慢性盆腔炎患者盆腔液病原菌分布及中西医结合疗效分析  

Analysis of the distribution characteristics of pathogenic bacteria in pelvic fluid of patients with chronic pelvic inflammatory disease and the clinical effect of integrated traditional Chinese and Western medicine treatment

作　　者：许东阳 康志媛 窦纪梁 吕文艳[4] XU Dongyang;KANG Zhiyuan;DOU Jiliang;LV Wenyan(Nanyang Medical Vocational School First Affiliated Hospital,Nanyang 473000,Henan,China;The First Affiliated Hospital of Henan University of Traditional Chinese Medicine;Henan Institute of Applied Technology;Nanyang Medical Higher Vocational School)

机构地区：[1]南阳医学高等专科学校第一附属医院,河南南阳473000 [2]河南中医药大学第一附属医院 [3]河南应用技术学院 [4]南阳医学高等专科学校

出　　处：《中国病原生物学杂志》2024年第10期1202-1205,1210,共5页Journal of Pathogen Biology

基　　金：河南省医学科技攻关计划项目(No.LHGJ20200234)。

摘　　要：目的 探析慢性盆腔炎患者盆腔液病原菌分布特点及中西医治疗效果。方法 选取2022-2023年的110例慢性盆腔炎患者为研究对象,选取同期就诊的80例急性盆腔炎患者,采集两组患者盆腔液标本,进行病原菌鉴定。选取同期体检健康女性110例为对照组,对比两组女性生殖道解脲支原体(Ureaplasma urealyticum,UU)、沙眼衣原体(Chlamydia trachomatis,CT)感染情况及阴道炎症情况。将110例慢性盆腔炎患者按照随机抽样法分成试验组和对照组,对照组采用常规西医治疗方案,试验组在对照组的基础上,加用大黄红藤煎加减进行中西医结合治疗,对比试验组与对照组患者治疗效果、临床症状消失时间及治疗前后炎性因子水平。结果 110例慢性盆腔炎患者病原菌主要为大肠埃希菌、凝固酶阴性葡萄球菌,80例急性盆腔炎患者病原菌主要为大肠埃希菌、粪肠球菌,急性盆腔炎患者大肠埃希菌、凝固酶阴性葡萄球菌占比低于慢性盆腔炎患者,粪肠球菌占比显著高于慢性盆腔炎患者。对比慢性盆腔炎患者与对照组UU、CT感染及阴道炎症情况,慢性盆腔炎患者UU感染率39.09%,CT感染率29.09%,BV感染率10.91%,VC感染率7.27%,TV感染率3.64%,AV感染率2.73%,UU、CT感染率显著高于对照组(P<0.05)。实验组患者总有效率为90.91%(50/55),对照组为70.91%(39/55),试验组总有效率显著高于对照组。试验组腹痛消失时间为(2.44±1.03)d,尿频尿急消失时间为(3.02±1.43)d,阴道黏膜充血消失时间为(2.02±0.78)d,体温恢复正常时间为(2.35±0.95)d,各项临床症状消失时间显著短于对照组(P<0.05)。两组患者治疗前各项炎性因子水平无差异,治疗后TNF-α、CRP、IL-6水平差异有统计学意义(P<0.05)。结论 慢性盆腔炎患者盆腔液病原菌主要为大肠埃希菌、凝固酶阴性葡萄球菌,UU、CT感染率较高。慢性盆腔炎患者经过中西医结合治疗后,临床治疗效果优于单纯西药治Objective To explore the distribution characteristics of pathogenic bacteria in pelvic fluid of patients with chronic pelvic inflammatory disease and the clinical effect of integrated traditional Chinese and Western medicine treatment.Methods A total of 110 patients with chronic pelvic inflammatory disease from 2022 to 2023 were selected as the research objects,and 8o patients with acute pelvic inflammatory disease who were treated during the same period were selected.Pelvic fluid specimens of patients in both groups were collected for pathogen identification.A total of 110 healthy women who underwent physical examination during the same period were selected as the control group.The infection status of Ureaplasma urealyticum(UU),Chlamydia trachomatis(CT)in the female reproductive tract and vaginal inflammation were compared between the two groups.The llo patients with chronic pelvic inflammatory disease were divided into the experimental group and the control group according to the random sampling method.The control group was treated with the conventional Western medicine treatment plan.On the basis of the control group,the experimental group was treated with modified Dahuang Hongteng Decoction for integrated traditional Chinese and Western medicine treatment.The therapeutic effects,the disappearance time of clinical symptoms and the levels of inflammatory factors before and after treatment were compared between the experimental group and the control group.Results The main pathogens in llo patients with chronic pelvic inflammatory disease were Escherichia coli and coagulase-negative Staphylococcus.The main pathogens in 80 patients with acute pelvic inflammatory disease were E.coli and Enterococcus faecalis.The proportions of E.coli and coagulase-negative Staphylococcus in patients with acute pelvic inflammatory disease were lower than those in patients with chronic pelvic inflammatory disease,and the proportion of E.faecalis was significantly higher than that in patients with chronic pelvic inflammatory disease.T

关 键 词：慢性盆腔炎 病原菌 中西医结合 

分 类 号：R711.33[医药卫生—妇产科学] R446.5[医药卫生—临床医学]