目的 探討消炎湯通過調(diào)節(jié)腸道微生態(tài)的變化對慢性盆腔炎大鼠的治療作用。方法 采用子宮內(nèi)注射苯酚膠漿建立大鼠慢性盆腔炎模型，造模2周后ig消炎湯5、10、20 g/kg，連續(xù)14 d，觀察大鼠子宮內(nèi)膜形態(tài)，qPCR檢測子宮組織中細(xì)胞間黏附分子（ICAM-1mRNA）表達(dá)情況，并采用16S rRNA高通道測序觀察慢性盆腔炎大鼠腸道菌群的構(gòu)成和比例。結(jié)果 各給藥組中充血水腫現(xiàn)象少見，且炎癥浸潤程度好于婦科千金片組。與模型組相比，消炎湯各劑量組子宮組織中ICAM-1mRNA的表達(dá)均有下調(diào)，尤以消炎湯20 g/kg組為甚（P<0.01）。與模型組相比，消炎湯20 g/kg組Simpson指數(shù)顯著上升（P<0.05）。給予消炎湯治療后腸道菌群多樣性、豐度均得到一定程度改善，但未見統(tǒng)計學(xué)差異。與模型組相比，消炎湯10、20 g/kg組乳桿菌、梭狀芽孢桿菌OUT比例有不同程度升高。治療后，消炎湯20、10 g/kg組OUT比例較模型組明顯下降。結(jié)論 消炎湯能夠明顯改善慢性盆腔炎大鼠子宮的炎癥程度，有效減少黏連的發(fā)生，作用機(jī)制與其調(diào)節(jié)腸道微生態(tài)影響雌激素代謝有關(guān)。

Objective To investigate the therapeutic effect of Xiaoyan Decoction on chronic pelvic inflammatory disease in rats by regulating the changes of intestinal microecology. Methods Chronic pelvic inflammatory disease models in rats were established with injection of phenol mucilage in uterus. After 2 weeks of model establish, rats in Xiaoyan Decoction were ig administered with 5, 10, and 20 g/kg for 14 d. Endometrial morphology in rats was observed, cell adhesion molecule ICAM-1 expression was detected by qPCR method, intestinal flora composition and proportion in chronic pelvic inflammation rat was adopted with 16S rRNA high channel sequencing. Results Hyperemia and edema were rare in each group, and the degree of inflammatory infiltration was better than that in Fuke Qianjin Tablets group. Compared with the model group, the expression of ICAM-1mRNA in the uterus tissues of Xiaoyan Decoction was down-regulated, especially in 20 g/kg group (P<0.01). Compared with the model group, the Simpson index was significantly increased in 20 g/kg Xiaoyan Decoction group (P<0.05). After the treatment of Xiaoyan Decoction, the diversity and abundance of intestinal flora were improved to some extent, but there was no statistical difference. Compared with the model group, the OUT ratio of Lactobacillus and Clostridium in the 10 and 20 g/kg Xiaoyan Decoction groups was increased in different degrees. After treatment, the proportion of OUT in 10 and 20 g/kg Xiaoyan Decoction group was significantly lower than that in the model group. Conclusion Xiaoyan decoction can significantly improve the inflammatory degree of uterus in rats with chronic pelvic inflammatory disease, and effectively reduce the occurrence of adhesion. The mechanism of action is related to the regulation of intestinal microecology and the influence of estrogen metabolism.

R966;R285.5

天津市衛(wèi)生健康委員會中醫(yī)中西醫(yī)結(jié)合科研課題（2017066）