中药保留灌肠法治疗湿热瘀结型慢性盆腔炎临床优化方案及疗效观察:基于正交设计  

Study on the Clinical Optimization Scheme and Clinical Effect of Chronic Pelvic Inflammation by TCM Reserved Enema Method Based on Orthogonal Design

作　　者：张丽 王瑞杰 刘向娥 张熙渊 Zhang Li;Wang Ruijie;Liu Xiang'e;Zhang Xiyuan(Baiyin Hospital of Integrated Traditional Chinese and Western Medicine,Baiyin 730900,China)

机构地区：[1]白银市中西医结合医院,甘肃白银730900

出　　处：《亚太传统医药》2023年第11期111-116,共6页Asia-Pacific Traditional Medicine

基　　金：白银市科技计划项目:基于正交试验设计法对中药保留灌肠法治疗湿热瘀结型慢性盆腔炎(CPID)临床方案优化研究(2021-1-25Y)。

摘　　要：目的:中药保留灌肠法广泛应用于中医临床,但由于其缺乏标准的操作方案,造成疗效逐渐下降,及其他一些不良后果。探讨采用正交设计试验法,优化中药保留灌肠法治疗湿热瘀结型CPID的临床治疗方案及疗效。方法:将178例符合纳入标准的湿热瘀结型CPID患者,按照正交设计方案随机分组,共为9组。选择插入肛管的深度(cm)、药液在肠道的保留时间(h)和灌肠操作的时辰作为因素,每个因素设计3个水平,按照L9(34)正交表安排试验,进行临床观察。入组患者均给予西药抗生素治疗方案,结合中药保留灌肠疗法,1个疗程为7 d,临床疗效观察2个疗程。治疗效果以慢性盆腔炎湿热蕴结证中医证候、局部体征积分、红细胞比容等作为指标进行方案评价。结果:结果显示,中药保留灌肠法治疗湿热瘀结型CPID的最佳操作方案是在早晨9∶00-11:00之间进行灌肠操作,将肛管插入肛门15cm,灌肠药液在肠道保留4 h。结论:通过研究建立的中药保留灌肠的最佳操作方案,可在一定程度上提高临床治疗湿热瘀结型CPID的效果。同时,该优化治疗方案可减轻操作过程中对患者造成的不适,还可减少在灌肠过程中由于操作不规范而造成的药液浪费,节省医疗资源,从而提高患者对该中医治疗方案的依从性及满意度,提高患者对医疗水平的认可度。Objective:Traditional Chinese medicine-sparing enema method is widely used in TCM clinical practice,but due to its lack of standard operation plan,resulting in a gradual decline in efficacy,and some other adverse consequences.Methods:178 patients with stasis CPID who met the inclusion criteria were randomized according to an orthogonal design in 9 groups.The factors chose the depth of the anal canal,the retention time of the fluid in the intestine,and the time of the enema.Each factor was designed at three levels,and the trial was arranged according to the L_9(3~4)orthogonal table for clinical observation.All the enrolled patients were given anti-inflammatory treatment plan with western medicine,combined with traditional Chinese medicine retained enema therapy.7 days was 1 treatment course,and 2 treatment courses were observed.The treatment effect was evaluated by the TCM syndrome,local physical sign integral,and red blood cell specific volume of chronic pelvic inflammation.Results:The best retention enema method of traditional Chinese medicine for CPID is to perform the enema between 9 and 11 am,insert the anal canal into the anus for 15cm,and retain the enema solution in the intestine for 4h.Conclusion:Through this study,we established the best operation scheme for preserving enema,so as to improve the effect of clinical treatment of CPID.At the same time,the optimized treatment plan can reduce the discomfort caused by the operation process,but also reduce the waste of medicine liquid due to the irregular operation,save medical resources,so as to improve the compliance and satisfaction of the TCM treatment method,and improve the recognition of the medical level of our hospital.

关 键 词：中药保留灌肠 正交设计试验法 湿热瘀结型 慢性盆腔炎 临床研究 

分 类 号：R271[医药卫生—中医妇科学]