本文關(guān)鍵詞：加味敗藤合劑治療盆腔炎性疾病后遺癥濕熱瘀阻證的臨床研究　出處：《南京中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 加味敗藤合劑 濕熱瘀阻 盆腔炎性疾病后遺癥 血液流變學 血小板參數(shù) 炎性因子

【摘要】：目的：本研究旨在對加味敗藤合劑治療盆腔炎性疾病后遺癥濕熱瘀阻證進行臨床研究。以期通過比較量化評分、實驗室檢查的變化情況及對不良反應(yīng)事件的跟蹤控制,對其有效性及安全性作出評價。方法：選擇2015年1月-2016年1月于江蘇省中西醫(yī)結(jié)合醫(yī)院婦科門診就診病人共60例,嚴格按照納入、排除標準進行篩選。采用隨機對照的方法按1：1的比例分成兩組,治療組(口服加味敗藤合劑)與對照組(口服抗婦炎膠囊)各30例,共治療兩個療程。療程結(jié)束后觀察所有患者治療前后癥狀體征積分、相關(guān)療效指標及安全性指標的變化情況。結(jié)果：1.治療組中醫(yī)證候療效總有效率為96.7%,局部體征療效總有效率為100%,VAS評分有效率為100%,綜合療效總有效率為96.7%。對照組中醫(yī)證候療效總有效率為83.3%,局部體征療效總有效率為80%,VAS評分有效率為96.7%,綜合療效總有效率為80%。兩組相比,中醫(yī)證候療效、局部體征療效、綜合療效、VAS評分等各方而差異均有統(tǒng)計學意義。2.治療后兩組患者血液流變學各項指標(血漿黏度、全血高切、全血低切、血沉、血小板聚集率)較前均明顯下降(P0.05或P0.01)。治療組各項指標改善情況與對照組相比,組間有顯著性差異(P0.01)。治療前后差值組間比較,治療組在全血高切、全血低切、血小板聚集率等方而作用較對照組具有顯著性差異(P0.01)。對于改善血漿黏度及血沉方而,組間無明顯差異。3.治療后兩組患者血小板計數(shù)均較治療前降低,差異具有統(tǒng)計學意義(P0.05),治療后組間相比,差異無統(tǒng)計學意義。治療組平均血小板體積指數(shù)明顯上升(P0.01),對照組較治療前無明顯差異,組間差異具有統(tǒng)計學意義(P0.05)。4.治療后兩組患者CRP指標均得到明顯改善(P0.05),組間相比差異無統(tǒng)計學意義。5.治療后治療組患者TNF-α IL-6水平較治療前均明顯下降,差異有統(tǒng)計學意義(P0.05或P0.01)；對照組患者TNF-α水平較前下降(P0.05),IL-6治療前后差異無統(tǒng)計學意義；組間相比,治療組兩項指標變化情況較對照組差異具有統(tǒng)計學意義(P0.05或P0.01)。6.所有患者在治療期間均未出現(xiàn)毒副作用及其他不良反應(yīng)。結(jié)論：加味敗藤合劑治療盆腔炎性疾病后遺癥濕熱瘀阻證,在總有效率、具體癥狀體征評分、血流變指標、血小板參數(shù)、血清炎性因子等方而均較對照組優(yōu)勢明顯。本方能夠明顯緩解局部及全身癥狀,改善血流變狀態(tài),降低患者體內(nèi)炎性因子水平,其作用機理可能是通過調(diào)節(jié)體內(nèi)免疫因子水平,糾正免疫失調(diào)來達到治療的口的。本方有效性及安全性均較佳,值得在臨床中應(yīng)用和推廣。
[Abstract]:Objective: the purpose of this study was to treat pelvic inflammatory disease sequelae dampness and heat stasis syndrome with Jiawei Puteng mixture, and to compare the quantitative score. Changes in laboratory examination and tracking control of adverse events. Methods: a total of 60 gynecological outpatients from January 2015 to January 2016 in Jiangsu Provincial Integrated Chinese and Western Medicine Hospital were selected to evaluate their efficacy and safety. According to the ratio of 1: 1, the treatment group (30 cases) and the control group (30 cases) were divided into two groups. Two courses of treatment. After the course of treatment, all patients were observed before and after the treatment of symptoms and signs score. Results: 1. The total effective rate of TCM syndromes in the treatment group was 96.7. the total effective rate of local signs was 100%. The effective rate of VAS score was 100 and the total effective rate of comprehensive curative effect was 96.7.The total effective rate of TCM syndromes in the control group was 83.3 and the total effective rate of local signs was 80%. The effective rate of VAS score was 96.7 and the total effective rate of comprehensive curative effect was 80.Compared with traditional Chinese medicine syndrome curative effect, local sign effect and comprehensive curative effect. After treatment, the hemorheology indexes (plasma viscosity, whole blood high shear, whole blood low shear, whole blood low shear, erythrocyte sedimentation rate) were significantly different between the two groups. Platelet aggregation rate) were significantly decreased than before P0.05 or P0.01. the improvement of the treatment group compared with the control group. There was significant difference between the two groups (P 0.01). The difference before and after treatment was high and low in the treatment group. Compared with the control group, platelet aggregation rate had a significant difference (P 0.01). It could improve plasma viscosity and erythrocyte sedimentation rate (ESR). There was no significant difference between the two groups. 3. After treatment, the platelet count in the two groups was lower than that before treatment, the difference was statistically significant (P 0.05), and after treatment, there was a significant difference between the two groups. The mean platelet volume index in the treatment group was significantly higher than that in the control group (P 0.01), but there was no significant difference between the control group and the control group. The difference between the two groups was statistically significant (P0.05N. 4. after treatment, the CRP indexes of the two groups were significantly improved (P0.05). After treatment, the level of TNF- 偽 IL-6 in the treatment group was significantly lower than that before treatment, the difference was statistically significant (P0.05 or P0.01). The level of TNF- 偽 in the control group was lower than that in the former group, and there was no significant difference between the two groups before and after treatment. Group comparison. The changes of two indexes in the treatment group were significantly different from those in the control group (P0.05 or P0.01). All patients did not have toxic side effects and other adverse reactions during the treatment. Conclusion: Jiawei Baiteng mixture in the treatment of pelvic inflammatory disease sequelae damp-heat stasis syndrome. In the total effective rate, specific symptoms and signs score, hemorheological index, platelet parameters, serum inflammatory factors and other prescription and obvious advantages over the control group. This prescription can significantly alleviate local and systemic symptoms, improve the hemorheological state. Reduce the level of inflammatory factors in patients, its mechanism may be by regulating the level of immune factors in vivo, to correct immune disorders to achieve the oral treatment. The efficacy and safety of the prescription is better. It is worth applying and popularizing in clinic.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.9

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