少腹逐瘀颗粒联合头孢他啶治疗慢性盆腔炎（气滞血瘀型）的随机对照研究

doi:10.3760/cma.j.issn.1007-1245.2022.11.022

摘要/Abstract

摘要： 目的　观察少腹逐瘀颗粒联合头孢他啶治疗慢性盆腔炎（CPID）（气滞血瘀型）的效果，为疾病治疗方案选择提供参考。方法　选取2019年6月至2021年6月海丰县妇幼保健院接诊的CPID（气滞血瘀型）患者112例进行前瞻性研究，以随机数字表法分为联合组、参照组，各56例。其中联合组年龄（38.58±8.03）岁，病程（5.05±1.66）年；参照组年龄（36.89±7.34）岁，病程（4.67±1.72）年。参照组予以头孢他啶治疗，联合组在参照组基础上联用少腹逐瘀颗粒治疗，均治疗2周。应用χ²检验比较两组疗效、不良反应、治疗后3个月、6个月复发率，配对t检验与独立样本t检验比较两组治疗前后盆腔包块长径、盆腔积液深度、血液流变学指标（高切全血比黏度、血浆比黏度、低切全血比黏度、红细胞比容）水平差异。结果　联合组总有效率高于参照组［89.29%（50/56）比71.43%（40/56）］（χ²=5.657，P=0.017），联合组不良反应总发生率与参照组比较［12.50%（7/56）比16.07%（9/56）］差异无统计学意义（χ²=0.292，P=0.589）；联合组治疗2周后盆腔包块长径、盆腔积液深度及高切全血比黏度、血浆比黏度、低切全血比黏度、红细胞比容分别为（1.06±0.38）cm、（1.42±0.48）cm、（2.86±0.49）mPa·s、（1.28±0.35）mPa·s、（6.41±1.56）mPa·s、（42.38±3.45）%，均低于参照组的（2.88±0.57）cm、（1.96±0.55）cm、（3.95±0.53）mPa·s、（1.77±0.38）mPa·s、（9.79±1.97）mPa·s、（45.07±4.02）%，两组比较差异均有统计学意义（t=19.881、5.536、11.301、7.098、10.066、3.800，均P<0.001）；治疗后3个月、6个月，联合组复发率低于参照组［1.82%（1/55）比14.55%（8/55）、7.41%（4/54）比25.93%（14/54）］，差异均有统计学意义（χ²=4.356、6.667，P=0.037、0.010）。结论　使用少腹逐瘀颗粒联合头孢他啶治疗CPID（气滞血瘀型）患者可改善血液流变学，促进盆腔包块及盆腔积液消退，增强疗效，减少复发，且可获得良好安全性。

关键词: 少腹逐瘀颗粒, 头孢他啶, 慢性盆腔炎, 气滞血瘀型, 血液流变学, 盆腔包块, 复发率

Abstract: Objective　To observe the effect of Shaofu Zhuyu granule combined with ceftazidime in the treatment of chronic pelvic inflammatory disease (CPID) and to provide references for the selection of a disease treatment scheme. Methods　One hundred and twelve patients with CPID admitted to Maternal and Child Health Center of Haifeng County from June 2019 to June 2021 were selected for the prospective study. They were divided into a combined group and a reference group by the random number table method, with 56 cases in each group. The combined group was (38.58 ± 8.03) years old, with a disease course of (5.05±1.66) years. The reference group was (36.89 ± 7.34) years old, with a disease course of (4.67±1.72) years. The reference group was treated with ceftazidime, and the combined group with Shaofu Zhuyu granule and ceftazidime, for 2 weeks. The curative effects, adverse reactions, and recurrence rates 3 and 6 months after the treatment were compared between the two groups by the χ² test, and the pelvic mass diameters, pelvic effusion depths, and hemorheological indexes (high shear whole blood specific viscosity, plasma specific viscosity, low shear whole blood specific viscosity, and hematocrit) before and after the treatment by the paired t test and independent-sample t test. Results　The total effective rate of the combined group was higher than that of the reference group [89.29% (50/56) vs. 71.43% (40/56); χ²=5.657, P=0.017). There was no statistical difference in the total incidence of adverse reactions between the combined group and the reference group [12.50% (7/56) vs. 16.07% (9/56); χ²=0.292, P=0.589]. After 2 weeks' treatment, the diameter of pelvic mass, depth of pelvic effusion, high shear whole blood specific viscosity, plasma specific viscosity, low shear whole blood specific viscosity, and hematocrit in the combined group were (1.06±0.38) cm, (1.42±0.48) cm, (2.86±0.49) mPa·s, (1.28±0.35) mPa·s, (6.41 ± 1.56) mPa·s, and (42.38 ± 3.45)%, which were lower than those in the reference group [(2.88±0.57) cm, (1.96±0.55) cm, (3.95±0.53) mPa·s, (1.77±0.38) mPa·s, (9.79±1.97) mPa·s, and (45.07±4.02)%] (t=19.881, 5.536, 11.301, 7.098, 10.066, and 3.800; all P<0.001). Three and six months after the treatment, the recurrence rates in the combined group were lower than those in the reference group [1.82% (1/55) vs. 14.55% (8/55) and 7.41% (4/54) vs. 25.93% (14/54); χ²=4.356 and 6.667, P=0.037 and 0.010]. Conclusion　Shaofu Zhuyu granule combined with ceftazidime in the treatment of patients with CPID can improve hemorheology, promote the regression of pelvic mass and pelvic effusion, enhance curative effect, reduce recurrence, and obtain good safety.

Key words: Shaofu Zhuyu granule, Ceftazidime, Chronic pelvic inflammatory disease, Qi stagnation and blood stasis type, Hemorheology, Pelvic mass, Recurrence rate

林诗鹏, 陈芙蓉, 郑赛媚. 少腹逐瘀颗粒联合头孢他啶治疗慢性盆腔炎（气滞血瘀型）的随机对照研究[J]. 国际医药卫生导报, 2022, 28(11): 1574-1578.

Lin Shipeng, Chen Furong, Zheng Saimei. Randomized controlled study of Shaofu Zhuyu granule combined with ceftazidime in treatment of chronic pelvic inflammatory disease [J]. International Medicine and Health Guidance News, 2022, 28(11): 1574-1578.

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