠治疗盆腔炎性疾病后遗症性包块54例[J].中国实验方剂学杂志,2015,21(10):212-215.
[8]刘彤鸥,王加谋,王师菡.化瘀固本方对慢性盆腔炎大鼠相关细胞因子及血液流变学的影响[J].中药材,2016,39(1):170-173.
[9]薛丽霞.黄藤素分散片联合替硝唑治疗慢性盆腔炎的临床研究[J].现代药物与临床,2017,32(6):1081-1084.
[10]秦翠梅,于洪建,陈建梅,等.三棱-莪术有效组分配伍液对慢性盆腔炎大鼠盆腔粘连的影响[J].中成药,2018,40(6):1233-1237.
[11]杨敏,王媛.左炔诺孕酮宫内释放系统对IGF-1的影响及预防盆腔炎疗效分析[J].湖南师范大学学报(医学版),2016,13(6):96-99.