清热利湿化瘀汤联合针灸治疗慢性盆腔炎湿热瘀结证临床研究

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（P＜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（P＜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（P＜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（P＜0.05）；治疗后，针药组较中药组、针灸组有更明显的优势（P＜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（P＜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。

Clinical Study on Chronic Pelvic Inflammatory Disease with Syndrome of Damp-heat and Blood-stasis by Qing-Re Li-Shi Hua-Yu Decoction Combined with Acupuncture Therapy

This study was aimed to observe the clinical curative effect of Qing-Re Li -Shi Hua-Yu (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-Sanyinjiao 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 observation 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 acupuncture 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 purulent 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 clinical practice.