目的 探討金雞化瘀顆粒聯(lián)合阿奇霉素治療慢性盆腔炎的臨床效果。方法 選取2016年6月-2018年8月唐山市豐潤(rùn)區(qū)中醫(yī)醫(yī)院收治的94例慢性盆腔炎患者，隨機(jī)分成對(duì)照組（n=47）和治療組（n=47）。其中對(duì)照組口服阿奇霉素片，0.5 g/次，1次/d。治療組在此基礎(chǔ)上口服金雞化瘀顆粒，10 g/次，3次/d。所有患者均治療14 d。比較兩組臨床療效及治療前后主癥積分變化；并于治療前后，行常規(guī)婦科B超檢查測(cè)量患者輸卵管直徑和盆腔包塊直徑，使用魏氏法測(cè)定紅細(xì)胞沉降率（ESR），由血常規(guī)檢查測(cè)定血小板計(jì)數(shù)（PLT）值，同時(shí)利用酶聯(lián)免疫法檢測(cè)兩組患者血清腫瘤壞死因子（TNF）-α、白介素（IL）-4水平，分別采用免疫比濁法和化學(xué)發(fā)光法分析血清C反應(yīng)蛋白（CRP）、糖蛋白抗原125（CA₁₂₅）水平；匯總兩組不良反應(yīng)及隨訪(fǎng)6個(gè)月的復(fù)發(fā)情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別是83.0%、95.7%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。與治療前相比，兩組治療后各項(xiàng)主癥（下腹脹痛或刺痛、腰骶脹痛、帶下量多、帶下色黃質(zhì)稠或氣臭）積分均顯著降低（P<0.05）；但治療組下降更顯著（P<0.05）。兩組治療后輸卵管直徑、盆腔包塊直徑較治療前均顯著縮短（P<0.05），且治療組減小更顯著（P<0.05）。與治療前對(duì)比，兩組治療后ESR、PLT值及血清TNF-α、CRP、CA₁₂₅濃度均顯著降低（P<0.05），而血清IL-4水平均顯著升高（P<0.05）；且治療后，治療組上述指標(biāo)（ESR、PLT、TNF-α、IL-4、CRP、CA₁₂₅）的改善效果均顯著優(yōu)于對(duì)照組同期（P<0.05）。隨訪(fǎng)6個(gè)月，對(duì)照組和治療組的復(fù)發(fā)率分別是25.5%、8.5%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 金雞化瘀顆粒聯(lián)合阿奇霉素治療慢性盆腔炎的整體療效顯著，可有效緩解患者癥狀，改善輸卵管形態(tài)，縮小盆腔包塊，糾正血瘀狀態(tài)，正性調(diào)控體內(nèi)促炎/抗炎因子表達(dá)，降低復(fù)發(fā)風(fēng)險(xiǎn)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of jinji Huayu Granules combined with azithromycin in treatment of chronic pelvic inflammation. Methods 94 Patients with chronic pelvic inflammatory admitted to Tangshan Fengrun distDrict Hospital of Traditional Chinese Medicine from June 2016 to August 2018 were randomly divided into control group (n=47) and treatment group (n=47). The control group was po administered with Azithromycin Tablets, 0.5 g/time, 1 time daily. The treatment group was po administered with Jinji Huayu Granules on the basis of control group, 10 g/time, three times daily. All patients were treated for 14 days. The clinical efficacy and the changes of main symptom scores before and after treatment were compared between the two groups. Before and after treatment, routine gynecological B-ultrasound examination was performed to measure the diameter of fallopian tube and pelvic mass of the subjects, the erythrocyte sedimentation rate (ESR) was determined by Wechsler method, the platelet count (PLT) was determined by routine blood examination, and the serum levels of tumor necrosis factor (TNF)-α and interleukin (IL)-4 were detected by enzyme-linked immunosorbent assay. The serum levels of C-reactive protein (CRP) and glycoprotein antigen 125(CA₁₂₅) were analyzed by immunoturbidimetry and chemiluminescence respectively. Adverse reactions and recurrence after 6 months follow-up of the two groups were summarized. Results The total effective rate of the treatment group was 95.7%, significantly higher than that of the control group (83.0%) (P<0.05). Compared with before treatment, the scores of main symptoms (lower abdominal distending pain or stabbing pain, lumbosacral distending pain, leukorrhagia, leukorrhagia yellow and thick or smelly) after treatment in both groups were significantly reduced (P<0.05). However, the decrease was more significant in the treatment group (P<0.05). After treatment, the diameter of fallopian tube and pelvic mass in the two groups were significantly shorter than before treatment (P<0.05), and the reduction in the treatment group was more significant (P<0.05). Compared with before treatment, ESR, PLT values and serum TNF-α, CRP, CA₁₂₅ concentrations in the two groups were significantly decreased after treatment (P<0.05), while serum IL-4 levels were significantly increased (P<0.05). After treatment, the improvement effect of the above indexes (ESR, PLT, TNF-α, IL-4, CRP, CA₁₂₅) in the treatment group is significantly better than that in the control group at the same time (P<0.05). The recurrence rate of the treatment group after 6 months of follow-up was 8.5%, significantly lower than that of the control group (25.5%, P<0.05). Conclusion Jinji Huayu Granules combined with azithromycin has a significant overall effect in the treatment of chronic pelvic inflammatory, and can effectively relieve the symptoms of patients, improve the shape of fallopian tubes, and can reduce pelvic mass, correct blood stasis state, positively regulate the expression of pro-inflammatory and anti-inflammatory factors, reduce the risk of recurrence, which has a certain clinical application value.

R984