常规药物治疗联合藤菊灌肠液治疗慢性盆腔炎的效果观察_吴亦民.pdf

论著 社区中医药CHINESE COMMUNITY DOCTORS中国社区医师2023年第39卷第2期慢性盆腔炎是妇科常见疾病，以下腹部坠胀痛和腰骶酸痛于经期前后或过度劳累时加剧为主要症状，常伴有月经失调，如经期延长、痛经、白带增多、性状改变等1。主要感染因素为多种微生物、细菌等病常规药物治疗联合藤菊灌肠液治疗慢性盆腔炎的效果观察吴亦民蔡益锐518000深圳平乐骨伤科医院(深圳市坪山区中医院)，广东 深圳doi:10.3969/j.issn.1007-614x.2023.02.034摘要目的：探讨常规药物治疗联合藤菊灌肠液治疗慢性盆腔炎的效果。方法：选取2021年1月-2022年6月深圳平乐骨伤科医院收治的143例慢性盆腔炎患者为研究组，并选取同期收治的143例慢性盆腔炎患者为对照组，对照组开展常规药物口服治疗，研究组在对照组基础上给予藤菊灌肠液治疗。比较两组治疗前后症状与体征积分，症状显著减轻与消失时间、治疗总有效率。结果：治疗前，两组疼痛、月经失调、白带、发热乏力积分比较，差异无统计学意义(P0.05)；治疗后，两组疼痛、月经失调、白带、发热乏力积分低于治疗前，且研究组低于对照组，差异有统计学意义(P0.05)。治疗前，两组子宫压痛、增粗、肿物、压痛积分比较，差异无统计学意义(P0.05)；治疗后，两组子宫压痛、增粗、肿物、压痛积分低于治疗前，且研究组低于对照组，差异有统计学意义(P0.05)。研究组疼痛、月经失调、白带、发热乏力症状显著减轻与消失时间短于对照组，差异有统计学意义(P0.05)。研究组治疗总有效率高于对照组，差异有统计学意义(P0.05)。结论：在慢性盆腔炎患者的治疗中，增加藤菊灌肠液辅助治疗，可显著改善患者的相关症状、体征表现，明显缩短患者治疗后相关症状、体征减轻与消失时间，改善治疗效果。关键词藤菊灌肠液；慢性盆腔炎；症状积分；体征积分Observation on Effect of Conventional Drug Treatment Combined with Tengju Enema in Treatment of Chronic PelvicInflammatory DiseaseWu Yi-min,Cai Yi-ruiShenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan Hospital of Traditional Chinese Medicine),Shenzhen 518000,GuangdongProvince,ChinaAbstractObjective:To explore the effect of conventional drug treatment combined with Tengju enema in the treatment of chronicpelvic inflammatory disease.Methods:A total of 143 patients with chronic pelvic inflammatory disease who were treated inShenzhen Pingle Orthopedic Hospital from January 2021 to June 2022 were selected as the study group.During the same period,143 patients with chronic pelvic inflammatory disease as the control group.The control group received oral treatment withconventional drugs,and the study group received Tengju enema treatment on the basis of control group.The scores of symptomsand signs before and after treatment,the time of significant symptom relief and disappearance and the treatment effect werecompared between the two groups.Results:Before treatment,there was no significant difference in the scores of pain,menstrualdisorders,white vaginal discharge,fever and fatigue between the two groups(P0.05).After treatment,the scores of pain,menstrual disorders,white vaginal discharge,fever and fatigue in the two groups were lower than those before treatment,and thestudy group was lower than the control group,and the difference was statistically significant(P0.05).Aftertreatment,the uterine tenderness,thickening,mass and tenderness scores in the two groups were lower than those before treatment,and the study group was lower than the control group,and the difference was statistically significant(P0.05).The time ofsignificant relief and disappearance for symptoms of pain,menstrual disorders,white vaginal discharge,fever and fatigue in thestudy group were shorter than that in the control group,and the difference was statistically significant(P0.05).The overalleffective rate of treatment in the study group was higher than that in the control group,and the difference was statisticallysignificant(P0.05).Conclusion:In the treatment of patients with chronic pelvic inflammatory disease,the implementation ofTengju enema treatment can significantly improve the relevant symptoms and signs of patients,significantly shorten the time ofrelief and disappearance of the relevant symptoms and signs after treatment,and improve the treatment effect.Key wordsTengju enema;Chronic pelvic inflammatory disease;Symptom score;Sign score102论著 社区中医药CHINESE COMMUNITY DOCTORS中国社区医师2023年第39卷第2期原体通过女性生殖器创伤处的淋巴管上行感染，侵入身体其他系统再经血循传播，或感染盆腔中其他脏器后直接蔓延，最终引起内生殖器、盆腔腹膜、结缔组织的感染2。通常病程迁延，具有缠绵难愈，容易复发等特点。目前通常采用抗生素治疗，但是长久用药容易产生耐药，甚至诱发菌群失调3。我国传统医学认为，对于慢性盆腔炎开展中药灌肠配合常规治疗，能够缩短病程，提高治愈率，效果较好4。藤菊灌肠液为我院经验协定处方，用于保留灌肠治疗盆腔炎，本研究旨在探讨藤菊灌肠液治疗慢性盆腔炎的效果，现报告如下。资料与方法选取2021年1月-2022年6月深圳平乐骨伤科医院收治的143例慢性盆腔炎患者为研究组，给予藤菊灌肠液治疗，并选取同期收治的慢性盆腔炎患者(143例)为对组，仅开展常规药物口服治疗。研究组年龄2049岁，平均(27.233.28)岁；病程27年，平均(4.110.57)年。对照组年龄 1947 岁，平均(28.432.51)岁；病程28年，平均(4.220.63)年。两组患者基本资料比较，差异无统计学意义(P0.05)，具有可比性。纳入标准：患者符合慢性盆腔炎的诊断标准；患者具有相关的临床表现；患者签署治疗同意书；患者年龄2050岁。排除标准：合并心肝肾重要脏器疾病者；过敏体质者或药物过敏者；精神疾患者；近期服用相似或相拮抗作用药物者；准备生育或处于哺乳期者；不愿合作或无法合作者。方法：对照组开展妇科千金片口服，配合抗生素(如头孢类)口服治疗。研究组在对照组基础上给予藤菊灌肠液治疗，方药由红藤30 g，野菊花15 g，败酱草 15 g 组成，取以上药材加冷水 500600 mL 浸泡30 min，煎煮至药液100200 mL，滤过药液温度冷却至30左右备用。灌肠前先让患者排空大小便，避开经期，用润滑过的导管插入肛门1015 cm，药液用1次性灌肠袋连接导管缓缓灌入80150 mL，根据患者耐受程度保留灌肠30120 min。1次/d。10天为1个疗程。必要时可连续23个疗程。观察指标及疗效判定标准：观察两组患者治疗前后症状积分、体征积分，症状包括疼痛、月经失调、白带、发热乏力4项，体征包括子宫压痛、输卵管增粗、肿物、压痛4项。上述每项评分03分，症状与体征满分 12 分，分数越高代表症状与体征越严重。观察两组患者症状显著减轻与消失时间。观察两组患者治疗效果，a.痊愈：症状缓解，体征消失；b.显效：症状显著好转，超声下轻微异常；c.有效：症状好转，局部有轻压痛；d.无效：不满足以上标准5。总有效率=(痊愈+显效+有效)/总例数100%。统计学方法：数据运用SPSS 22.0统计学软件分析；计量资料以(xs)表示，采用t检验；计数资料以n(%)表示，采用2检验；P0.05为差异有统计学意义。结果两组治疗前后症状积分比较：治疗前，两组疼痛、月经失调、白带、发热乏力积分比较，差异无统计学意义(P0.05)；治疗后，两组疼痛、月经失调、白带、发热乏力积分低于治疗前，且研究组低于对照组，差异有统计学意义(P0.05)。见表1。两组治疗前后体征积分比较：治疗前，两组子宫压痛、增粗、肿物、压痛积分比较，差异无统计学意义(P0.05)；治疗后，两组子宫压痛、增粗、肿物、压痛积分低于治疗前，且研究组低于对照组，差异有统计学意义(P0.05)。见表2。两组症状显著减轻与消失时间比较：研究组疼痛、月经失调、白带、发热乏力症状显著减轻与消失时间短于对照组，差异有统计学意义(P0.05)。见表3。两组治疗效果比较：研究组治疗总有效率高于对照组，差异有统计学意义(P0.05)。见表4。表1两组治疗前后症状积分比较(xs，分)组别n疼痛月经失调白带发热乏力治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后研究组1433.280.410.760.57*2.910.280.480.21*2.820.310.