目的 探讨止痛化癥胶囊联合阿莫西林克拉维酸钾治疗慢性盆腔炎的临床疗效。方法 选取2019年8月—2020年8月在河南中医药大学第三附属医院治疗的84例慢性盆腔炎患者，随机分为对照组（42例）和治疗组（42例）。对照组患者口服阿莫西林克拉维酸钾片，1片/次，2次/d。治疗组患者在对照组基础上口服止痛化癥胶囊，2～3次/d，4粒/次。两组患者连续治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状好转时间，血清白细胞介素21（IL-21）、白细胞介素17（IL-17）、C反应蛋白（CRP）和肿瘤坏死因子α（TNF-α）水平及不良反应情况。结果 治疗后，治疗组临床总有效率明显高于对照组率（P<0.05）；治疗后，治疗组患者下腹疼痛、白带量多、腰骶疼痛、经期量多好转时间均明显短于对照组（P<0.05）。治疗后，两组患者血清IL-21、IL-17、CRP、TNF-α水平均明显降低（P<0.05），且治疗组患者明显低于对照组（P<0.05）。治疗组不良反应发生率明显低于对照组（P<0.05）。结论 止痛化癥胶囊与阿莫西林克拉维酸钾片联合治疗慢性盆腔炎，临床效果显著，临床症状改善明显，机体免疫功能得到增强，能有效降低炎症反应，且不良反应发生率较低。

Objective To investigate the clinical efficacy of Zhitong Huazheng Capsules combined with amoxicillin and clavulanate potassium in treatment of chronic pelvic inflammatory disease. Methods Patients (84 cases) with chronic pelvic inflammatory disease in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from August 2019 to August 2020 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were po administered with Amoxicillin and Clavulanate Potassium Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Zhitong Huazheng Capsules on the basis of the control group, 4 grains/time, 2 — 3 times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the improvement time of clinical symptoms, the serum levels of IL-21, IL-17, CRP and TNF-α, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the upturn times of lower abdominal pain, excessive leucorrhea, lumbosacral pain and menstrual volume in the treatment group were significantly shorter than that in the >control group (P < 0.05). After treatment, the serum levels of IL-21, IL-17, CRP, and TNF-α in the two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion The combination of Zhitong Huazheng Capsules and Amoxicillin and Clavulanate Potassium Tablets in the treatment of chronic pelvic inflammatory disease has significant clinical effects, significant improvement in clinical symptoms, enhanced immune function, effective reduction of inflammation, and the incidence of adverse reactions is low.

R984

河南省中医药科学研究专项课题（20-21ZY2016）；全国中医药创新骨干人才项目[豫卫中医（2019）1号