| 引用本文:金志国1，王程荣2，曾会军3.消癥解毒饮协定方联合阿奇霉素改善慢性盆腔炎患者血液微循环的效果观察[J].世界中医药,2020,(01):. |
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| 消癥解毒饮协定方联合阿奇霉素改善慢性盆腔炎患者血液微循环的效果观察 |
| Effects of Xiaozheng Jiedu Decoction Combined with Azithromycin on Improving Blood Microcirculation in Patients with Chronic Pelvic Inflammatory Disease |
| 投稿时间：2018-11-29 |
| DOI：10.3969/j.issn.1673-7202.2020.01.016 |
| 中文关键词: 慢性盆腔炎 消癥解毒饮协定方 盆腔包块直径 血液微循环 GM-CSF VCAM-1 MCP-1 临床研究 |
| English Keywords:Chronic pelvic inflammatory disease Xiaozheng Jiedu Decoction Diameter of pelvic mass Blood microcirculation GM-CSF VCAM-1 MCP-1 Clinical research |
| 基金项目:首都卫生发展科研专项项目-自主创新项目（首发2014-2-2081） |
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| 中文摘要: |
| 目的：探讨消癥解毒饮协定方联合阿奇霉素改善慢性盆腔炎患者血液微循环的效果及对外周血粒细胞-巨噬细胞集落刺激因子（GM-CSF）、血管细胞黏附分子-1（VCAM-1）、单核细胞趋化蛋白-1（MCP-1）水平的影响。方法：选取2017年2月至2018年4月南昌大学第三附属医院收治的慢性盆腔炎患者100例作为研究对象，按照随机数字表法分为对照组和观察组，每组50例。对照组患者给予阿奇霉素片口服，0.5 g/次，1次/d；观察组患者在对照组基础上加用消癥解毒饮协定方内服。2组均以7 d为1个疗程，连续治疗3个疗程。比较2组治疗的临床效果，通过超声检查测量患者治疗前后盆腔包块平均直径，评价中医证候积分，监测患者治疗前后卵巢动脉血流状况及外周血GM-CSF、VCAM-1、MCP-1水平，记录治疗过程中患者的不良反应。结果:观察组有效率90.3%，明显高于对照组的72.0%，2组比较差异有统计学意义（P<0.05）。治疗前，2组患者盆腔包块直径、中医证候总积分、卵巢血流动力学各指标以及外周血GM-CSF、VCAM-1、MCP-1水平差异均无统计学意义（P>0.05）；治疗后，2组患者盆腔包块直径较治疗前缩小，中医证候总积分明显下降，卵巢动脉PSV、PI、RI值均高于治疗前，外周血GM-CSF、VCAM-1、MCP-1水平低于治疗前，同组治疗前后比较，差异有统计学意义（P<0.05）；治疗后，观察组患者盆腔包块直径更小，中医证候总积分更低，卵巢动脉PSV、PI、RI值更高，外周血GM-CSF、VCAM-1、MCP-1水平更低，2组以上各指标比较差异均有统计学意义（均P<0.05）。治疗过程中，观察组不良反应发生率8.0%，明显低于对照组的20.0%，2组比较差异有统计学意义（P<0.05）。结论:消癥解毒饮协定方联合阿奇霉素治疗慢性盆腔炎利于缩小盆腔包块、缓解盆腔疼痛，改善卵巢血流动力，降低外周血GM-CSF、VCAM-1、MCP-1水平，以减轻盆腔组织的炎性浸润，用药安全性更高，值得临床推广运用。 |
| English Summary: |
| To investigate the effect of Xiaozheng Jiedu Decoction combined with azithromycin on improving blood microcirculation in patients with chronic pelvic inflammatory disease and the peripheral blood Granulocyte macrophage colony stimulating factor-(Granulocyte macrophage-colony stimulating factor，GM-CSF)，vessel cell adhesion molecule-1(VCAM-1)and monocyte chemokinin-1(MCP-1)levels.Methods:A total of 100 patients with chronic pelvic inflammatory disease admitted to The Third Affiliated Hospital of Nanchang University from February 2017 to April 2018 were selected and divided into a control group and an observation group according to the random number table method.Patients in the control group were given azithromycin tablets orally，0.5 g/time，1 time/d.The observation group patients in the control group were added oral administration of Xiaozheng Jiedu Decoction，7 days for 1 course of treatment，continuous treatment for 3 courses of treatment.The clinical effects of the 2 groups of patients were compared.The average diameter of pelvic masses before and after treatment was measured by ultrasonic examination.The TCM syndrome score was evaluated.The blood flow status of ovarian artery and the levels of GM-CSF，VCAM-1 and MCP-1 in peripheral blood of the patients before and after treatment were monitored，and adverse reactions of the patients during the treatment were recorded.Results:The effective rate of 90.3% in the observation group was significantly higher than 72.0% in the control group，and the difference was statistically significant(P<0.05).Before treatment，there was no statistically significant difference in pelvic mass diameter，TCM syndrome total score，ovarian hemodynamic indexes，peripheral blood GM-CSF，VCAM-1 and MCP-1 levels between the 2 groups(P>0.05).After treatment，the diameter of pelvic masses in the 2 groups was slightly smaller than that before treatment.The total score of TCM syndromes was significantly decreased.The PSV，PI and RI values of the ovarian artery were significantly higher than that before treatment，and the levels of GM-CSF，VCAM-1 and MCP-1 in peripheral blood were significantly lower than those before treatment.The difference was statistically significant before and after treatment in the same group(P<0.05).Compared between the 2 groups，the observation group showed smaller pelvic mass diameter，lower TCM syndrome total score，higher PSV，PI and RI values of ovarian artery，and lower levels of GM-CSF，VCAM-1 and MCP-1 in peripheral blood(P<0.05).During the treatment，the incidence of adverse reactions in the observation group was 8.0%，significantly lower than the incidence of adverse reactions in the control group of 20.0%.The drug safety of the observation group was higher，and the difference was statistically significant(P<0.05).Conclusion:Xiaozheng Jiedu Decoction combined with azithromycin has an ideal effect in the treatment of chronic pelvic inflammation，which is beneficial to reduce pelvic mass，relieve pelvic pain，improve ovarian hemodynamics，reduce peripheral blood GM-CSF，VCAM-1 and MCP-1 levels to reduce inflammatory infiltration of pelvic tissue，and is worthy of clinical application. |
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