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不同治疗方案对慢性盆腔炎临床疗效及炎性因子水平的影响比较

Effect of different antibiotic therapy in the treatment of patients with chronic pelvic inflammation disease and the influence on inflammatory factors

摘要:

目的 比较不同抗生素治疗方案对慢性盆腔炎的临床疗效及炎性因子水平的影响.方法 选取慢性盆腔炎患者78例,采用电脑产生试验病例随机号码法分为观察组(抗生素序贯法)和对照组(抗生素序贯转化法),每组39例.治疗10 d后,观察两组的临床疗效,对比治疗前后血清中IL-1(白介素-1)、IL-2(白介素-2)水平表达情况;并比较两组患者经济成本、用药期间不良反应发生情况,并于治疗结束6个月后随访两组患者复发情况.结果 经过10 d治疗后,观察组总有效率94.59%,对照组的总有效率为86.49%,观察组总缓解率高于对照组,差异有统计学意义(χ2=5.41,P=0.00).治疗前,观察组IL-1表达为(413.47±38.59)μg/L,IL-2表达水平为(489.43±44.58)ng/L,对照组IL-1表达为(419.47±40.46)μg/L,IL-2表达水平为(490.47±47.40)ng/L,两组治疗前IL-1(t=0.65,P=0.52)及IL-2(t=0.10,P=0.92)表达水平差异无统计学意义;治疗后,观察组IL-1表达为(288.53±32.48)μg/L,低于治疗前(t=15.07,P=0.00),IL-2表达水平为(288.53±32.48)ng/L,高于治疗前(t=14.65,P=0.00).治疗后,对照组IL-1表达为(358.41±43.47)μg/L,低于治疗前(t=15.07,P=0.00),IL-2表达水平为(550.46±32.90)ng/L,高于治疗前(t=14.65,P=0.00).观察组IL-1(t=7.83,P=0.00)及IL-2(t=9.66,P=0.00)改善情况均优于对照组.观察组药品成本及给药费用分别为(115.47±3.48)元、(27.45±2.01)元,对照组分别为(120.45±3.39)元、(27.45±2.01)元,两组药品成本(t=2.44,P=0.17)及给药费用(t=0.00,P=1.00)差异无统计学意义.观察组中2例患者出现胃肠道不适反应,对照组为1例,差异无统计学意义(χ2=0.35,P=0.56).两组发生的不良反应均较为轻微,停药后自行缓解或消失.6个月后,观察组复发2.56%(1/39),对照组为15.38%(6/39),观察组复发率低于对照组(χ2=3.92,P=0.04).结论 采用抗生素序贯转换治疗方法即先静脉滴注抗生素,后转为口服联合用药,近期及远期临床疗效佳,且安全可靠,未增加患者经济负担,值得临床推广使用.

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abstracts:

Objective To compare the effects of different antibiotic regimens on clinical efficacy and inflam-matory factors in patients with chronic pelvic inflammatory disease .Methods 78 patients with chronic pelvic inflam-matory disease were enrolled .They were randomly divided into observation group ( antibiotic sequential method ) and control group ( sequential transformation of antibiotics ) by computer generation test case random number method , 39 cases in each group.After treatment for 10 days,the clinical efficacy was observed ,the serum IL -1 and IL-2 levels before and after treatment were compared .The economic costs , adverse events during the course of treatment were compared between the two groups , and 6 months after treatment , the recurrence was followed up in the two groups.Results After 10 days of treatment , the total effective rate was 94.59% in the observation group and 86.49%in the control group .The total remission rate in the observation group was higher than that in the control group(χ2 =5.41,P=0.002).Before treatment,the levels of IL-1 and IL-2 of the observation group were (413.47 ± 38.59)μg/L,(489.43 ±44.58)ng/L,respectively,which of the control group were (419.47 ±40.46)μg/L, (490.47 ±47.40)ng/L,respectively,and the differences were not statistically significant between the two groups (t=0.65,0.10,P=0.52,0.92).After treatment,the IL-1 level of the observation group [(288.53 ±32.48)μg/L] was lower than before treatment (t=15.07,P=0.00),and IL-2 level [(288.53 ±32.48)ng/L] was higher than before treatment (t=14.65,P=0.00).After treatment,the IL-1 level of the control group[(358.41 ±43.47)μg/L] was lower than before treatment (t=15.07,P=0.00),and IL-2 level [(550.46 ±32.90)ng/L] was higher than before treatment (t=14.65,P=0.00).The improvement of IL -1 and IL-2 levels in the observation group were better than those in the control group (t=7.83,9.66,all P=0.00).The cost of drug and drug expense of the obser-vation group were (115.47 ±3.48) RMB and (27.45 ±2.01) RMB,respectively,which of the control group were (120.45 ±3.39)RMB,(27.45 ±2.01)RMB,respectively,the differences between the two groups were not statisti-cally significant (t=2.44,0.00,P=0.17,1.00).There were 2 cases with gastrointestinal discomfort in the observa-tion group and 1 case in the control group ,the difference between the two groups was not statistically significant (χ2 =0.35,P=0.56).The adverse reactions of two groups were relatively minor ,self-mitigation or disappeared after with-drawl the drug.After treatment for 6 months,the recurrence rate was 2.56%(1/39) in the observation group and 15.38%(6/39) in the control group.The recurrence rate of the observation group was lower than that of the control group(χ2 =3.92,P=0.04).Conclusion The antibiotic sequential conversion therapy is the first intravenous antibi-otics,and then oral combination ,the recent and long -term clinical efficacy is good ,and it is safe and reliable ,without increasing the economic burden of patients ,and is worthy of clinical use .

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作者: 童美红 [1] 张涛 [2]
作者单位: 宁波市奉化区妇幼保健院药剂科, 浙江省宁波,315500 [1] 浙江大学医学院附属第二医院妇科, 浙江省杭州,310009 [2]
期刊: 《中国基层医药》2018年25卷8期 1006-1009页 ISTIC
栏目名称: 论著
DOI: 10.3760/cma.j.issn.1008-6706.2018.08.015
发布时间: 2018-04-27
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