目的 探讨妇炎舒胶囊联合头孢噻肟钠治疗慢性盆腔炎的临床效果。方法 选择2020年2月—2020年10月在河南大学淮河医院治疗的74例慢性盆腔炎患者，随机分成对照组和治疗组，每组各37例。对照组静脉滴注注射用头孢噻肟钠，每次2 g加入生理盐水100 mL，2次/d；治疗组在对照组的基础上口服妇炎舒胶囊，5粒/次，3次/d。两组患者均治疗3周。观察两组患者临床疗效，比较治疗前后两组患者临床症候积分，血清血红素氧合酶1（HO-1）、细胞间黏附分子-1（ICAM-1）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）、白细胞介素-26（IL-26）和基质金属蛋白酶-2（MMP-2）水平，Smad-3、miRNA-224-3P和Smad-7水平，子宫血流动力学指标子宫血流搏动指数（PI）、血流最大峰值流速（Vs）和血流阻力指数（RI）。结果 治疗后，治疗组总有效率为97.30%，明显高于对照组的81.08%（P<0.05）。治疗后，两组中医症候评分均显著降低（P<0.05），且治疗组降低更明显（P<0.05）。治疗后，两组血清HO-1、ICAM-1、GM-CSF、IL-26、MMP-2水平均明显下降（P<0.05），且治疗组下降更明显（P<0.05）。治疗后，两组血清Smad-3水平明显降低，而miRNA-224-3P和Smad-7明显升高（P<0.05），且治疗组改善更明显（P<0.05）。治疗后，两组PI、RI均下降，而Vs均显著增高（P<0.05），且治疗组改善更明显（P<0.05）。结论 妇炎舒胶囊联合注射用头孢噻肟钠治疗慢性盆腔炎可有效改善患者临床症状，降低机体炎症反应，改善血流动力学，其抗炎作用与调节miRNA-224-3P、Smad信号通路有关。

Objective To investigate the clinical efficacy of Fuyanshu Capsules combined with cefotaxime sodium in treatment of chronic pelvic inflammatory disease.Methods Patients (74 cases) with chronic pelvic inflammatory disease in Huaihe Hospital of Henan University from February 2020 to October 2020 were randomly divided into control and treatment groups, and each group had 37 cases. Patients in the control group were iv administered with Cefotaxime Sodium for injection, 2 g/time added into normal saline 100 mL, twice daily. Patients in the treatment group were po administered with Fuyanshu Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 3 weeks. After treatment, the clinical efficacy was evaluated, and the clinical symptom scores, the levels of serum HO-1, ICAM-1, GM-CSF, IL-26, and MMP-2, the levels of Smad-3, miRNA-224-3P and Smad-7, the uterine hemodynamic index of PI, RI andVs in two groups before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 97.30%, which was significantly higher than 81.08% of the control group (P<0.05). After treatment, the scores of TCM symptoms in two groups were significantly decreased (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of HO-1, ICAM-1, GM-CSF, IL-26 and MMP-2 were significantly decreased in two groups, especially in the treatment group (P<0.05). After treatment, the level of serum Smad-3 were significantly decreased, while the level of miRNA-224-3P and Smad-7 were significantly increased in two groups (P<0.05), and the improvement was more obvious in the treatment group (P<0.05). After treatment, PI and RI were significantly decreased, while Vs were significantly increased in two groups (P<0.05), and the improvement in the treatment group was more obvious (P<0.05).Conclusion Fuyanshu Capsules combined with cefotaxime sodium in treatment of chronic pelvic inflammatory disease can effectively improve the clinical symptoms, reduce inflammatory reaction and improve hemodynamics, and the anti-inflammatory effect is related to the regulation of miRNA-224-3P and Smad signal pathway.

R984

河南省高等学校重点科研项目计划（17A320023）