CAJ | 학술논문

目的：观察清热利湿化瘀汤联合针灸治疗慢性盆腔炎湿热瘀结证的临床疗效。方法：将120例病例随机分为针药组、中药组、针灸组，每组各40例，中药组给予口服清热利湿化瘀汤，针灸组给予针刺三阴交、气海等穴位，针药组口服清热利湿化瘀汤同时给予针灸治疗，各组疗程均为2个月。观察3组的临床疗效，临床症状及体征改善情况，实验室指标变化，复发情况。结果：与治疗前比较，治疗后，针药组与中药组、针灸组总有效率明显提升（孕约0.05）。与治疗前比较，3组在腹痛、下腹坠胀、腰酸、带下增多、痛经、月经失调、神疲乏力、附件增厚、盆腔压痛、盆腔包块等临床症状及体征方面均有明显的改善（孕约0.05）；治疗后，针药组较中药组、针灸组临床症状及体征改善有更明显的优势（孕约0.05）。与治疗前比较，3组在宫颈或阴道黏液脓性分泌物、阴道分泌物湿片镜下白细胞、白细胞总数、中性粒细胞绝对值等均有明显的改善（孕约0.05）；治疗后，针药组较中药组、针灸组有更明显的优势（孕约0.05）。治疗结束6、9、12个月后，针药组的复发率明显低于中药组及针灸组（孕约0.05）。结论：清热利湿化瘀汤联合针灸治疗慢性盆腔炎湿热瘀结证疗效显著，优于单纯中药及单纯针灸治疗，值得临床推广。
목적：관찰청열리습화어탕연합침구치료만성분강염습열어결증적림상료효。방법：장120례병례수궤분위침약조、중약조、침구조，매조각40례，중약조급여구복청열리습화어탕，침구조급여침자삼음교、기해등혈위，침약조구복청열리습화어탕동시급여침구치료，각조료정균위2개월。관찰3조적림상료효，림상증상급체정개선정황，실험실지표변화，복발정황。결과：여치료전비교，치료후，침약조여중약조、침구조총유효솔명현제승（잉약0.05）。여치료전비교，3조재복통、하복추창、요산、대하증다、통경、월경실조、신피핍력、부건증후、분강압통、분강포괴등림상증상급체정방면균유명현적개선（잉약0.05）；치료후，침약조교중약조、침구조림상증상급체정개선유경명현적우세（잉약0.05）。여치료전비교，3조재궁경혹음도점액농성분비물、음도분비물습편경하백세포、백세포총수、중성립세포절대치등균유명현적개선（잉약0.05）；치료후，침약조교중약조、침구조유경명현적우세（잉약0.05）。치료결속6、9、12개월후，침약조적복발솔명현저우중약조급침구조（잉약0.05）。결론：청열리습화어탕연합침구치료만성분강염습열어결증료효현저，우우단순중약급단순침구치료，치득림상추엄。
This study was aimed to observe the clinical curative effect of Qing-Re Li-Shi Hua-Y u (QRLSHY) decoction combined with acupuncture in the treatment of chronic pelvic inflammatory disease (PID) with syndrome of damp-heat and blood-stasis. A total of 120 cases were randomly divided into the acupuncture combined with traditional Chinese medicine (TCM) group, TCM group, and acupuncture group, with 40 cases in each group. The TCM group was given oral administration with QRLSHY decoction. The acupuncture group was given acupuncture on SP6-Sanyinj iao and RN6-Qihai . The acupuncture combined with TCM group was given oral administration with QRLSHY decoction and acupuncture treatment. The treatment course of each group was 2 months. The ob-servation was made on clinical efficacy, clinical symptoms, body signs, changes of laboratory indexes, and relapse rate of three groups. The results showed that compared with pretreatment, the total effective rate of the acupunc-ture combined with TCM group, TCM group and the acupuncture group was obviously increased after treatment (P< 0 . 05 ) . Compared with pretreatment , the clinical symptoms and body signs such as abdominal pain , abdominal bulge, backache, leucorrhea increased, dysmenorrhea, menstrual disorders, lassitude, appendix thickening, pelvic tenderness, and pelvic mass were significantly improved in all three groups (P < 0.05). After treatment, clinical symptoms and body signs of the acupuncture treatment with TCM group had more obvious advantages than the TCM group and the acupuncture group ( P < 0 . 05 ) . Compared with pretreatment , the cervical or vaginal mucus pu-rulent secretion, vaginal wet film mirror of white blood cells, white blood cell count, absolute neutrophil count of all three groups were significantly improved ( P < 0 . 05 ) . After treatment , the acupuncture combined with TCM group had more obvious advantages than the TCM group and acupuncture group ( P < 0 . 05 ) . The relapse rate of the acupuncture combined with TCM group was obviously lower than the TCM group and the acupuncture group 6 months, 9 months, and 12 months after treatment (P < 0.05). It was concluded that QRLSHY decoction combined with acupuncture had obvious clinical curative effect in the treatment of chronic PID with syndrome of damp-heat and blood-stasis. The effect was better than only use TCM or acupuncture. It is worth of promoting in the clini-cal practice .