目的 探讨暖宫七味丸联合克林霉素磷酸酯注射液治疗慢性盆腔炎的疗效。方法 选择上海市嘉定区南翔医院在2023年4月—2024年4月收治的慢性盆腔炎患者共计90例，将所有患者按随机数字表法分对照组和治疗组，各包括45例。对照组患者静滴克林霉素磷酸酯注射液，0.6 g加入100 mL生理盐水，1次/d。治疗组在对照组基础上吞服暖宫七味丸，15粒/次，2次/d。两组持续治疗2周。比较两组患者的治疗效果、疼痛程度、盆腔超声指标、血清因子和血液流变学。结果 治疗后，对照组的总有效率为82.22%，治疗组总有效率为95.56%%，组间差异显著（P＜0.05）。治疗后，两组下腹、腰骶的视觉模拟评分法（VAS）评分显著减小（P＜0.05），治疗组下腹、腰骶的VAS评分低于对照组（P＜0.05）。两组治疗后的盆腔包块最大直径、盆腔积液均减小（P＜0.05）；治疗组治疗后盆腔包块最大直径、盆腔积液低于对照组（P＜0.05）。两组治疗后血清高迁移率族蛋白B1（HMGB1）、白细胞介素-1β（IL-1β）、单核细胞趋化蛋白-1（MCP-1）水平均明显降低（P＜0.05），治疗组患者治疗后血清HMGB1、IL-1β、MCP-1水平低于对照组（P＜0.05）。治疗后，两组患者的血浆黏度、血细胞比容、红细胞聚集指数均降低（P＜0.05），且治疗组患者血浆黏度、血细胞比容、红细胞聚集指数低于对照组（P＜0.05）。结论 暖宫七味丸联合克林霉素磷酸酯注射液可提高慢性盆腔炎的临床疗效，减轻疼痛程度、盆腔体征和炎症反应，改善血液流变学。

Objective To explore the efficacy of Nuangong Qiwei Pills combined with Clindamycin Phosphate Injection in treatment of chronic pelvic inflammatory disease. Methods A total of 90 patients with chronic pelvic inflammatory disease admitted to Shanghai Jiading Nanxiang Hospital from April 2023 to April 2024 were selected. All patients were divided into control group and treatment group using a random number table method, with 45 patients in each group. The control group patients received iv Clindamycin Phosphate Injection, 0.6 g added to 100 mL physiological saline, once daily. The treatment group po administered with Nuangong Qiwei Pills on the basis of the control group, 15 pills/time, twice daily. Two groups continued treatment for 2 weeks. The treatment efficacy, pain level, pelvic ultrasound indicators, serum factors, and hemorheology between two groups of patients were compared. Results After treatment, the total effective rate of the control group and treatment group were 82.22% and 95.56%, with significant differences between two groups (P < 0.05). After treatment, the visual analogue scale (VAS) scores of the lower abdomen and lumbosacral area in two groups significantly decreased (P < 0.05), and the VAS scores of the lower abdomen and lumbosacral area in the treatment group were lower than those in the control group (P < 0.05). The maximum diameter of pelvic masses and pelvic fluid accumulation decreased in two groups after treatment (P < 0.05). The maximum diameter of pelvic masses and pelvic fluid accumulation in the treatment group were lower than those in the control group after treatment (P < 0.05). After treatment, the levels of high mobility group protein B1 (HMGB1), interleukin-1β (IL-1β), and monocyte chemoattractant protein-1 (MCP-1) in two groups were significantly reduced (P < 0.05). The levels of HMGB1, IL-1β, and MCP-1 in the treatment group were lower than those in the control group (P < 0.05). After treatment, the plasma viscosity, hematocrit, and erythrocyte aggregation index of two groups decreased (P < 0.05), and the plasma viscosity, hematocrit, and erythrocyte aggregation index of the treatment group were lower than those of the control group (P < 0.05). Conclusion The combination of Nuangong Qiwei Pills and Clindamycin Phosphate Injection can improve the clinical efficacy of chronic pelvic inflammatory disease, alleviate pain, pelvic signs, and inflammatory reactions, and improve blood rheology.

R984

上海市嘉定区卫生健康委员会科研项目（2019-QN-11）