加味败藤合剂治疗盆腔炎性疾病后遗症湿热瘀阻证的临床研究

发布时间：2018-01-01 02:24

本文关键词：加味败藤合剂治疗盆腔炎性疾病后遗症湿热瘀阻证的临床研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：本研究旨在对加味败藤合剂治疗盆腔炎性疾病后遗症湿热瘀阻证进行临床研究。以期通过比较量化评分、实验室检查的变化情况及对不良反应事件的跟踪控制,对其有效性及安全性作出评价。方法：选择2015年1月-2016年1月于江苏省中西医结合医院妇科门诊就诊病人共60例,严格按照纳入、排除标准进行筛选。采用随机对照的方法按1：1的比例分成两组,治疗组(口服加味败藤合剂)与对照组(口服抗妇炎胶囊)各30例,共治疗两个疗程。疗程结束后观察所有患者治疗前后症状体征积分、相关疗效指标及安全性指标的变化情况。结果：1.治疗组中医证候疗效总有效率为96.7%,局部体征疗效总有效率为100%,VAS评分有效率为100%,综合疗效总有效率为96.7%。对照组中医证候疗效总有效率为83.3%,局部体征疗效总有效率为80%,VAS评分有效率为96.7%,综合疗效总有效率为80%。两组相比,中医证候疗效、局部体征疗效、综合疗效、VAS评分等各方而差异均有统计学意义。2.治疗后两组患者血液流变学各项指标(血浆黏度、全血高切、全血低切、血沉、血小板聚集率)较前均明显下降(P0.05或P0.01)。治疗组各项指标改善情况与对照组相比,组间有显著性差异(P0.01)。治疗前后差值组间比较,治疗组在全血高切、全血低切、血小板聚集率等方而作用较对照组具有显著性差异(P0.01)。对于改善血浆黏度及血沉方而,组间无明显差异。3.治疗后两组患者血小板计数均较治疗前降低,差异具有统计学意义(P0.05),治疗后组间相比,差异无统计学意义。治疗组平均血小板体积指数明显上升(P0.01),对照组较治疗前无明显差异,组间差异具有统计学意义(P0.05)。4.治疗后两组患者CRP指标均得到明显改善(P0.05),组间相比差异无统计学意义。5.治疗后治疗组患者TNF-α IL-6水平较治疗前均明显下降,差异有统计学意义(P0.05或P0.01)；对照组患者TNF-α水平较前下降(P0.05),IL-6治疗前后差异无统计学意义；组间相比,治疗组两项指标变化情况较对照组差异具有统计学意义(P0.05或P0.01)。6.所有患者在治疗期间均未出现毒副作用及其他不良反应。结论：加味败藤合剂治疗盆腔炎性疾病后遗症湿热瘀阻证,在总有效率、具体症状体征评分、血流变指标、血小板参数、血清炎性因子等方而均较对照组优势明显。本方能够明显缓解局部及全身症状,改善血流变状态,降低患者体内炎性因子水平,其作用机理可能是通过调节体内免疫因子水平,纠正免疫失调来达到治疗的口的。本方有效性及安全性均较佳,值得在临床中应用和推广。
[Abstract]:Objective: the purpose of this study was to treat pelvic inflammatory disease sequelae dampness and heat stasis syndrome with Jiawei Puteng mixture, and to compare the quantitative score. Changes in laboratory examination and tracking control of adverse events. Methods: a total of 60 gynecological outpatients from January 2015 to January 2016 in Jiangsu Provincial Integrated Chinese and Western Medicine Hospital were selected to evaluate their efficacy and safety. According to the ratio of 1: 1, the treatment group (30 cases) and the control group (30 cases) were divided into two groups. Two courses of treatment. After the course of treatment, all patients were observed before and after the treatment of symptoms and signs score. Results: 1. The total effective rate of TCM syndromes in the treatment group was 96.7. the total effective rate of local signs was 100%. The effective rate of VAS score was 100 and the total effective rate of comprehensive curative effect was 96.7.The total effective rate of TCM syndromes in the control group was 83.3 and the total effective rate of local signs was 80%. The effective rate of VAS score was 96.7 and the total effective rate of comprehensive curative effect was 80.Compared with traditional Chinese medicine syndrome curative effect, local sign effect and comprehensive curative effect. After treatment, the hemorheology indexes (plasma viscosity, whole blood high shear, whole blood low shear, whole blood low shear, erythrocyte sedimentation rate) were significantly different between the two groups. Platelet aggregation rate) were significantly decreased than before P0.05 or P0.01. the improvement of the treatment group compared with the control group. There was significant difference between the two groups (P 0.01). The difference before and after treatment was high and low in the treatment group. Compared with the control group, platelet aggregation rate had a significant difference (P 0.01). It could improve plasma viscosity and erythrocyte sedimentation rate (ESR). There was no significant difference between the two groups. 3. After treatment, the platelet count in the two groups was lower than that before treatment, the difference was statistically significant (P 0.05), and after treatment, there was a significant difference between the two groups. The mean platelet volume index in the treatment group was significantly higher than that in the control group (P 0.01), but there was no significant difference between the control group and the control group. The difference between the two groups was statistically significant (P0.05N. 4. after treatment, the CRP indexes of the two groups were significantly improved (P0.05). After treatment, the level of TNF- 伪 IL-6 in the treatment group was significantly lower than that before treatment, the difference was statistically significant (P0.05 or P0.01). The level of TNF- 伪 in the control group was lower than that in the former group, and there was no significant difference between the two groups before and after treatment. Group comparison. The changes of two indexes in the treatment group were significantly different from those in the control group (P0.05 or P0.01). All patients did not have toxic side effects and other adverse reactions during the treatment. Conclusion: Jiawei Baiteng mixture in the treatment of pelvic inflammatory disease sequelae damp-heat stasis syndrome. In the total effective rate, specific symptoms and signs score, hemorheological index, platelet parameters, serum inflammatory factors and other prescription and obvious advantages over the control group. This prescription can significantly alleviate local and systemic symptoms, improve the hemorheological state. Reduce the level of inflammatory factors in patients, its mechanism may be by regulating the level of immune factors in vivo, to correct immune disorders to achieve the oral treatment. The efficacy and safety of the prescription is better. It is worth applying and popularizing in clinic.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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