【作者】 侯莉莉；

【导师】 韩冰；

【作者基本信息】 天津中医学院 ， 中医妇科学， 2004， 博士

【摘要】 本课题在总结三十余年临床经验的基础上，立“逐瘀清化法”治疗慢性盆腔炎，并创研妇炎净合剂。采用随机、对照法对妇炎净合剂治疗慢性盆腔炎进行了临床疗效评价。使用L16(28) 表正交分析法对妇炎净合剂进行了拆方分析，研究方中各药物的作用。经典方法对妇炎净合剂进行了一般药效学及模型病理观察，观察了试验药对大鼠脾细胞、NIH3T3成纤维细胞增殖及Ⅲ型胶原蛋白mRNA表达的影响，以探讨妇炎净合剂对脾细胞、成纤维细胞及胶原转录基因的调节作用。通过以上实验研究，从整体、细胞、分子水平系统分析了妇炎净合剂治疗慢性盆腔炎的机理。结果如下：(1) 临床观察结果：采用随机、对照方法观察治疗180例慢性盆腔炎患者，其中治疗组120例、对照组60例，结果显示，治疗组有效率96． 67％，愈显率78． 33％，对照组有效率80％，愈显率34％，两组比较有显著性差异(P＜0． 01) 。治疗组腹痛、腹坠胀、腰酸痛、带下主要症状的改善，优于对照组，两组比较有显著性差异(P＜0． 01) 。(2) 正交分析结果：采用L16(28) 正交表分析表明，妇炎净合剂方中A、B、E、F、D药物是主要作用因素。(3) 一般药效学研究结果：妇炎净合剂具有抑制二甲苯至小鼠耳肿胀，抑制大鼠塑料环肉芽肿增生，减少小鼠冰醋酸所致扭体次数，提高大鼠痛阈，降低小鼠冰醋酸所致腹腔毛细血管通透性的作用。(4) MTT法检测显示：妇炎净合剂能抑制体外培养大鼠脾细胞、NIH3T3成纤维细胞增生。RT-PCR方法检测结果：妇炎净合剂能抑制NIH3T3成纤维细胞Ⅲ型胶原蛋白mRNA的表达。结论妇炎净合剂是临床治疗慢性盆腔炎的有效药物。具有镇痛、减轻渗出、减少局部增生、减轻盆腔病理改变的药理作用。深入研究表明，妇炎净合剂可抑制成纤维细胞增生及其Ⅲ型胶原蛋白mRNA表达，分析该作用是药物逆转慢性炎症局部病理改变的重要机制之一，体现了“逐瘀清化”法在慢性盆腔炎治疗中的重要意义。更多还原

【Abstract】 Objective: The subject systematicly treats chronic pelvic inflammatory disease (CPID) with "Zhu Yu Qing Hua" method based on better clinical effects in 30 years over, established "FU YAN JING" mixture. To observe and study clinical effects of chronic pelvic inflammatory disease (CPID) by Fu Yan Jing mixture, explore the mechanisms on improving chronic inflammatory pathology.Method and Result: (1) In clinic, using method of random, contrast for observing and treating 180 cases of patients with chronic pelvic inflammatory disease (CPID), dividing them into 120 cases in treating group, 60 cases in controlling group. The results show that in total effects, there are totally effective rate 96.67% and cure rate and markedly effective rate 78.33%. Compared with control group, there is obvious differential (/><0.01). In the effects of clinical symptom such as abdominal pain, backache and leucorrhagia, there are totally effective rate 95.65%, 96.36%, 88.10%, compared with control group, there is obvious differential (P<0.01).(2) The result of orthogonal design: Apply orthogonal design method of LI A (2 ) orthogonal table . The result show that herbal medicine A,B,D,E,F is mainlyfactor in Fu Yan Jing mixture.(3) The result of normal mechanism: The result of normal mechanism shows that Fu Yan Jing mixture can reduce mouse’s inflammation of ear by dimethylbenzene, inhibit rat’s granulose tissue growth by foreign body subject, reduce mouse’s wriggle times by glacial acetic-acid, raise rat’s threshold of pain, reduce mouse’s abdominal blood capillary penetrating character by glacial acetic-acid.(4) The result of monitors by MTT method shows that, Fu Yan Jing mixture can inhibit proliferation of rat’s spleen cell, and inhibit NIH3T3 fibroblastic proliferation. Applying reverse transcriptase polymerase chain reaction (RT-PCR) technique monitor the expression of collagen type III mRNA , the result showsthat Fu YanJing mixture can inhibit the expression of collagen type III mRNA.Conclusion: Clinical observing of Fu Yan Jing mixture show that, it’s clinical effects on chronic pelvic inflammatory disease (CPID) is sure. Deeply research show that , Fu Yan Jing mixture can inhibit the expression of collagen type III mRNA and inhibit NIH3T3 fibroblastic proliferation. Explore that, it is one of the important mechanism for reducing chronic inflammatory pathomorphism. It embodies important factor of "Zhu Yu Qin Hua" method in treat chronic pelvic inflammatory disease (CPID).更多还原