中药外治法治疗盆腔炎性疾病后遗症所致慢性盆腔痛的循证研究及临床验证  

Evidence-Based Study and Clinical Validation of External Application of Chinese Medicines in Treating Chronic Pelvic Pain Caused by Sequelae of Pelvic Inflammatory Diseases

作　　者：徐立 薛晓鸥[1] XU Li;XUE Xiao-ou(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《世界中西医结合杂志》2024年第6期1145-1151,1156,共8页World Journal of Integrated Traditional and Western Medicine

基　　金：2018国家重点研发计划(2018YFC1704100);名老中医经验研究与推广应用一体化平台构建(2018YFC1704106)。

摘　　要：目的获得临床医师对于盆腔炎性疾病后遗症所致慢性盆腔痛(SPID-CPP)外治中药的推荐用药。方法通过两轮德尔菲法专家问卷的形式,获得临床医师对于盆腔炎性疾病后遗症最为关注的临床问题并进行重要性积分,以获取临床问题。再通过文献检索纳入系统评价及随机对照试验,进行偏倚分析以获得证据体,得出初步推荐意见,再经过一轮德尔菲法问卷调查后得出最终推荐意见,再经过多中心临床试验加以验证。结果三轮德尔菲法的专家积极程度、专家意见集中度及专家权威系数均较高,结果可信度较好;91.11%的临床医师强推荐清热除湿、化瘀止痛类中成药用于湿热瘀结证SPID-CPP的外治;临床研究显示清热除湿、化瘀止痛类中药保留灌肠治疗湿热瘀结证SPID-CPP的总有效率为87.22%。结论临床医师对于中药外治法治疗SPID-CPP的关注度最高,在具体用药方面更倾向于使用中成药制剂,其中化瘀散结灌肠液治疗SPID-CPP湿热瘀结证的推荐意见最强。对于临床常见的湿热瘀结型SPID-CPP,清热除湿、化瘀止痛类中药保留灌肠有效率高。Objective To obtain clinician's recommendation of the Chinese medicines for the external treatment of chronic pelvic pain caused by the sequelae of pelvic inflammatory diseases(SPID-CPP).Methods Two rounds of expert questionnaire surveys(Delphi method)were conducted to obtain the clinical questions concerned most by clinicians for the sequelae of pelvic inflammatory diseases and the importance points were scored to obtain clinical questions.Systematic reviews and randomized controlled trials were included by literature search,and the bias analysis was performed to obtain the evidence.The final recommendations were obtained after another round of questionnaire survey and verified by multi-center clinical trials.Results The active participation,opinion concentration,and authority coefficient of experts in the three rounds of surveys were high,which indicated high credibility of the results.Among the surveyed clinicians,91.11% strongly recommend Chinese patent medicines for clearing heat and drying dampness as well as resolving stasis and relieving pain for external treatment of SPID-CPP patients with the syndrome of dampness-heat combined with stasis.The clinical trials showed that the total response rate of retention enema of Chinese medicines for clearing heat and drying dampness as well as resolving stasis and relieving pain was 87.22% in the treatment of SPID-CPP.Conclusion Clinicians paid high attention to the external application of Chinese medicines for treating SPID-CPP and preferred the use of Chinese patent medicines,with the strongest recommendation of enema for resolving stasis and dissipating mass for treating SPID-CPP patients with the syndrome of dampness-heat combined with stasis.For the patients with the syndrome above,the retention enema of Chinese medicines for clearing heat and removing dampness as well as resolving stasis and relieving pain has high a response rate.

关 键 词：德尔菲法 盆腔炎性疾病后遗症 慢性盆腔痛 外治法 

分 类 号：R711.33[医药卫生—妇产科学]