中西医结合联合疗法治疗盆腔炎性疾病对患者血清TNF-α表达的影响

Effect of integrated Chinese-Western therapy on serum TNF-α expression in pelvic inflammatory disease

关键词:  盆腔炎性疾病  中药口服兼灌肠  芙蓉散  肿瘤坏死因子-α

Key words:  pelvic inflammatory disease  oral traditional Chinese medicine and enema  Hibiscus Powder  tumor necrosis factor-α

摘要:

[目的] 初步探讨治疗盆腔炎性疾病的可能作用机制,为临床提供有效的治疗方法及理论依据。[方法] 选择天津市南开医院盆腔炎性疾病住院患者110例。随机分为对照组(单纯抗生素治疗)和治疗组(抗生素治疗基础上中药口服兼灌肠并腹部外敷芙蓉散),各55例。连续用药14 d,对比观察两组患者治疗1周、治疗2周时与治疗前的临床疗效、盆腔包块、白细胞计数(WBC)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)的变化。[结果] 1)对照组、治疗组的总有效率分别为78.2%、92.7%,有统计学差异(P<0.05).2)用药1周时:对照组与治疗组比较盆腔包块大小无统计学差异(P>0.05),治疗组则与治疗前比较有统计学差异(P<0.05);用药2周时,对照组与治疗组均跟治疗前、治疗1周时比较均有统计学意义(P<0.05),而治疗组作用优于对照组。3)两组治疗前后血清TNF-α的变化与盆腔包块变化一致。4)两组治疗前WBC,CRP比较均无统计学差异(P>0.05);治疗后两组WBC,CRP均明显下降,且存在时间依赖性关系。治疗2周、治疗1周时均与治疗前比较WBC,CRP均有统计学差异(P<0.05),而治疗1周与治疗2周时两组间比较均无明显统计学差异(P>0.05). [结论] 抗生素治疗的基础上中药口服兼灌肠同时腹部芙蓉散外敷的中西医结合治疗方法明显提高临床疗效,明显减小盆腔包块,其机制可能与降低TNF-α的表达有关,值得临床进一步研究和推广使用。

Abstract:

[Objective] Preliminary study of the mechanism of pelvic inflammatory disease, and it may provide effective treatment methods and theoretical basis for clinic. [Methods] Select inpatient 110 cases of pelvic inflammatory disease of Tianjin Nankai Hospital. They were randomly divided into control group (simple antibiotic treatment) and the treatment group (based on antibiotic therapy, add oral traditional Chinese medicine and enema and abdominal topical Hibiscus Powder), 55 cases of each group. Continuous medication for 14 days, compared two groups who were cured for 1 week, 2 weeks of treatment and before treatment of changes about clinical efficacy, pelvic mass, white blood cell count (WBC), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α). [Results] 1) In the control group, the total efficiency of the treatment group was 78.2%, 92.7% in the treatment group, and it had significant difference (P<0.05). 2)The size of pelvic mass before treatment had no significant difference compared with the control group(P>0.05), and the treatment group was statistically significant compared with before treatment(P<0.05). Medication two weeks, both the control group and the treatment group compared with before treatment, 1 week later, there were significant differences(P<0.05), while the effect of the treatment group was better than the control group. 3)Changes in serum TNF-α was consistent with pelvic mass before and after treatment. 4) Before treatment, WBC, CRP showed no significant difference (P>0.05). After treatment, WBC, CRP were significantly decreased, being the time-dependent relationship. When the two weeks of treatment, one week of treatment were compared with before treatment, WBC and CRP were statistically significant (P<0.05). The comparison between one week of treatment and two weeks of treatment had no significant statistical difference in the two groups (P>0.05 ). [Conclusion] On the basis of antibiotic therapy, add oral traditional Chinese medicine and enema and abdominal topical Hibiscus Powder, this integrated Chinese-Western therapy obviously improve the clinical efficacy, reduce pelvic mass. The mechanism may be associated with decreased expression of TNF-α, and it is worthy of further research and application.