妇宝颗粒冲剂治疗慢性盆腔炎的临床及实验研究

【作者】 田德禄；

【导师】 肖承悰；

【作者基本信息】 北京中医药大学 ， 中西医结合临床， 2003， 博士

【摘要】 目的：观察妇宝颗粒冲剂治疗慢性盆腔炎的临床疗效，了解妇宝颗粒冲剂对患者的体液免疫和细胞免疫功能以及血液循环的影响，从而探讨慢性盆腔炎的主要病因病机、其免疫功能和血液循环的异常变化、以及妇宝颗粒冲剂治疗慢性盆腔炎的作用机理。方法：评价治疗前后患者的症状体征积分，测定治疗前后患者静脉血浆中T、B、NK淋巴细胞亚群、免疫球蛋白G（IgG）、血栓素B2（TXB2）、6-酮-前列腺素F1α（6-Keto-F1α）、尿中分泌型免疫球蛋白A（sIgA）、免疫球蛋白G（IgG）的含量水平的变化，监测治疗前后B超、妇科检查情况的变化。结果：治疗40例慢性盆腔炎患者的综合疗效结果：痊愈1例，占2.50%；显效20例，占50.00%；有效19例，占47.50%；无效0例。总有效率100%，愈显率52.5%。治疗后局部体征评分和证候评分均有显著改善（P＜0.01）。治疗后患者血浆中的总T淋巴细胞（Total T)、T辅助细胞（T Helper，Th）、T抑制细胞（T Suppressor，Ts）均较治疗前明显增高，比较有显著性差异（P＜0.01）；治疗后Th/Ts（T Lymph H/S）较治疗前升高，比较有显著性差异（P＜0.05）；治疗后总NK细胞（Total NK）较治疗前下降，比较有显著性差异（P＜0.05）；治疗前后总B淋巴细胞（Total B）无明显变化，比较无显著性差异（P＞0.05）。治疗前后患者血浆中IgG含量比较无显著性差异（P＞0.05）。治疗后患者尿中sIgA、IgG含量均高于治疗前，其差异有显著性意义（P＜0.01）。治疗前患者血浆中TXB2含量明显下降，比较有显著性意义（P＜0.01）；治疗前6-Keto-PGF1α含量明显增高，比较有显著性意义（P＜0.01）；治疗前TXB2/6-Keto-PGF1α比值明显下降，比较有显著性意义（P＜0.01）。治疗后B超及妇科检查情况均较治疗前改善。结论：通过分析，提出肾虚肝郁是慢性盆腔炎的主要病机。妇宝颗粒冲剂治疗慢性盆腔炎具有确切疗效，并且可以显著提高慢性盆腔炎患者体液免疫和细胞免疫功能；同时能降低NK细胞含量，推测这是该方阻止患者纤维组织增生的机制之一。妇宝颗粒冲剂还能够改善慢性盆腔炎患者的血液循环功能。更多还原

【Abstract】 Objective: Our objective is to observe the clinical curative effect of Fu Bao granule on chronic pelvic inflammation and to find out its effects on the humoral immunity, the cellular immunity and the blood circulation of chronic pelvic inflammation patients. With such, we will be able to investigate the main pathogeny and pathogenesis of chronic pelvic inflammation, the abnormal variations reflected in the patients’immunologic functions and blood circulation condition, and thereby understand the functioning mechanisms of Fu Bao granule on chronic pelvic inflammation patients. Methods: The patients’ symptom and physical sign integrals were evaluated before and after the treatment. The serum concentrations of lymphocyte T, B and NK cells, IgG, TXB2 and 6-Keto-PGF1α and the urine concentrations of sIgA and IgG were tested before and after the treatment. The patients’ pelvic ultrasound-B and gynecological examinations were monitored before and after the treatment. Results: The composite curative effect of treating 40 chronic pelvic inflammation patients are as follows: 1 patient was cured (2.50%), 20 patients showed apparent effects (50.00%), 19 patients showed visible effects (47.50%), and none was of no effects. Both the local physical sign integrals and syndrome integrals remarkably improved (P＜0.01). The serum levels of total T, T helper (Th) and T suppressor (Ts) were elevated after the treatment (P＜0.01). The ratio of Th to Ts (Th/Ts) was also elevated (P＜0.05). The total NK level was reduced after the treatment (P＜0.05). There was no obvious difference observed on the levels of total B and IgG before and after the treatment (P＞0.05) . The urine concentrations of sIgA and IgG were elevated after the treatment (P＜0.01). The serum concentration of TXB2 was reduced and that of 6-Keto-PGF1α was elevated after the treatment (P＜0.01) . The ratio of TXB2 to 6-Keto-PGF1α (TXB2/6-Keto-PGF1α) was elevated after the treatment (P＜0.01) . Both the patients’ pelvic ultrasound-B and gynecological examinations showed improvement after the treatment.Conclusion: From our analysis, kidney deficiency and liver stasis are the main pathogeneses of chronic pelvic inflammation. Fu Bao granule shows a positive effect on chronic pelvic inflammation patients. It not only improved the functions of both humoral immunity and cellular immunity, but also reduced the serum levels of<WP=6>the NK cells, which may have been one of the mechanisms in inhibiting the process of fibrous tissue hyperplasia. It can also improve the patients’ blood circulation condition.更多还原