摘要：
Objective To analyze the effect of antimicrobial enema liquid to explore different bacterial infection patients with chronic pelvic inflammatory disease by clearing away heat and promoting diuresis, detumescence,promoting blood circulation and relieving pain, and to investigate the influence of antimicrobial enema liquid applicated in rectal on endovaginal microecologics.Methods Seventy-one cases of chronic pelvic inflammatorydisease patients were selected as the research objects in Obstetrics and Gynecology Hospital Affiliated to Fudan University from March 2011 to January 2012.The bacterial culture of cervical secretions in patients with chronic pelvic inflammatory disease(excluding the vulva and vaginitis) was swab by cotton swab, then bacterial culture and bacterial vaginal infection Wulian analysis were conducted.The minimal inhibitory concentration(MIC) and minimum bactericidal concentration(MBC) of the common pathogenic bacteria were determined by using the flat dish two times dilution method according to the different kinds of pathogenic bacteria.Wulian analysis bacterial vaginal infection was reviewed after patients received the same kind of enema rectal administration.Results Main pathogenic bacteria in 71 cases of patients with chronic pelvic inflammatory disease were enterococcus faecalis of 12.5％ (4/71), beta hemolytic streptococcus of 31.25％ (10/17), escherichia coli of 34.38％ (11/71), Staphylococcus aureus of 28.13％ (9/71), mlicrococcus scarlatinae of 6.25％ (2/71), bacillus typhosus of 6.25％ (2/71), Shigella of 3.13％ (1/71), staphylococcus epidermidis of 3.13％ (1/71), klebsiella pneumoniae of 3.13％ (1/71) and pseudomonas aeruginosa of 3.13％ (1/71) .Chronic pelvic inflammatory disease enema on enterococcus faecalis, beta hemolytic streptococcus, escherichia coli, staphylococcus aureus and antibacterial activity was obvious, the minimum inhibitory concentration (MIC) were the original drug concentration of 1/32,1/32,1/16, 1/16, the minimum bactericidal concentration(MBC) respectively as raw material concentrations of 1/16, 1/8, 1/8, 1/8;has certain antibacterial activity against streptococcus pyogenes, typhoid salmonella, shigella flexneri, the MIC were the original drug concentrations of 1/8,1/8,1/4,the MBC were the original drug concentrations of 1/8,1/4,1/4.In vitro antibacterial activity on pseudomonas aeruginosa, coagulase negative staphylococci was not obvious.There were statistically significant differences in PH activity abnormality rate (67.61％ vs 36.62％), positive rate of catalase (66.20％ vs 29.58％), leukocyte esterase (56.33％ vs 29.58％), neuraminidase (53.52％ vs 25.35％), proline aminopeptidase (57.75％ vs 32.39％) and glucosaminidase(52.11％ vs 22.55％) after enema liquid applicated in rectal, and the difference was significant(P＜0.5).Conclusion The use of clearing away heat and promoting diuresis, detumescence, Huoxue Zhitong enema on chronic pelvic inflammatory disease pathogenic bacteria have certain inhibition, especially enterococcus faecalis infection.The drug has efficient on chronic pelvic inflammatory disease and endovaginal microecologics.%目的 探究不同细菌感染的慢性盆腔炎患者采用清热利湿、消肿散结、活血止痛的灌肠液体外抗菌作用效果,以及对阴道微生态的改善作用.方法 选取2011年3月至2012年1月来我院治疗的慢性盆腔炎患者71例作为研究对象.采用棉拭子法拭取慢性盆腔炎(排除外阴及阴道炎)患者宫颈管内分泌物进行细菌培养和细菌性阴道感染五联分析,根据致病菌的不同种类采用平皿二倍稀释法测定慢性盆腔炎灌肠液体外对常见致病菌的最小抑菌浓度及最低杀菌浓度.患者接受同种灌肠液直肠用药治疗后复查细菌性阴道感染五联分析.结果 71例患者中其中主要致病菌为粪肠球菌12.5％(4/71),乙型溶血性链球菌31.25％ (10/17),大肠埃希菌34.38％(11/71),金黄色葡萄球菌28.13％(9/71),化脓性链球菌6.25％(2/71),伤寒沙门杆菌6.25％(2/71),福氏志贺杆菌3.13％(1/71),表皮葡萄球菌3.13％(1/71),肺炎克雷伯菌3.13％(1/71),铜绿色假单胞菌3.13％(1/71).慢性盆腔炎灌肠液对粪肠球菌,乙型溶血性链球菌,大肠埃希菌,金黄色葡萄球菌有较明显的抑菌活性,最小抑菌浓度分别为原药浓度的1/32,1/32,1/16,1/16,最低杀菌浓度分别为原药浓度的1/16,1/8,1/8,1/8,对化脓性链球菌、伤寒沙门杆菌、福氏志贺杆菌有一定的抑菌活性,最小抑菌浓度分别为原药浓度的1/8、1/8、1/4,最低杀菌浓度分别为原药浓度的1/8、1/4、1/4.对铜绿假单胞菌、凝固酶阴性葡萄球菌的体外抑菌活性不明显.患者直肠用药治疗前后,pH活性异常率(67.61％与36.62％)、过氧化氢酶阳性率(66.20％与29.58％)、白细胞酯酶阳性率(56.33％与29.58％)、唾液酸苷酶阳性率(53.52％与25.35％)、脯氨酸氨基肽酶阳性率(57.75％与32.39％)和氨基葡萄糖苷酶阳性率(52.11％与22.55％)比较差异均有统计学意义(P均＜0.05).结论 采用具有清热利湿、消肿散结、活血止痛灌肠液对慢性盆腔炎常见致病菌具有一定抑制作用,且可以显著改善阴道微环境,提高机体自愈性.
