【作者】 苏政巧；

【导师】 吴绪平；

【作者基本信息】 湖北中医学院 ， 针灸推拿学， 2009， 硕士

【摘要】 目的慢性盆腔炎是妇科常见病、多发病,其发病率有逐年上升的趋势,因病情较顽固,病程较长,常久治不愈,严重影响了妇女的身心健康和正常生活,给家庭及社会造成了较大的负担。一般的临床治疗见效慢、远期效果欠佳、复发率高。针灸治疗本病独具特色,疗效肯定。本课题采用温和灸治疗慢性盆腔炎,在临床观察的基础上,检测患者治疗前后外周血免疫球蛋白、T淋巴细胞亚群的变化,探讨温和灸治疗慢性盆腔炎的作用机理,为艾灸治疗本病提供科学的实验依据。方法60例患者均为湖北省丹江口市第一医院针骨科和妇科住院病人,符合慢性盆腔炎诊断标准。按照随机数字表,将患者分为观察组和对照组。观察组30例,采用温和灸治疗,取穴:关元、中极、子宫、阴陵泉（双）、足三里（双）、三阴交（双）。取华佗牌清艾条（苏州医疗用品厂）1支,将艾条的一端点燃,对准施灸部位,约距15～25mm左右进行熏灸,使患者局部有温热感而无灼痛为度,每穴灸5分钟。上述方法于月经干净后开始治疗,每日1次,经期停灸。对照组30例,采用口服妇科千金片治疗,每次6片,1日3次,温水吞服。2个月后评定疗效。患者治疗前及治疗结束后,空腹抽取肘静脉血4ml,分别检测血清免疫球蛋白、外周血T淋巴细胞亚群含量。结果1.观察组治愈率为43.3%,总有效率为96.6%;对照组治愈率为23.3%,总有效率为76.7%。观察组治愈率及总有效率明显优于对照组,经统计学处理,有显著性差异（P＜0.05）。2.两组治疗前后症状积分的比较,观察组和对照组治疗前后症状积分均明显降低（P＜0.01）,但观察组降低更显著,与对照组比较,有极显著性差异（P＜0.01）。表明观察组在改善患者症状方面优于对照组。3.治疗前观察组和对照组血清IgG、IgA、IgM比较,无显著性差异（P＞0.05）。治疗后两组患者血清IgG、IgA含量均呈上升趋势,但观察组明显上升（P＜0.01）,与对照组比较,有显著性差异（P＜0.05）;治疗后两组患者血清IgM含量均呈上升趋势,与治疗前比较,仅观察组有显著性差异（P＜0.05）。4.治疗前治疗组与对照组各项指标比较,均无显著性差异,表明两组患者具有可比性。治疗后两组CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺均呈升高趋势,但观察组显著升高,与治疗前比较,经统计学处理,有极显著性差异（P＜0.01）,与对照组比较,有显著性差异（P＜0.05）。治疗后两组CD₈⁺含量均呈下降趋势,但观察组明显降低,与对照组比较,有显著性差异（P＜0.05）。结论1.温和灸治疗慢性盆腔炎,临床疗效显著,明显优于对照组。2.温和灸在改善慢性盆腔炎患者症状方面明显优于对照组。3.艾灸能显著调节慢性盆腔炎患者血清免疫球蛋白及外周血T淋巴细胞亚群含量,提高机体的免疫功能,这可能是艾灸治疗本病的作用机理之一。更多还原

【Abstract】 ObjectivesChronic pelvic inflammatory disease is a common and frequently occurring gynecology disease,its incidence is increasing year by year,the trend because of a stubborn illness,longer course,patients often has seriously complaint of the physical and mental health of women and a normal life,it has been a greater burden of the family and the community.The general clinical results slow,long-term effects of poor,high recurrence rate.acupuncture and moxibustion treatment has a unique effective,we used warming moxibustion treatment of chronic pelvic inflammatory disease,on the basis of clinical observation,through observation before and after treatment,we detected the contents of peripheral blood Immunoglobulin and T lymphocyte subgroup,so as to approach the mechanism of action of treat chronic pelvic inflammatory disease by warming moxibustion.Methodssixty patients were selected from the department of Acupuncture and orthopaedics of Danjiangkou NO.1 hospital of Hubei province,they were all consistent with Chronic pelvic inflammatory disease diagnostic criteria.All the cases were randomly divided into two groups,observation group and control group,each group was thirty.Observation group adopts warming moxibustion treatment on Guanyuan,Zhongji,Zigong,Yinlingquan,Zusanli, Sanyinjiao acupionts.Three to five minutes one acupoint,one time a day and suspension between menstruation,control group adopted gynecology Qianjin pill for oral use,six pills one time and three times one day.After two months treatment,we evaluated the clinical therapeutic effect and detected the variation of the contents of peripheral blood Immunoglobulin and T lymphocyte subgroup.Results1.Healing rate and total effective rate of observation group is 43.3%and 96.6%respectively,but control group’s healing rate is 23.3%and it’s total effective is 76.7%.this shows that observation group is more excellent than control group in curative effect（P＜0.05）.2.Warming moxibustion treatment can improve patien’s symptoms obviously（P＜0.01）,compared with control group,there is omly a wild improvement in cardinal symptoms（P＜0.01）.3.The contents of blood serum IgG、IgA、IgM in two groups pretherapy are nearly equivalency.After treatment,the contents of blood serum IgG、IgA showed an upward trend,While the content was obviously higher in observation group（P＜0.01）,compared with control Group,the statistical comparison shows a significant difference（P＜0.05）.After treatment,the contents of blood serum IgM showed an upward trend,compared with pretherapy,observation group has a significant difference（P＜0.05） merely.4.After treatment,the contents of blood serum CD₃⁺、CD₄⁺、CD₄⁺/CD₈showed an upward trend,While the content was obviously higher in observation group（P＜0.01）,compared with control Group,the statistical comparison shows a significant difference（P＜0.05）.After treatment,the contents of blood serum CD₈⁺ showed a downward trend,However,the observation group decreased significantly（P＜0.01 ）;compared with the control group,there was a significant difference（P＜0.05）.Conclusion1.The clinical curative effect of chronic pelvic inflammatory by using warming moxibustion treatment is predominance,which is superior than control group obviously.2.Warming moxibustion treatment can improve patien’s symptoms obviously,which is superior than control group obviously.3.warming moxibustion can accommodate the contents of peripheral blood Immunoglobulin and T lymphocyte subgroup on chronic pelvic inflammatory patients,improve organism immune function,it is a possible mechanism of treatment the disease by warming moxibustion.更多还原