中西医结合治疗慢性盆腔炎的临床研究

目的：探讨中西医结合治疗慢性盆腔炎的临床疗效。方法：2011年3月～2012年6月，采用口服抗生素联合中医辨证治疗慢性盆腔炎患者46例。年龄23～47岁，中位数29岁。病程6个月～3年，中位数2年。临床表现为慢性下腹部疼痛，急性发作时伴发热、寒战、食欲不振等；部分患者体检可发现下腹部肿物及局部压迫刺激征。盆腔 B 超、CT 及实验室检查均排除器质性疾病。给予左氧氟沙星口服，500mg/次，1次/d；联合应用甲硝唑口服，500mg/次，1次/d；共治疗14 d。中药治疗给予加味桂枝茯苓汤口服，1剂/d，水煎2次，早晚分服，治疗1个月为1个疗程，连续治疗2～3个疗程。同时给予中药穴位贴敷，夏季12 h换药1次，冬季2 d换药1次。月经期停用，换药12次为1个疗程，连续治疗2～3个疗程。治疗结束后随访观察并评价疗效。结果：本组46例患者均获得随访，随访时间6～9个月，中位数7个月。按照自拟的慢性盆腔炎疗效评定标准评价疗效，本组治愈39例，显效3例，好转4例。结论：采用口服抗生素联合中医辨证治疗慢性盆腔炎，疗效可靠，患者易于接受，值得临床推广应用。

Clinical research on treating chronic pelvic inflammatory disease in the integrative medicine

Objective： To investigate the effect of the integrative medicine on treating chronic pelvic inflammatory disease. Methods 46 cases chronic pelvic inflammatory disease treated with oral antibiotics combined TCM differentiation treatment from March 2011 to June 2012 were selected. Among those patients aged 23 to 47 years, median 29 years. The course of disease was 6 months to 3 years, median 2 years. The clinical manifestations were chronic pain in the lower abdomen, acute onset with fever, chills, loss of appetite etc. Some patients can be found abdominal mass and local compression irritation when physical. Pelvic B ultrasound, CT and laboratory tests were excluded organic diseases. Given levofloxacin oral 500mg each time, 1 times a day; the combined application of metronidazole oral, 500mg each time, 1 times a day for 14 d. TCM medicine treatment was given modified Guizhi Fuling decoction, daily 1 agent, water frying 2 times, sooner or later each time, 1 months for 1 courses, continuous treated for 2~3 courses. At the same time, the acupoint application of TCM medicine was given, summer 12h dressing once, winter 2d dressing once. Menstrual period to stop using, dressing 12 times as a course of treatment, continuous treatment for 2 to 3 courses. The effects were observed and evaluated after treatment. Results： 46 patients were followed up, follow up time was 6-9 months, median 7 months. Efficacy was evaluated; the group cured 39 cases, effective in 3 cases, 4 cases improved. Conclusion： Oral antibiotics combined TCM differentiation treatment is effective on treating chronic pelvic inflammatory disease, worthy of a wide clinical application.