1、新中医2023年2月第55卷第4期NEW CHINESE MEDICINEFebruary 2023 Vol.55 No.4收稿日期 2022-02-10修回日期 2022-11-18作者简介张伟（1982-），男，主管药师，E-mail：。银花泌炎灵片联合抗生素治疗湿热瘀阻证盆腔炎性疾病后遗症临床研究张伟1，白雪钗2，卢丹英31.德清县人民医院药剂科，浙江 德清 3132002.浙江省人民医院妇科，浙江 杭州 3100143.德清县人民医院中医科，浙江 德清 313200摘要目的：观察银花泌炎灵片联合抗生素治疗湿热瘀阻证盆腔炎性疾病后遗症（PID）的临床疗效及其对血清白细胞介素-6（IL-6
2、）、白细胞介素-8（IL-8）水平的影响。方法：选取 PID 患者 64 例，按随机数字表法分为治疗组和对照组各 32 例。对照组给予奥硝唑片、左氧氟沙星片等常规抗菌治疗，治疗组在对照组的基础上加用银花泌炎灵片治疗。2 组均治疗 3 个月经周期。比较 2 组血常规指标、湿热瘀阻证证候评分、IL-6、IL-8 水平及总体临床疗效。结果：治疗组总有效率为 96.88%，对照组为 75.00%，2 组比较，差异有统计学意义（P0.05）。治疗前，2 组白细胞计数、中性粒细胞比例比较，差异无统计学意义（P0.05）；治疗后，2 组白细胞计数、中性粒细胞比例均较治疗前显著降低（P0.05），且治疗组 2
3、 项指标均低于对照组（P0.05）。治疗前，2 组下腹胀痛且痛处固定、腰骶胀痛、带下量多、白带色黄质稠、低热起伏、神疲乏力、月经量多、小便黄赤、大便干燥等中医证候评分比较，差异无统计学意义（P0.05）；治疗后，2 组上述各项中医证候评分均较治疗前明显降低（P0.05），且治疗组各项证候评分均低于对照组（P0.05）。治疗前，2 组血清 IL-6、IL-8 水平比较，差异无统计学意义（P0.05）；治疗后，2 组 IL-6、IL-8 水平均较治疗前明显降低（P0.05），且治疗组 2 项指标均低于对照组（P0.05）。结论：银花泌炎灵片联合抗生素治疗湿热瘀阻证 PID 能进一步抑制炎症反应，明
4、显改善中医证候，疗效优于单纯抗生素治疗。关键词盆腔炎性疾病后遗症；湿热瘀结证；银花泌炎灵片；抗生素；炎症因子中图分类号R711.33文献标志码A文章编号0256-7415（2023）04-0108-04DOI：10.13457/ki.jncm.2023.04.024Clinical Study on Yinhua Miyanling Tablets Combined with Antibiotics for Sequelae ofPelvic Inflammatory Disease with Damp-Heat Stagnation SyndromeZHANG Wei，BAI Xuechai
5、，LU DanyingAbstract：Objective：To observe the clinical effect of Yinhua Miyanling Tablets combined withantibiotics for sequelae of pelvic inflammatory disease(PID)with damp-heat stagnation syndrome and itseffect on levels of interleukin-6(IL-6)and interleukin-8(IL-8)in serum.Methods：A total of 64 cas
6、es ofpatients with sequelae of PID were selected and divided into the treatment group and the control groupaccording to the random number table method，with 32 cases in each group.The control group was givenroutine antimicrobial therapy including Ornidazole Tablets and Levofloxacin Tablets，and the tr
7、eatmentgroup was additionally treated with Yinhua Miyanling Tablets based on the treatment of the control group.Both groups were treated for 3 menstrual cycles.The blood routine indexes，syndrome scores of damp-heat stagnation syndrome，levels of IL-6 and IL-8 in serum，and total clinical effects were
8、comparedbetween the two groups.Results：The total effective rate was 96.88%in the treatment group and 75.00%108新中医2023年2月第55卷第4期NEW CHINESE MEDICINEFebruary 2023 Vol.55 No.4盆腔炎性疾病（PID）后遗症多由急性盆腔炎治疗不当或因患者体质较差使病情迁延不愈所致，其病程较长，且易反复发作。现代医学治疗 PID 后遗症常以抗生素控制病情为主，但总体效果一般，且长期服用抗生素易引起耐药性1。中医学认为，PID 后遗症归属于癥瘕、不孕等
9、范畴，湿、热、瘀、毒是重要致病因素，湿瘀互结、留滞冲任胞脉为核心病机2。中医临床治疗 PID 后遗症多以清热解毒、活血利湿为主。笔者近年来观察银花泌炎灵片联合抗生素治疗湿热瘀阻证 PID 后遗症的临床疗效，结果报道如下。1临床资料1.1诊断标准PID 后遗症诊断参考妇产科学3中相关标准。有盆腔炎性疾病病史，且盆腔疼痛超过6 个月，给予非阿片类药治疗无效果；存在腰骶酸痛、下腹疼痛、坠胀，经行期加重，白带异常，月经失调；子宫呈后位，宫体、附件压痛和活动受限，或伴有单侧或双侧附件区增厚并能触及包块；影像学检查示盆腔有积液。1.2辨证标准参考 中药新药临床研究指导原则（试行）4中湿热瘀结证标准。主症：
10、下腹胀痛（或刺痛）且痛处固定、腰骶胀痛、带下量多、色黄质稠；次症：低热起伏、神疲乏力、经期腹痛加重、月经量多（或伴经期延长）、小便黄赤、大便干燥；舌脉：舌质（暗）红，或边尖瘀点或瘀斑，苔黄腻或白腻，脉弦涩或弦滑。1.3纳入标准符合上述诊断及辨证标准；年龄2060 岁；入组前 1 个月内未给予相关治疗；知情且签署知情同意书。1.4排除标准合并盆腔肿瘤、阴道炎以及子宫内膜异位症等疾病；患精神疾病；伴心、肺、肝、肾、血液系统等严重功能障碍；用药依从性差；对本研究使用药物过敏；既往有盆腔手术或盆腔疾病史。1.5一般资料选取 2018 年 6 月2021 年 6 月德清县人民医院收治的 PID 后遗症患
11、者 64 例，按随机数字表法分为治疗组和对照组各 32 例。治疗组年龄2843 岁，平均（34.554.40）岁；病程 1027 个月，平均（14.412.29）个月。对照组年龄 2744 岁，in the control group，the difference being significant(P0.05).Before treatment，there was no significantdifference being found in the comparison of white blood cell counts and neutrophil proportion between
12、 thetwo groups(P0.05).After treatment，the white blood cell counts and neutrophil proportion in the twogroups were significantly decreased when compared with those before treatment(P0.05)，and the twoindexes in the treatment group were lower than those in the control group(P0.05).Before treatment，ther
13、e was no significant difference being found in the comparison of scores of traditional Chinese medicine(TCM)syndromes including distending pain in lower abdominal，fixation in pain place，distending pain inlumbosacral spine，large leukorrhea amount，yellow and thick leukorrhea，alternative low-grade feve
14、r，mental fatigue and lack of strength，large menstrual volume，brown urine and dry stool between the twogroups(P0.05).After treatment，the above TCM syndrome scores in the two groups were significantlydecreased when compared with those before treatment(P0.05)，and the above TCM syndrome scores inthe tre
15、atment group were lower than those in the control group(P0.05).Before treatment，there was nosignificant difference being found in the comparison of levels of IL-6 and IL-8 in serum between the twogroups(P0.05).After treatment，the levels of IL-6 and IL-8 in serum in the two groups were significantlyd
16、ecreased when compared with those before treatment(P0.05)，and the two indexes in the treatmentgroup were lower than those in the control group(P0.05).Conclusion：Yinhua Miyanling Tabletscombined with antibiotics for PID with damp-heat stagnation syndrome can further inhibit inflammatoryresponses and significantly improve TCM syndromes，whose curative effect is better than that of simpleantibiotics.Keywords：Sequelae of pelvic inflammatory disease；Damp-heat stagnation syndrome；YinhuaMiyanling Tablet