少腹逐瘀汤保留灌肠联合抗菌药物治疗寒湿凝滞型慢性子宫内膜炎的临床研究  

Clinical study on the effect of Shaofu Zhuyu decoction retention enema combined with antibiotics on chronic endometritis of the cold-dampness stagnation type

作　　者：鲍蔓蔓 吴丽敏[2] 乔宗惠 李晓伟 杨美霞 刘英 BAO Manman;WU Limin;QIAO Zonghui;LI Xiaowei;YANG Meixia;LIU Ying

机构地区：[1]阜阳市妇女儿童医院,安徽阜阳236000 [2]中国科学技术大学附属第一医院,安徽合肥230001

出　　处：《中医临床研究》2024年第24期98-102,共5页Clinical Journal Of Chinese Medicine

基　　金：阜阳市卫生健康委科研课题(2019-85);国家自然科学基金项目(81373671)。

摘　　要：目的:观察少腹逐瘀汤保留灌肠联合抗菌药物治疗寒湿凝滞型慢性子宫内膜炎(Chronic Endometritis,CE)的临床疗效。方法:选取90例宫腔镜检查术后寒湿凝滞型CE患者,随机分为对照组和观察组各45例。两组均予常规抗菌药物治疗14 d,观察组加用少腹逐瘀汤保留灌肠治疗,于治疗后第一次月经干净的3~7 d复查宫腔镜及子宫内膜组织免疫组化。比较两组临床疗效、治疗前后中医证候积分、免疫组化CD38、CD138的阳性检出率及两组患者治疗期间不良反应事件的发生率。结果:观察组总有效率达97.8%(44/45),高于对照组的82.2%(37/45),差异有统计学意义(P<0.05)。治疗后,两组患者的下腹坠痛、月经异常、带下增多中医证候积分均较治疗前显著降低(P<0.01),且观察组均明显低于对照组(P<0.05);两组的免疫组化CD38、CD138的阳性检出率均较治疗前显著降低(P<0.01),且观察组均明显低于对照组(P<0.05);两组患者治疗期间不良反应事件发生率的差异无统计学意义(P>0.05)。结论:少腹逐瘀汤保留灌肠联合抗菌药物治疗寒湿凝滞型CE疗效确切,可有效改善患者的中医证候,减轻浆细胞浸润,安全性良好。Objective:To observe the clinical effect of Shaofu Zhuyu decoction(少腹逐瘀汤)retention enema combined with antibiotics on chronic endometritis of the cold-dampness stagnation type.Methods:A total of 90 patients with chronic endometritis of the cold-dampness stagnation type after hysteroscopy were selected and divided randomly into the control group and the observation group,with 45 cases in each group.Both groups were treated with doxycycline orally for 14 days,and the observation group was additionally treated with Shaofu Zhuyu decoction retention enema.Hysteroscopy and endometrial immunohistochemistry were performed 3 to 7 days after the first menstrual period after treatment.The clinical efficacy,TCM syndrome score before and after treatment,the positive detection rate of CD38 and CD138 in immunohistochemistry and the incidence of adverse events during treatment were compared between the two groups.Results:The total effective rate in the observation group was 97.8%(44/45),which was higher than that in the control group,82.2%(37/45),and the difference was statistically significant(P<0.05).After treatment,the scores of TCM syndromes of lower abdominal pain,abnormal menstruation and profuse vaginal discharge in both groups were significantly lower than those before treatment(P<0.01),and in the observation group was significantly lower than the control group(P<0.05).The positive rates of immunohistochemical CD38 and CD138 in 2 groups were significantly lower than those before treatment(P<0.01),and in the observation group was significantly lower than the control group(P<0.05).There was no significant difference in the incidence of adverse events between two groups during treatment(P>0.05).Conclusion:Shaofu Zhuyu decoction retention enema combined with antibiotics has definite efficacy in the treatment of chronic endometritis of the cold-dampness stagnation type,which can effectively ameliorate the TCM syndromes of patients,and reduce plasma cell infiltration,and it has good safety.

关 键 词：慢性子宫内膜炎 寒湿凝滞型 少腹逐瘀汤 中药保留灌肠 免疫组化 

分 类 号：R271[医药卫生—中医妇科学]