清热复膜汤治疗慢性子宫内膜炎疗效及作用机制探讨

目的:观察清热复膜汤治疗慢性子宫内膜炎(CE)疗效及其作用机制。方法:将CE患者70例随机数字表法分为观察组(35例)与对照组(35例)。对照组常规西药治疗,观察组在对照组基础上加用清热复膜汤治疗。比较两组治疗效果,测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-4、IL-6、IL-10、IL-17、转化生长因子-β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、血管细胞黏附分子(VCAM-1)、丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平变化。结果:治疗总有效率观察组(97.1%)与对照组(91.4%)无差异(P>0.05),观察组痊愈及显效率(85.7%)高于对照组(71.4%)(P<0.05)。治疗第2、3、4疗程时,观察组中医证候积分均低于对照组(P<0.05)。观察组血清TNF-α、IL-1β、IL-6、IL-17、MMP-9、VCAM-1、MDA、AOPP水平均较对照组降低,血清IL-4、IL-10、TGF-β1、SOD、GSH-Px水平较对照组升高(P<0.05)。随访6个月观察组复发率(6.7%)低于对照组(28.0%)(P<0.05),不良反应观察组(11.4%)与对照组(8.6%)无差异。结论:清热复膜汤治疗CE可提高临床疗效降低复发率,其机制可能与抑制炎症反应及氧化损伤等有关。

Analysis of the efficacy and the mechanism of Qingrefumo decoction for treating women with chronic endometritis

Objective:To observe the clinical efficacy of Qingrefumo decoction for treating women with chronic endometritis(CE),and to investigate its mechanism.Methods:70 women with CE were selected and were randomly divided into observation group(35 cases)and control group(35 cases)by random number table.The women in the control group were given conventional medicine treatment,and the women in the observation group were given Qingrefumo decoction except to conventional medicine treatment.The efficacy of women was compared between the two groups.The changes of the serum levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-4,IL-6,IL-10,IL-17,transforming growth factor-β1(TGF-β1),matrix metalloproteinase-9(MMP-9),vascular cell adhesion molecule(VCAM-1),malondialdehyde(MDA),advanced oxidized protein product(AOPP),superoxide dismutase(SOD),and glutathione peroxidase(GSH-Px)of women in the two groups were measured.Results:There was no significant difference in the total effective rate of women(97.1%vs.91.4%)between the two groups(P>0.05).The rate of recovery or efficiency of women in the observation group(85.7%)was significant higher than that(71.4%)of women in the control group(P<0.05).During the second,third and fourth course of treatment,TCM syndrome scores of women in the observation group were all significant lower than those of women in the control group(P<0.05).The levels of serum TNF-α,IL-1β,IL-6,IL-17,MMP-9,VCAM-1,MDA,and AOPP of women in the observation group were all significant lower than those of women in the control group,while the levels of serum IL-4,IL-10,TGF-β1,SOD,and GSH-Px were significant higher than those of women in the control group(P<0.05).6 months after followed up,the recurrence rate of women in the observation group(6.7%)was significant lower than that(28.0%)of women in the control group(P<0.05),and there was no significant difference in the rate of adverse reaction of women(11.4%vs.8.6%)between the two groups.Conclusion:Qingrefumo decoction for treating women with CE can improve the clinical efficacy and reduce recurrence rate,which’s mechanism may be related to the inhibition of inflammation and oxidative damage.