银蒲四逆四妙失笑散加减辨治盆腔炎性疾病远期后遗症及对免疫-炎症因子的调节作用  

Modified Yinpu Sini Simiao Shixiao palvis on Immune Inflammatory Factors of Patients with Long-term Sequelae of Pelvic Inflammatory Disease

作　　者：张秀荣 郝浩[2] ZHANG Xiu-rong;HAO Hao(Maternal and Child Healthcare Center of Shandong Province, Ji＇nan 250014, China;Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Ji＇nan 250006, China)

机构地区：[1]山东省妇幼保健院,济南250014 [2]山东中医药大学附属医院,济南250006

出　　处：《中国实验方剂学杂志》2018年第11期179-184,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山东省科技厅重点项目(2016GSF202029)

摘　　要：目的：观察银蒲四逆四妙失笑散辨证加减治疗盆腔炎性疾病远期后遗症（SPID）（湿热瘀阻证）的临床疗效及对T淋巴细胞亚群和Th1/Th2细胞因子的调节作用。方法：将符合要求的132例SPID采用区组法,按SAS软件生成的随机分为对照组和观察组各66例。两组患者均给予盆炎清罐肠,于月经干净后3 d开始,每晚1次,连续10 d。对照组口服妇科千金胶囊,2粒/次,3次/d;观察组内服银蒲四逆四妙失笑散辨证治疗,1剂/d。两组患者连续治疗3个月经周期,行经期停服。进行治疗前后湿热瘀阻证和盆腔体征评分;进行治疗前后生活质量评价;检测治疗前后T淋巴细胞亚群（CD3^＋,CD4^＋,CD8^＋及CD4^＋/CD8^＋）和白细胞介素-2（IL-2）,IL-4,IL-6,IL-10,肿瘤坏死因子-α（TNF-α）水平。结果：治疗后观察组患者湿热瘀阻证和盆腔体征评分均低于对照组（P〈0.01）;观察组生活量表各维度评分和总分均高于对照组（P〈0.01）;观察组CD4^＋水平和CD4^＋/CD8^＋比例均高于对照组（P〈0.05）,CD8^＋低于对照组（P〈0.05）;观察组患者血清IL-2,IL-4和IL-10均高于对照组（P〈0.01）,IL-6,IL-8和TNF-α均低于对照组（P〈0.01）;观察组临床疗效总有效率为95.16%,高于对照组的83.33%（χ^2=4.481,P〈0.05）。结论：在采用中药保留灌肠的基础上,银蒲四逆四妙失笑散加减内服辨证治疗湿热瘀阻型SPID患者,可减轻症状、体征,提高患者的生活质量,并能调节免疫-炎症因子的作用,临床疗效明显,值得进一步的研究。Objective： To observe the clinical efficacy of modified Yinpu Sini Simiao Shixiao palvis on long-term sequelae of pelvic inflammatory disease(SPID） with damp heat stasis syndrome,and its regulatory effect on immune inflammatory factors. Method： One hundred and thirty-two patients with SPID were randomly divided into control group and observation group by random number table. Both groups＇ patients got Pengyanqing enema at night since the third day after the end of menstruation,for successively 10 days. Patients in control group got Fuke Qianjin capsule,2 grains/time,3 times/days. Patients in observation group got modified Yinpu Sini Simiao Shixiao palvis,1 dose/day. The treatment lasted for 3 menstrual cycles,and discontinued during the menstrual period.Before and after treatment,the damp-heat stasis syndrome and pelvic signs were scored,and the quality of life was evaluated. Levels of T lymphocyte subsets(CD3^＋,CD4^＋,CD8^＋and CD4^＋/CD8^＋）,interleukin-2(IL-2）,IL-4,IL-6,IL-10 and tumor necrosis factor-α(TNF-α） were detected. Result： The scores of damp-heat stasis syndrome and pelvic signs in observation group were lower than those in control group(P〈0. 01）. And the score at all dimensions and the total score of life scale in observation group were higher than those in control group(P〈0. 01）. Levels of CD4^＋and CD4^＋/CD8^＋,IL-2,IL-4 and IL-10 in observation group were higher than those in control group(P〈0. 05,P〈0. 01）,and levels of IL-6,IL-8 and TNF-α in observation group were lower than those in control group(P〈0. 01）. The total effective rate in observation group was 95. 16%,which was higher than 83. 33% in control group(χ^2= 4. 481,P〈0. 05）. Conclusion： In addition to retention enema with Chinese medicine,modified Yinpu Sini Simiao Shixiao palvis is also given to relieve symptoms and signs,improve the quality of life and immunity of the patients,and regulate immune inflammatory factors.

关 键 词：盆腔炎性疾病后遗症 湿热瘀阻证 银蒲四逆四妙失笑散 T淋巴细胞亚群 辅助性T细胞 

分 类 号：R271[医药卫生—中医妇科学] R271.1[医药卫生—中医学]