目的 探讨消炎汤通过调节肠道微生态的变化对慢性盆腔炎大鼠的治疗作用。方法 采用子宫内注射苯酚胶浆建立大鼠慢性盆腔炎模型，造模2周后ig消炎汤5、10、20 g/kg，连续14 d，观察大鼠子宫内膜形态，qPCR检测子宫组织中细胞间黏附分子（ICAM-1mRNA）表达情况，并采用16S rRNA高通道测序观察慢性盆腔炎大鼠肠道菌群的构成和比例。结果 各给药组中充血水肿现象少见，且炎症浸润程度好于妇科千金片组。与模型组相比，消炎汤各剂量组子宫组织中ICAM-1mRNA的表达均有下调，尤以消炎汤20 g/kg组为甚（P<0.01）。与模型组相比，消炎汤20 g/kg组Simpson指数显著上升（P<0.05）。给予消炎汤治疗后肠道菌群多样性、丰度均得到一定程度改善，但未见统计学差异。与模型组相比，消炎汤10、20 g/kg组乳杆菌、梭状芽孢杆菌OUT比例有不同程度升高。治疗后，消炎汤20、10 g/kg组OUT比例较模型组明显下降。结论 消炎汤能够明显改善慢性盆腔炎大鼠子宫的炎症程度，有效减少黏连的发生，作用机制与其调节肠道微生态影响雌激素代谢有关。

Objective To investigate the therapeutic effect of Xiaoyan Decoction on chronic pelvic inflammatory disease in rats by regulating the changes of intestinal microecology. Methods Chronic pelvic inflammatory disease models in rats were established with injection of phenol mucilage in uterus. After 2 weeks of model establish, rats in Xiaoyan Decoction were ig administered with 5, 10, and 20 g/kg for 14 d. Endometrial morphology in rats was observed, cell adhesion molecule ICAM-1 expression was detected by qPCR method, intestinal flora composition and proportion in chronic pelvic inflammation rat was adopted with 16S rRNA high channel sequencing. Results Hyperemia and edema were rare in each group, and the degree of inflammatory infiltration was better than that in Fuke Qianjin Tablets group. Compared with the model group, the expression of ICAM-1mRNA in the uterus tissues of Xiaoyan Decoction was down-regulated, especially in 20 g/kg group (P<0.01). Compared with the model group, the Simpson index was significantly increased in 20 g/kg Xiaoyan Decoction group (P<0.05). After the treatment of Xiaoyan Decoction, the diversity and abundance of intestinal flora were improved to some extent, but there was no statistical difference. Compared with the model group, the OUT ratio of Lactobacillus and Clostridium in the 10 and 20 g/kg Xiaoyan Decoction groups was increased in different degrees. After treatment, the proportion of OUT in 10 and 20 g/kg Xiaoyan Decoction group was significantly lower than that in the model group. Conclusion Xiaoyan decoction can significantly improve the inflammatory degree of uterus in rats with chronic pelvic inflammatory disease, and effectively reduce the occurrence of adhesion. The mechanism of action is related to the regulation of intestinal microecology and the influence of estrogen metabolism.

R966;R285.5

天津市卫生健康委员会中医中西医结合科研课题（2017066）