灌汤1号联合蒿芩清胆汤加味治疗盆腔炎性疾病后遗症的疗效及对患者免疫功能及炎症水平的影响  

Efficacy of Guantang No.1 combined with modified Haoqin Qingdan Decoction in treating sequelae of pelvic inflammatory disease and its effects on immune function and inflammatory levels

作　　者：曹俊红 胡俊攀 李捷 孙艳敏 王冰玉 CAO Jun-hong;HU Jun-pan;LIJie;SUN Yan-min;WANG Bing-yu(Department of Gynecology,Henan Hospital of Traditional Chinese Medicine(the Second Affiliated Hospital of Henan University of Chinese Medicine),Zhengzhou 450002,Henan,CHINA)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院)妇科,河南郑州450002

出　　处：《海南医学》2025年第5期678-683,共6页Hainan Medical Journal

基　　金：河南省中医药科学研究专项项目(编号:2022ZY1082)。

摘　　要：目的探究灌汤1号联合蒿芩清胆汤加味治疗盆腔炎性疾病后遗症(SPID)的疗效及对患者免疫功能及炎症水平的影响。方法前瞻性选取2021年2月至2024年2月河南省中医院(河南中医药大学第二附属医院)收治的102例SPID患者作为研究对象。使用信封法将患者分为联合组和对照组各51例。对照组患者给予蒿芩清胆汤加味治疗,联合组患者给予蒿芩清胆汤加味联合灌汤1号治疗,疗程均为20 d。比较两组患者治疗前、治疗20 d后的中医证候积分、疼痛状态[模拟视觉评分量表(VAS)]、盆底局部体征(盆底包块最大直径、盆腔积液最大深度)、血液流变学(血浆黏度、红细胞沉降率、纤维蛋白原含量)、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)],同时比较两组患者的不良反应发生率。结果联合组患者的治疗总有效率为96.08%,明显高于对照组的84.31%,差异有统计学意义(P<0.05);治疗前,两组患者的主症、次症积分比较差异均无统计学意义(P>0.05),治疗后,联合组患者的主症、次症积分分别为(1.97±0.32)分、(1.87±0.27)分,明显低于对照组的(2.36±0.37)分、(2.16±0.36)分,差异均有统计学意义(P<0.05);治疗前,两组患者的VAS评分、盆底包块最大直径、盆腔积液最大深度比较差异均无统计学意义(P>0.05),治疗后,联合组患者的VAS评分、盆底包块最大直径、盆腔积液最大深度明显低于对照组,差异均有统计学意义(P<0.05);治疗前,两组患者的血液流变学指标比较差异均无统计学意义(P>0.05),治疗后,联合组患者的血液流变学指标明显低于对照组,差异均有统计学意义(P<0.05);治疗前,两组患者的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较差异均无统计学意义(P>0.05),治疗后,联合组患者的CD4^(+)、CD4^(+)/CD8^(+)分别为(38.55±4.01)%、1.54±0.28,明显高于对照组的(36.Objective To investigate the efficacy of Guantang No.1 combined with modified Haoqin Qingdan Decoction in treating sequelae of pelvic inflammatory disease(SPID)and its effects on immune function and inflammatory levels.Methods A total of 102 patients with SPID admitted to Henan Hospital of Traditional Chinese Medicine(the Second Affiliated Hospital of Henan University of Chinese Medicine)between February 2021 and February 2024 were prospectively enrolled.According to envelope method,patients were divided into a combined group(n=51)and a control group(n=51).Patients in the control group received modified Haoqin Qingdan Decoction,while those in the combined group received Guantang No.1 combined with modified Haoqin Qingdan Decoction,for 20 days.Traditional Chinese medicine(TCM)symptom scores,pain status(Visual Analogue Scale[VAS]),pelvic signs(maximum diameter of pelvic mass,maximum depth of pelvic effusion),hemorheology(plasma viscosity,erythrocyte sedimentation rate,fibrinogen levels),immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),and serum inflammatory factors(C-reactive protein[CRP],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6])before and after treatment were compared between the two groups.Adverse events were also compared.Results The total response rate of treatment in the combined group was significantly higher than that in the control group(96.08%vs 84.31%,P<0.05).Before treatment,there was no significant difference in scores of main and secondary symptoms between the two groups(P>0.05).After treatment,scores of main and secondary symptoms in the combined group were(1.97±0.32)points and(1.87±0.27)points,significantly lower than(2.36±0.37)points and(2.16±0.36)points in the control group(P<0.05).Before treatment,there was no significant difference in VAS score,the maximum diameter of pelvic mass or the maximum depth of pelvic effusion between the two groups(P>0.05).After treatment,VAS score,the maximum diameter of pelvic mass and the maximum depth of pelvic effusion in the combined group were sig

关 键 词：盆腔炎性疾病后遗症 盆腔痛 蒿芩清胆汤 灌汤1号 免疫功能 炎症因子 疗效 

分 类 号：R711.33[医药卫生—妇产科学]