穴位贴敷联合理冲汤加减治疗气虚血瘀型盆腔炎性疾病后遗症临床研究  

Effect of acupoint application combined with modified Lichong Decoction on sequelae of pelvic inflammatory disease of Qi-deficiency and blood-stasis type

作　　者：石琳子 张启丽 张欣欣 SHI Linzi;ZHANG Qili;ZHANG Xinxin(Department of TCM Gynecology,Chuzhou Chinese Western Medicine Hospital,Chuzhou,Anhui 239000)

机构地区：[1]安徽省滁州市中西医结合医院中医妇科,安徽滁州239000

出　　处：《河北中医》2024年第9期1445-1449,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2020年度中国民族医药学会科研项目(编号:2020ZY076-570101)。

摘　　要：目的观察穴位贴敷联合理冲汤加减治疗气虚血瘀型盆腔炎性疾病后遗症的抗炎作用及对盆腔血流动力、免疫学指标的影响。方法将98例气虚血瘀型盆腔炎性疾病后遗症患者按照随机数字表法分为2组。对照组49例予理冲汤加减治疗,治疗组49例予穴位贴敷联合理冲汤加减治疗。比较2组临床疗效。比较2组治疗前后中医证候评分、子宫动脉搏动指数(PI)、舒张末期血流速度(EDV)、阻力指数(RI)、盆腔积液最大深径、盆腔包块直径、细胞间黏附分子1(ICAM-1)、单核细胞趋化蛋白-1(MCP-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、CD4^(+)、CD8^(+)、补体C3水平。结果治疗组总有效率97.96%(48/49),对照组总有效率83.67%(41/49),治疗组疗效优于对照组(P<0.05)。治疗后,2组下腹疼痛或坠痛、经行疼痛加重、精神萎靡、食少纳呆、经期延长或月经量多、经血淡暗或有块、体倦乏力、色白质稀、带下量多评分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后,2组盆腔积液最大深径、盆腔包块直径均较本组治疗前减小(P<0.05),且治疗组小于对照组(P<0.05)。治疗后,2组RI、PI均较本组治疗前降低(P<0.05),EDV较本组治疗前升高(P<0.05),且治疗组RI、PI低于对照组(P<0.05),EDV高于对照组(P<0.05)。治疗后,2组ICAM-1、MCP-1、GM-CSF水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,2组CD8^(+)水平均较本组治疗前降低(P<0.05),CD4^(+)、补体C3水平均较本组治疗前升高(P<0.05),且2组组间比较差异有统计学意义(P<0.05)。结论穴位贴敷联合理冲汤加减治疗盆腔炎性疾病后遗症患者,可提升抗炎效果,改善盆腔血流动力学及免疫学指标水平,减少盆腔积液及包块。Objective To observe the effect of acupoint application combined with modified Lichong Decoction on sequelae of pelvic inflammatory disease(PID)of Qi-deficiency and blood-stasis type and its impacts on hemodynamic and immunological indexes.Methods Ninety-eight patients with sequelae of PID of Qi-deficiency and blood-stasis type were assigned in a 1∶1 ratio to modified Lichong Decoction(control group)or acupoint application plus modified Lichong Decoction(treatment group)by a random number table.The clinical efficacy,traditional Chinese medicine(TCM)symptom scores,pulsation index(PI)in uterine artery,end-diastolic velocity(EDV),resistance index(RI),the maximum depth diameter and the diameter of pelvic mass,intercellular adhesion molecule 1(ICAM-1),monocyte chemotactic protein-1(MCP-1),granulocyte-macrophage colony-stimulating factor(GM-CSF),CD4^(+),CD8^(+),and complement component C3 were compared.Results The total effective rate of the treatment group was significantly higher than that of the control group(97.96%[48/49]vs 83.67%[41/49],P<0.05).TCM symptom scores(lower abdominal pain or falling pain,aggravation of menstruation,apatheia,poor appetite,menstrual extension or menorrhagia,pale or lumpy menstrual blood,body fatigue,color white matter thin,more leucorrhea)in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).The maximum depth of pelvic effusion and the diameter of pelvic mass in the both groups were significantly decreased(P<0.05),which were significantly smaller in the treatment group than in the control group(P<0.05).Significantly decreased RI and PI levels,and increased EDV level were found in the both groups(all P<0.05),which were significantly pronounced in the treatment group(all P<0.05).The contents of ICAM-1,MCP-1 and GM-CSF in the both groups were significantly decreased(P<0.05),which in the treatment group were significantly lower than those in the control group(P<0.05).Significantly decreased CD8^(+)leve

关 键 词：盆腔炎性疾病 穴位贴敷疗法 理冲汤 

分 类 号：R711.33[医药卫生—妇产科学] R245.9[医药卫生—临床医学] R289.5