目的 探討婦炎舒膠囊聯(lián)合頭孢噻肟鈉治療慢性盆腔炎的臨床效果。方法 選擇2020年2月—2020年10月在河南大學淮河醫(yī)院治療的74例慢性盆腔炎患者，隨機分成對照組和治療組，每組各37例。對照組靜脈滴注注射用頭孢噻肟鈉，每次2 g加入生理鹽水100 mL，2次/d；治療組在對照組的基礎(chǔ)上口服婦炎舒膠囊，5粒/次，3次/d。兩組患者均治療3周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥候積分，血清血紅素氧合酶1（HO-1）、細胞間黏附分子-1（ICAM-1）、粒細胞-巨噬細胞集落刺激因子（GM-CSF）、白細胞介素-26（IL-26）和基質(zhì)金屬蛋白酶-2（MMP-2）水平，Smad-3、miRNA-224-3P和Smad-7水平，子宮血流動力學指標子宮血流搏動指數(shù)（PI）、血流最大峰值流速（Vs）和血流阻力指數(shù)（RI）。結(jié)果 治療后，治療組總有效率為97.30%，明顯高于對照組的81.08%（P<0.05）。治療后，兩組中醫(yī)癥候評分均顯著降低（P<0.05），且治療組降低更明顯（P<0.05）。治療后，兩組血清HO-1、ICAM-1、GM-CSF、IL-26、MMP-2水平均明顯下降（P<0.05），且治療組下降更明顯（P<0.05）。治療后，兩組血清Smad-3水平明顯降低，而miRNA-224-3P和Smad-7明顯升高（P<0.05），且治療組改善更明顯（P<0.05）。治療后，兩組PI、RI均下降，而Vs均顯著增高（P<0.05），且治療組改善更明顯（P<0.05）。結(jié)論 婦炎舒膠囊聯(lián)合注射用頭孢噻肟鈉治療慢性盆腔炎可有效改善患者臨床癥狀，降低機體炎癥反應，改善血流動力學，其抗炎作用與調(diào)節(jié)miRNA-224-3P、Smad信號通路有關(guān)。

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

河南省高等學校重點科研項目計劃（17A320023）