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目的探讨克林霉素联合氨曲南治疗盆腔炎性疾病的疗效及对炎性因子水平的影响。方法选取2012年12月至2014年12月新疆医科大学第一附属医院诊治的盆腔炎性疾病患者214例为研究对象,采用随机数字表法分为对照组和观察组,各107例。对照组采用左氧氟沙星联合甲硝唑治疗,盐酸左氧氟沙星注射液200 mg+甲硝唑注射液1250 mg,加入到500 m L生理盐水中静脉滴注,每12小时1次,等临床病症改善后改为口服用药;观察组采用克林霉素联合氨曲南治疗,盐酸克林霉素注射液1200 mg+注射用氨曲南1000 mg,加入到500 m L生理盐水中静脉滴注,每12小时1次,等临床病症改善后改为口服用药。两组用药总疗程14 d。于治疗前后行中医证候积分和局部体征积分,比较两组患者治疗前后的炎性因子水平、临床病症改善情况、临床疗效、不良反应发生情况。结果治疗后,观察组白细胞计数、白细胞介素6、高敏C反应蛋白、肿瘤坏死因子α低于对照组[(7.6±0.8)×109/L比(11.2±1.0)×109/L,(66±4)ng/L比(103±13)ng/L,(8.4±1.2)mg/L比(14.0±1.0)mg/L,(2.1±0.5)ng/L比(2.8±0.6)ng/L],差异均有统计学意义(P<0.01)。治疗后,观察组患者中医证候积分、局部体征积分均低于对照组[(2.69±0.54)分比(6.12±0.76)分,(1.80±0.78)分比(3.64±0.95)分],差异均有统计学意义(P<0.01)。观察组患者中医证候积分疗效总有效率、局部体征积分疗效总有效率均高于对照组[99.1%(106/107)比85.0%(91/107),98.1%(105/107)比82.2%(88/107)],差异有统计学意义(P<0.05)。观察组患者总不良反应发生率低于对照组[1.9%(2/107)比10.3%(11/107)],差异有统计学意义(P<0.05)。结论克林霉素联合氨曲南治疗盆腔炎性疾病的效果较好,可明显改善患者的临床病症,显著降低患者的炎性因子水平,疗效显著且安全性高,值得临床推广使用。
Objective To investigate the effect of clindamycin combined with aztreonam on the treatment of pelvic inflammatory disease and its effect on the level of inflammatory cytokines. Methods A total of 214 patients with pelvic inflammatory disease diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from December 2012 to December 2014 were selected as the study subjects and divided into control group and observation group by random number table. The control group was treated with levofloxacin plus metronidazole, levofloxacin injection 200 mg + metronidazole injection 1250 mg, added to 500 m L saline intravenously once every 12 hours, and other clinical symptoms improved to oral The observation group was treated with clindamycin combined with aztreonam, clindamycin hydrochloride injection 1200 mg + aztreonam injection 1000 mg, added to 500 m L normal saline intravenously every 12 hours, After the clinical symptoms improved to oral medication. The total course of two groups medication 14 d. Before treatment and after treatment, TCM syndrome score and local body score were compared. The levels of inflammatory cytokines, clinical symptoms, clinical efficacy and adverse reactions before and after treatment were compared between the two groups. Results After treatment, the number of white blood cells, interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor α in the observation group were lower than those in the control group [(7.6 ± 0.8) × 109 / L L, (± SD) ± (3) ng / L of (103 ± 13) ng / L and (8.4 ± 1.2) mg / L], the differences were statistically significant (P <0.01). After treatment, the scores of TCM syndromes and local signs in the observation group were significantly lower than those in the control group [(2.69 ± 0.54) points (6.12 ± 0.76) points and (1.80 ± 0.78) points (3.64 ± 0.95) points, respectively) All were statistically significant (P <0.01). The total effective rate of TCM syndrome score and the total effective rate of local symptom score in the observation group were higher than those in the control group (99.1% (106/107) vs 85.0% (91/107), 98.1% (105/107) vs 82.2 % (88/107)], the difference was statistically significant (P <0.05). The incidence of adverse reactions in the observation group was lower than that in the control group [1.9% (2/107) vs 10.3% (11/107)]. The difference was statistically significant (P <0.05). Conclusion Clindamycin combined with aztreonam is effective in treating pelvic inflammatory disease, which can significantly improve the clinical symptoms of patients and significantly reduce the level of inflammatory cytokines in patients with significant efficacy and safety, which is worthy of clinical promotion.