膈下逐瘀汤治疗气滞血瘀型盆腔炎性疾病后遗症的临床研究及对炎性细胞因子的影响

发布时间：2018-09-12 19:10

【摘要】：1目的通过观察名方-膈下逐瘀汤治疗气滞血瘀型盆腔炎性疾病后遗症(Sequelae of PID)患者治疗前后的中医证候、症状、体征的改变,患者血清炎性细胞因子IL-1、IL-8、IL-10、TNF-α表达水平的变化及患者焦虑、抑郁改善情况,分析总结膈下逐瘀汤治疗盆腔炎性后遗症的临床综合疗效及治疗机制。2方法选取2014年11月~2015年11月就诊于安徽中医药大学第一附属医院妇科门诊及住院的气滞血瘀型的盆腔炎性疾病后遗症患者80例,其中年龄:20岁~29岁28人,30岁~34岁28人,35岁~45岁24人。病程6个月至1年21人,1年以上3年以下16人,3至5年23人。按患者就诊时间1比1的比例随机分组。分为治疗组(服用膈下逐瘀汤联合野菊花通络灌肠颗粒保留灌肠)和对照组(服用西药联合超短波理疗)各40例。分别记录两组患者治疗前后的中医证候、临床症状、局部体征的相应变化,分析临床综合疗效;同时记录治疗前后两组患者不良心理情绪变化、治疗前后患者炎性细胞因子IL-1、IL-8、IL-10、TNF-α表达水平变化情况。综合评价两组盆腔炎性疾病后遗症患者治疗效果;3结果治疗后结果显示:在综合疗效方面,治疗组和对照组的总有效率分别达到:85.0%和82.5%,治疗组优于对照组。经统计学分析,差异具统计学意义(P0.01);在中医证候疗效方面,治疗组和对照组的总有效率分别为95%和90%,治疗组优于对照组。经统计学分析,治疗组疗效有统计学意义(P0.01),对照组的疗效同样具有显著性差异(P0.05);治疗后两组病例中医证候积分方面,治疗组和对照组在治疗前中医症候总积分无明显差别(P0.05),治疗后对照组的中医证候分要高于治疗组(P0.05),对照组患者治疗后中医症候积分均较前有所降低,治疗组治疗后的整体得分都较治疗前有显著下降(P0.01)。治疗组优于对照组(p0.05)。在患者焦虑、抑郁评分方面,治疗前组间差异不显著,治疗后两组的抑郁、焦虑水平均显著下降(p0.05),其中治疗组的下降程度要大于对照组。在炎细胞因子IL-1、IL-8 IL-10、TNF-a方面,治疗组治疗后,细胞因子水平优于对照组(p0.05)。治疗后IL-1、IL-8显著低于治疗前(P0.05),IL-10显著高于治疗前(P0.05),TNF-a疗前后无显著统计学差异(P0.05)。治疗过程中均未发现明显不良反应。4结论膈下逐瘀汤治疗气滞血瘀型盆腔炎性疾病后遗症的疗效确切,能改善盆腔炎性疾病后遗症患者的临床症状、局部体征、中医症候,能调节炎细胞因子的表达水平,从而改善患者的不良心理状态。
[Abstract]:Objective to observe the changes of TCM syndromes, symptoms and signs of (Sequelae of PID) patients with Qi stagnation and Blood stasis Type pelvic inflammatory Disease sequelae before and after treatment. Changes of serum inflammatory cytokine IL-1,IL-8,IL-10,TNF- 伪 expression and improvement of anxiety and depression in patients, Analysis and summary of clinical comprehensive curative effect and treatment mechanism of Gexiazhuyu decoction in treating pelvic inflammatory sequelae methods from November 2014 to November 2015, Qi-stagnation blood was selected from gynecological outpatient and inpatient of the first affiliated Hospital of Anhui University of traditional Chinese Medicine. 80 cases of pelvic inflammatory disease sequelae of blood stasis type, Among them, age 20, age 29, age 28, age 30, age 34, age 28, age 35, age 45, age 24. The course of disease ranged from 6 months to 21 cases, and from 1 year to 3 years, from 3 to 5 years. The patients were randomly divided into two groups according to the ratio of 1: 1. The patients were divided into treatment group (treated with Gexia Zhuyu decoction combined with wild chrysanthemum Tongluo enema granule retention enema) and control group (taking western medicine combined with ultrashort wave physiotherapy). Record the corresponding changes of TCM syndromes, clinical symptoms and local signs before and after treatment, analyze the comprehensive clinical efficacy, and record the changes of bad psychological emotions of the two groups before and after treatment. Changes of inflammatory cytokine IL-1,IL-8,IL-10,TNF- 伪 expression before and after treatment. Comprehensive evaluation of the two groups of pelvic inflammatory disease sequelae treatment results after treatment results: in the comprehensive curative effect, the total effective rate of the treatment group and the control group reached 85.0% and 82.5% respectively, the treatment group is better than the control group. The total effective rate of treatment group and control group were 95% and 90% respectively, the treatment group was superior to the control group. After statistical analysis, the curative effect of the treatment group has statistical significance (P0.01), the control group also has significant difference (P0.05); after the treatment of two groups of cases of TCM syndromes integral, There was no significant difference between the treatment group and the control group in the total score of TCM symptoms before treatment (P0.05). After treatment, the TCM syndrome score of the control group was higher than that of the treatment group (P0.05), and the TCM symptom score of the control group was lower than that of the former. The overall score of treatment group was significantly lower than that before treatment (P0.01). The treatment group was superior to the control group (p0.05). There was no significant difference in the scores of anxiety and depression between the two groups before treatment. After treatment, the depression and anxiety level of the two groups decreased significantly (p0.05), and the degree of depression in the treatment group was greater than that in the control group. The level of cytokines in the treatment group was better than that in the control group (p0.05). After treatment, IL-1,IL-8 was significantly lower than that before treatment (P0.05) and IL-10 was significantly higher than that before treatment (P0.05). There was no significant difference before and after treatment (P0.05). Conclusion Gexia Zhuyu decoction is effective in treating the sequelae of pelvic inflammatory disease of qi stagnation and blood stasis type, and can improve the clinical symptoms, local signs and TCM symptoms of patients with pelvic inflammatory disease. Can regulate the expression level of inflammatory cytokines, thereby improving the poor psychological state of patients.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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