目的 观察经皮穴位联合经阴道电刺激治疗盆腔炎性疾病后遗症慢性盆腔痛(SPID-CPP)气滞血瘀型的疗效及对炎症因子的影响.方法 将120 例SPID-CPP气滞血瘀型患者按照随机数字表法分为2 组,对照组60 例予妇炎舒胶囊治疗,治疗组60 例在对照组治疗基础上加经皮穴位联合经阴道电刺激治疗,2 组均 3 个月经周期为 1 个疗程,治疗1 个疗程.比较2 组疗效;观察2 组治疗前后疼痛视觉模拟评分(VAS)、简明健康状况调查表(SF-36)评分变化;比较2 组治疗前后盆腔血流动力学指标、血清炎症因子指标变化.结果 治疗组总有效率 91.67%(55/60),对照组总有效率68.33%(41/60),治疗组疗效优于对照组(P<0.05).2 组治疗后疼痛VAS均较本组治疗前降低(P<0.05),治疗后治疗组疼痛VAS低于对照组(P<0.05),差值高于对照组(P<0.05).2 组治疗后SF-36 中 8 个维度评分均较本组治疗前升高(P<0.05),治疗后治疗组8 个维度评分均高于对照组(P<0.05).2 组治疗后子宫动脉收缩期血流峰值速度(PSV)、卵巢动脉PSV均较本组治疗前升高(P<0.05),子宫动脉搏动指数(PI)、子宫动脉阻力指数(RI)、卵巢动脉PI、卵巢动脉RI均较本组治疗前降低(P<0.05);治疗后治疗组子宫动脉PSV、卵巢动脉PSV均高于对照组(P<0.05),子宫动脉PI、卵巢动脉PI均低于对照组(P<0.05).2 组治疗后肿瘤坏死因子α(TNF-α)较本组治疗前降低(P<0.05),白细胞介素2(IL-2)、IL-10 均较本组治疗前升高(P<0.05);治疗后治疗组TNF-α低于对照组(P<0.05),IL-2、IL-10 均高于对照组(P<0.05).结论 经皮穴位联合经阴道电刺激治疗SPID-CPP气滞血瘀型,能改善患者慢性盆腔痛症状,提高生活质量,改善盆腔血淤微环境,调节机体免疫功能.
Objective To observe the efficacy of transcu-taneous electrical acupoint stimulation(TEAS)combined with transvaginal electrical stimulation(TES)on chronic pelvic pain(CPP)in patients with sequelae of pelvic inflammatory disease(SPID)with Syndrome of qi stagnation and blood stasis and its in-fluence on inflammatory factors.Methods A total of 120 patients with SPID-CPP(Syndrome of qi stagnation and blood stasis)were randomly assigned into the treatment group(n =60)and the control group(n =60).All patients were managed by Fuyan-shu capsule,and those in the treatment group were additionally treated with TEAS combined with TES.The treatment continued for 1 course(1 course for 3 menstrual cycles),the aim was to compare visual analogue scale(VAS)for pain,36-Item Short Form Health Survey(SF-36)scores,pelvic hemodynamic indexes,serum inflammatory factor.The curative effect was as-sessed.Results The overall effective rate in the treatment group was better than that in the control group(91.67%[55/60]vs 68.33%[41/60],[P<0.05],respectively).After treatment,VAS scores in the both groups were significantly decreased(P<0.05),which in the treatment group were significantly lower than the control group(P<0.05),and the difference was significantly higher than the control group(P<0.05).After treatment,the SF-36 scores of 8 dimensions in the both groups were significantly increased(P<0.05),which in the treatment group were significantly higher compared with the control group(P<0.05).The peak systolic velocity(PSV)of uterine artery and arteria ovarica in the both groups were significantly increased(P<0.05),the increase in the treatment group was more common than the control group(P<0.05).The pulsatility index(PI)and resistance index(RI)of uterine artery,PI and RI of arteria ovarica in the both groups were significantly decreased(P<0.05),PI of uterine artery and arteria ovarica was significantly lower in the treatment group than in the control group(P<0.05).Decreased tumor necrosis factor-alpha(TNF-α),and increased interleukin-2(IL-2)and IL-10 were detected in the two groups(all P<0.05),and the treatment group was superior to the control group for TNF-α,IL-2 and IL-10(all P<0.05).Conclusion For patients with SPID-CPP(Syndrome of qi stagnation and blood stasis),TEAS combined with TES can alleviate the symptoms of chronic pelvic pain,improve the quality of life,and regulate both pelvic blood stasis microenviron-ment and immune function.