摘要
目的:观察清热利湿化瘀方治疗湿热蕴结型盆腔炎性疾病后遗症的临床疗效及其对盆腔血瘀微环境及血清toll样受体4(TLR4)、SMAD同源物3(Smad3)、可溶性凋亡相关因子(sFas)的影响。方法:选取符合纳入标准的盆腔炎性疾病后遗症患者,共126例,按随机数字表法分为2组各63例。对照组给予常规西医治疗,观察组在常规西医治疗的基础上给予清热利湿化瘀方治疗,2组均连续治疗4周。观察治疗前后2组sFas、TLR4、肿瘤坏死因子-α(TNF-α)、血清高迁移率族蛋白1(HMGB1)、Smad3、转化生长因子-β1(TGF-β1)水平,检测子宫动脉最大血流速度(Vmax)、阻力指数(RI)、搏动指数(PI),测量炎性包块直径及盆腔积液的最大深径,评估2组中医证候评分及疼痛视觉模拟评分法(VAS)评分,比较2组临床疗效。结果:治疗后,2组sFas、TLR4、TNF-α、HMGB1、Smad3、TGF-β1、RI、PI均较治疗前降低,且观察组上述各项指标均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组Vmax均较治疗前升高,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,2组炎性包块直径、盆腔积液的最大深径、中医证候评分、疼痛VAS评分均较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。总有效率观察组96.83%,对照组88.89%,差异有统计学意义(P<0.05)。结论:清热利湿化瘀方治疗湿热蕴结型盆腔炎性疾病后遗症患者,可降低sFas、TLR4、TNF-α、HMGB1、Smad3、TGF-β1水平,抑制机体炎症状态,提升血流动力学,改善患者盆腔血瘀微环境状态,改善盆腔积液及炎性包块,缓解患者临床症状,提高临床疗效。
Objective:To observe the clinical effect of Qingre Lishi Huayu Prescription for sequelae of pelvic inflammatory disease of retention of damp-heat type,and its effect on pelvic blood stasis microenvironment,and toll-like receptor 4(TLR4),SMAD homologue 3(Smad3)and soluble apoptosis-related factors(sFAS)in serum.Methods:A total of 126 patients with sequelae of pelvic inflammatory disease who met the inclusion criteria were selected and randomly divided into two groups according to the random number table method,with 63 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with Qingre Lishi Huayu Prescription based on routine western medicine.Both groups were treated continuously for four weeks.In the two groups,sFas,TLR4,and levels of tumor necrosis factor-α(TNF-α),high mobility group protein 1(HMGB1),Smad3,and transforming growth factor-β1(TGF-β1)in serum were observed before and after treatment.The maximum blood flow velocity(Vmax),resistance index(RI),and pulsation index(PI)of the uterine artery were detected.The diameter of inflammatory masses and the maximum depth of pelvic fluid accumulation were measured.The traditional Chinese medicine(TCM)syndrome scores and pain in Visual Analogue Scale(VAS)scores were evaluated in the two groups.The clinical effects were compared between the two groups.Results:After treatment,sFas,TLR4,TNF-α,HMGB1,Smad3,TGF-β1,RI and PI in the two groups were decreased when compared with those before treatment,and the above indexes in the observation group were lower than those in the control group,differences being significant(P<0.05).After treatment,Vmax in both groups were increased when compared with those before treatment,and the one in the observation group was higher than that in the control group,the difference being significant(P<0.05).After treatment,the diameters of inflammatory masses,maximum depth of pelvic fluid accumulation,TCM syndrome scores,and pain in VAS scores in the two groups were decreased when compared with those before treatment,and the indexes in the observation group were lower than those in the control group,differences being significant(P<0.05).The total effective rate was 96.83%in the observation group and 88.89%in the control group,the difference being significant(P<0.05).Conclusion:The Qingre Lishi Huayu Prescription can reduce levels of sFas,TLR4,TNF-α,HMGB1,Smad3 and TGF-β1 in patients with sequelae of pelvic inflammatory disease of retention of damp-heat type,suppress the inflammatory state of the body,improve hemodynamics,pelvic blood stasis microenvironment,pelvic fluid accumulation and inflammatory masses,alleviate clinical symptoms,and enhance clinical effects.
作者
李兴华
李芳
于瑞蒙
范道燕
陈营营
LI Xinghua;LI Fang;YU Ruimeng;FAN Daoyan;CHEN Yingying(Department of Gynecology,Puyang Hospital of Traditional Chinese Medicine,Puyang Henan 457000,China)
出处
《新中医》
CAS
2023年第20期94-99,共6页
New Chinese Medicine
基金
中国科学技术协会青年人才托举工程项目(2021-RNRC2-B06)
作者简介
李兴华(1983-),女,医学硕士,副主任医师,E-mail:xiadaili006@126.com。
