Clinical Efficacy and Mechanism of Longdan Xiegantang in Treatment of Pelvic Inflammatory Infertility / 中国实验方剂学杂志

ABSTRACT

Objective:To observe the clinical efficacy of Longdan Xiegantang in the treatment of pelvic inflammatory infertility with damp-heat phlegm and phlegm, in order to explore its mechanism of action. Method:Totally 150 patients with phlegm and inflammatory pelvic inflammatory infertility admitted to First Hospital of Hunan University of Chinese Medicine from January 2017 to December 2018 were enrolled in the study. According to the random number, the patients were divided into control group and observation group, with 75 cases in each group. Control group was given antibiotics combined with Gandan Shuangqing granule, and observation group was given Longdan Xiegantang combined with antibiotics. Both groups were treated for 6 weeks. The clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, blood rheology and serum biochemical parameters, inflammatory factor levels and immune function indexes of the two groups were compared. Result:The total effective rate of observation group was 93.33%, which was higher than 78.67% of control group (χ2=6.480, P<0.05). The pregnancy rate of observation group was 58.33%, which was significantly higher than 33.82% of control group (χ2=8.862, P<0.01). Before treatment, there was no significant difference in TCM syndrome score, hemorheology, serum biochemical index, inflammatory factor level and immune function between the two groups. Compared with before treatment, the TCM syndrome scores of lower abdominal pain, anal bulge, lumbosacral pain, abnormal bandage and menstrual disorders were significantly reduced, the levels of plasma viscosity, hematocrit, high and low-shear whole blood viscosity were significantly reduced, the level of inhibin-A (INH-A) was significantly increased, the level of progesterone (P) and beita chorionic gonadotropin (β-HCG) were significantly reduced, the levels of serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased, the levels of CD4+ and CD8+ were significantly increased, and the levels of IgA, IgG and IgM were significantly decreased (P<0.05). After treatment, in observation group, TCM syndrome scores of the lower abdominal pain, anal bulge, lumbosacral pain, abnormal bandage and menstrual disorders were significantly reduced, the levels of plasma viscosity, hematocrit, high and low-shear whole blood viscosity were significantly reduced, the level of INH-A was significantly increased, and the level of P and β-HCG were significantly reduced, the levels of serum CRP, IL-6, TNF-α were significantly decreased, the levels of CD4+ and CD8+ were significantly increased, and the levels of IgA, IgG and IgM were significantly decreased (P<0.05). There was no obvious adverse reaction in two groups during the treatment. Conclusion:Longdan Xiegantang has a good clinical effect in treating pelvic inflammatory infertility with damp-heat phlegm and phlegm, and can reduce TCM syndrome scores, and increase pregnancy rate. The mechanism may be correlated with the improvement of blood rheology and serum biochemical indicators, the inhibition of inflammatory factors and the enhancement of immune function.