龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕的疗效及作用机制

李姣; 林洁

doi:10.13422/j.cnki.syfjx.20192322

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龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕的疗效及作用机制

临床 | 更新时间：2021-02-09

- 龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕的疗效及作用机制
- Clinical Efficacy and Mechanism of Longdan Xiegantang in Treatment of Pelvic Inflammatory Infertility
- 中国实验方剂学杂志 2020年26卷第6期页码：85-90
- 作者机构：
  
  湖南中医药大学　第一附属医院，长沙　 410007
- 作者简介：
  
  [第一作者]　李姣，硕士，主治医师，从事中医妇产科临床工作，E-mail：985579807@qq.com
  *林洁，硕士，教授，主任医师，从事中西医结合治疗不孕症、反复流产及月经不调等工作，E-mail：linjie8919@126.com
- 基金信息：
  
  湖南省教育厅科学研究项目(2017B195)
- DOI：10.13422/j.cnki.syfjx.20192322
  中图分类号： R22; R242; R2-031;R287
- 收稿日期：2019-04-02，
  
  网络出版日期：2019-08-16，
  
  纸质出版日期：2020-03-20
- 稿件说明：
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李姣, 林洁. 龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕的疗效及作用机制[J]. 中国实验方剂学杂志, 2020,26(6):85-90.

Jiao LI, Jie LIN. Clinical Efficacy and Mechanism of Longdan Xiegantang in Treatment of Pelvic Inflammatory Infertility[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(6): 85-90.
李姣, 林洁. 龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕的疗效及作用机制[J]. 中国实验方剂学杂志, 2020,26(6):85-90. DOI： 10.13422/j.cnki.syfjx.20192322.

Jiao LI, Jie LIN. Clinical Efficacy and Mechanism of Longdan Xiegantang in Treatment of Pelvic Inflammatory Infertility[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(6): 85-90. DOI： 10.13422/j.cnki.syfjx.20192322.

摘要

目的：

观察龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕的临床疗效，并探讨其治疗的作用机制。

方法：

选择湖南中医药大学第一附属医院2017年1月至2018年12月收治的150例湿热瘀结型盆腔炎性不孕患者为研究对象，按照随机数字表法分为对照组和观察组，每组75例，对照组给予抗生素联合肝胆双清颗粒治疗，观察组给予龙胆泻肝汤联合抗生素治疗，两组均连续治疗6周。比较两组患者的临床疗效、中医证候积分、血液流变学及血清生化指标、炎症因子水平和免疫功能指标。

结果：

观察组总有效率93.33%(70/75)，高于对照组的78.67%(59/75)(

＝6.480，

0.05)。观察组妊娠率58.33%，显著高于对照组的33.82%(

＝8.862，

0.01)。治疗前两组患者的中医证候积分、血液流变学及血清生化指标、炎症因子水平和免疫功能指标差异无统计学意义。与本组治疗前比较，治疗后两组患者下腹腹痛、肛门坠胀、腰骶疼痛、带下异常和月经失调等中医证候积分降低(

0.05)；血液流变学指标血浆黏度、红细胞积压、全血黏度高切和低切水平降低(

0.05)；抑制素-A(INH-A)水平升高，孕酮(P)和

-绒毛膜促性腺激素(

-HCG)水平降低(

0.05)；血清C-反应蛋白(CRP)，白细胞介素-6(IL-6)和肿瘤坏死因子(TNF)-

水平降低(

0.05)；CD4

＋

和CD8

＋

水平升高(

0.05)；免疫球蛋白(Ig)A，IgG，IgM水平降低(

0.05)。与对照组治疗后比较，观察组下腹腹痛、肛门坠胀、腰骶疼痛、带下异常和月经失调等中医证候积分降低，血液流变学指标血浆黏度、红细胞积压、全血黏度高切和低切水平降低，INH-A水平升高，P和

-HCG水平显著降低，血清CRP，IL-6和肿瘤坏死因子(TNF-

)水平显著降低，CD4

＋

和CD8

＋

水平升高，IgA，IgG和IgM水平降低(

0.05)。两组患者在治疗期间未见明显不良反应。

结论：

龙胆泻肝汤治疗湿热瘀结型盆腔炎性不孕具有较好的临床疗效，可降低中医证候积分，提高妊娠率，其机制可能与改善血液流变学及血清生化指标，抑制炎症因子表达和增强免疫功能有关。

Abstract

Objective:

To observe the clinical efficacy of Longdan Xiegantang in the treatment of pelvic inflammatory infertility with damp-heat phlegm and phlegm

in order to explore its mechanism of action.

Method:

Totally 150 patients with phlegm and inflammatory pelvic inflammatory infertility admitted to First Hospital of Hunan University of Chinese Medicine from January 2017 to December 2018 were enrolled in the study. According to the random number

the patients were divided into control group and observation group

with 75 cases in each group. Control group was given antibiotics combined with Gandan Shuangqing granule

and observation group was given Longdan Xiegantang combined with antibiotics. Both groups were treated for 6 weeks. The clinical efficacy

traditional Chinese medicine (TCM) syndrome scores

blood rheology and serum biochemical parameters

inflammatory factor levels and immune function indexes of the two groups were compared.

Result:

The total effective rate of observation group was 93.33%

which was higher than 78.67% of control group (

=6.480

0.05). The pregnancy rate of observation group was 58.33%

which was significantly higher than 33.82% of control group (

=8.862

0.01). Before treatment

there was no significant difference in TCM syndrome score

hemorheology

serum biochemical index

inflammatory factor level and immune function between the two groups. Compared with before treatment

the TCM syndrome scores of lower abdominal pain

anal bulge

lumbosacral pain

abnormal bandage and menstrual disorders were significantly reduced

the levels of plasma viscosity

hematocrit

high and low-shear whole blood viscosity were significantly reduced

the level of inhibin-A (INH-A) was significantly increased

the level of progesterone (P) and beita chorionic gonadotropin (

-HCG) were significantly reduced

the levels of serum C-reactive protein (CRP)

interleukin-6 (IL-6) and tumor necrosis factor-

(TNF-

) were significantly decreased

the levels of CD4

and CD8

were significantly increased

and the levels of IgA

IgG and IgM were significantly decreased (

0.05). After treatment

in observation group

TCM syndrome scores of the lower abdominal pain

anal bulge

lumbosacral pain

abnormal bandage and menstrual disorders were significantly reduced

the levels of plasma viscosity

hematocrit

high and low-shear whole blood viscosity were significantly reduced

the level of INH-A was significantly increased

and the level of P and

-HCG were significantly reduced

the levels of serum CRP

IL-6

TNF-

were significantly decreased

the levels of CD4

and CD8

were significantly increased

and the levels of IgA

IgG and IgM were significantly decreased (

0.05). There was no obvious adverse reaction in two groups during the treatment.

Conclusion:

Longdan Xiegantang has a good clinical effect in treating pelvic inflammatory infertility with damp-heat phlegm and phlegm

and can reduce TCM syndrome scores

and increase pregnancy rate. The mechanism may be correlated with the improvement of blood rheology and serum biochemical indicators

the inhibition of inflammatory factors and the enhancement of immune function.

关键词

Keywords

references

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