Impact of pelvic floor therapeutic instrument assisted with traditional Chinese medicine on inflammation and hormone levels in patients with pelvic inflammatory disease
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摘要:
目的 分析盆底治疗仪辅助阴道内中药对慢性盆腔炎(CPID)患者的炎症及激素水平的影响，为CPID的治疗提供更为充分的理论依据。 方法 以2020年3月—2023年10月期间杭州市第三人民医院收治的90例CPID患者为研究对象，按照治疗方式的不同分为中药灌肠组与阴道内治疗组各45例。2组均给予盆底治疗仪治疗，接受中药灌肠的为中药灌肠组，接受阴道内治疗的为阴道内治疗组。比较2组患者临床疗效、炎症水平、激素水平以及不良反应发生率。 结果 治疗结束后，阴道内治疗组总有效率(91.11%，41/45)高于中药灌肠组(75.56%，34/45, P＜0.05)；阴道内治疗组TNF-α、CRP低于中药灌肠组(P＜0.05)，IL-2、IL-4水平高于中药灌肠组(P＜0.05)；阴道内治疗组促卵泡生成素(FSH)低于中药灌肠组，雌二醇(E2)高于中药灌肠组(P＜0.05)；阴道内治疗组卵巢动脉和子宫动脉搏动指数(PI)高于中药灌肠组，阻力指数(RI)低于中药灌肠组。 结论 盆底治疗仪辅助阴道内中药治疗CPID患者，可降低炎症因子水平，调节体内激素水平，改善血流动力学水平，提高临床疗效。 Abstract:Objective To analyze the effects of pelvic floor therapeutic instrument assisted with traditional Chinese medicine in vagina on inflammation and hormone level of patients with chronic pelvic inflammatory disease (CPID), so as to provide more sufficient theoretical basis for the treatment of CPID. Methods Ninety patients with CPID admitted to Hangzhou Third People's Hospital from March 2020 to October 2023 were divided into two groups according to different treatment methods: the enema group with traditional Chinese medicine and the vaginal treatment group, with 45 patients in each group. Both groups were treated with pelvic floor therapeutic instrument, with the enema group also receiving traditional Chinese medicine via enema and the intravaginal group receiving it vaginally. The clinical efficacy, inflammation levels, hormone levels, and incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate in the vaginal treatment group (91.11%, 41/45) was higher than that in the enema group (75.56%, 34/45, P < 0.05). Tumor necrosis factor-α and CRP levels in the vaginal treatment group were lower than those in the traditional Chinese medicine enema group (P < 0.05), while the levels of interleukin-2 and interleukin-4 were higher (P < 0.05). Follicle-stimulating hormone levels in the vaginal treatment group was lower than that in the traditional Chinese medicine enema group, and estradiol was higher (P < 0.05). Additionally, proteasome inhibitor levels of ovarian artery and uterine artery in the vaginal treatment group were higher than that in the traditional Chinese medicine enema group, and resistance index was lower compared to the enema group. Conclusion Pelvic floor therapeutic instrument assisted with vaginal Chinese medicine can reduce the level of inflammatory factors, regulate hormones levels, improve the level of hemodynamics, and enhance the clinical efficacy in the treatment of CPID. -
表 1 2组慢性盆腔炎患者一般资料比较
Table 1. Comparison of general data between two groups of patients with chronic pelvic inflammatory disease
组别 例数 年龄(x±s，岁) 生育史[例(%)] 人流或清宫史[例(%)] 盆腔炎类型[例(%)] 有 无 有 无 子宫内膜炎 输卵管卵巢炎 盆腔结缔组织炎 阴道内治疗组 45 39.72±12.34 27(60.00) 18(40.00) 25(55.56) 20(44.44) 17(37.78) 12(26.66) 16(35.56) 中药灌肠组 45 41.32 ±14.17 26(57.78) 19(42.22) 26(57.78) 19(42.22) 18(40.00) 16(35.56) 11(24.44) 统计量 0.571a 0.046b 0.045b 1.526b P值 0.569 0.830 0.831 0.466 注：a为t值，b为χ2值。 
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表 2 2组慢性盆腔炎患者临床疗效比较[例(%)]
Table 2. Comparison of clinical efficacy between two groups of patients with chronic pelvic inflammatory disease between the two groups[cases(%)]
组别 例数 治愈 显效 有效 无效 总有效 阴道内治疗组 45 11(24.44) 18(40.00) 12(26.67) 4(8.89) 41(91.11) 中药灌肠组 45 8(17.78) 16(35.56) 10(22.22) 11(24.44) 34(75.56) 统计量 -1.470a 4.677b P值 0.142 0.031 注：a为Z值，b为χ2值。
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表 3 2组慢性盆腔炎患者治疗前后炎症因子水平比较(x±s)
Table 3. Comparison of inflammatory factors before and after treatment between two groups of patients with chronic pelvic inflammatory disease(x±s)
组别 例数 TNF-α(ng/L) t值 P值 IL-2(ng/L) t值 P值 治疗前 治疗后 治疗前 治疗后 阴道内治疗组 45 73.84±8.62 52.22±6.92 13.139 ＜0.001 2.82±0.64 4.73±0.58 -14.834 ＜0.001 中药灌肠组 45 73.79±8.65 63.85±7.87 5.720 ＜0.001 2.71±0.56 3.55±0.65 -6.568 ＜0.001 统计量 0.027a 49.081b 0.868a 115.484b P值 0.978 ＜0.001 0.388 ＜0.001 组别 例数 IL-4(ng/L) t值 P值 CRP(mg/L) t值 P值 治疗前 治疗后 治疗前 治疗后 阴道内治疗组 45 53.98±6.62 82.49±9.45 -16.592 ＜0.001 24.34±6.24 10.36±2.52 13.935 ＜0.001 中药灌肠组 45 55.94±7.55 65.14±15.22 -3.637 0.001 23.84±7.61 14.27±5.61 6.790 ＜0.001 统计量 1.309a 17.697b 1.189a 4.403b P值 0.194 ＜0.001 0.239 0.039 注：a为t值，b为F值。
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表 4 2组慢性盆腔炎患者治疗前后血清性激素水平比较(x±s)
Table 4. Comparison of serum sex hormone levels before and after treatment between two groups of patients with chronic pelvic inflammatory disease(x±s)
组别 例数 FSH(IU/L) t值 P值 LH(IU/L) t值 P值 治疗前 治疗后 治疗前 治疗后 阴道内治疗组 45 9.84±2.02 6.22±2.12 8.293 ＜0.001 6.52±2.64 6.13±2.08 0.786 0.434 中药灌肠组 45 9.79±1.95 8.15±2.37 3.585 0.001 6.51±3.06 6.45±1.89 0.112 0.911 统计量 0.119a 30.193b 0.017a 1.472b P值 0.905 ＜0.001 0.987 0.228 组别 例数 PRL t值 P值 E2(pg/mL) t值 P值 治疗前 治疗后 治疗前 治疗后 阴道内治疗组 45 16.98±6.62 17.49±5.45 0.399 0.691 23.36±9.52 58.19±20.29 -10.425 ＜0.001 中药灌肠组 45 18.94±4.55 17.14±6.22 1.567 0.121 23.27±7.61 38.07±14.35 -6.112 ＜0.001 统计量 1.637a 0.506b 0.050a 50.190b P值 0.106 0.479 0.961 ＜0.001 注：a为t值，b为F值。
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表 5 2组CPID患者治疗前后子宫内动脉血流动力学比较(x±s)
Table 5. Comparison of hemodynamics of uterine artery before and after treatment between two groups of CPID patients(x±s)
组别 例数 PI t值 P值 RI t值 P值 PSV(cm3/s) t值 P值 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 阴道内治疗组 45 0.54±0.09 0.80±0.10 12.960 ＜0.001 0.81±0.09 0.63±0.09 9.487 ＜0.001 13.58±1.12 14.79±1.10 1.795 0.076 中药灌肠组 45 0.56±0.07 0.71±0.11 7.717 ＜0.001 0.84±0.07 0.75±0.10 4.946 ＜0.001 13.62±1.15 14.17±1.49 1.960 0.053 统计量 1.177a 4.061b 1.765a 5.983b 0.167a 0.940b P值 0.243 ＜0.001 0.081 ＜0.001 0.868 0.350 注：a为t值，b为F值。
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