| Objective: Pelvic inflammatory disease(PID),a gynecological disease,has a high morbidity and seriously affects the physical and mental health of women.The etiology of PID is pathogen infection,which can lead to tissue congestion,edema,local adhesion and poor blood circulation.In recent years,the researchers found that Traditional Chinese Medicine combined with Chemical Medicine could ameliorate the quality of life and improve the treatment effect in the treatment of PID.Therefore,in this paper,we will study the pharmacokinetics and pharmacodynamics of azithromycin combined with FKQJP based on the clinical practice in order to provide scientific basis for the clinical use of drugs,and to explore the rationality of the combination.Methods and Results: Part ?: The rats model of PID was established by injecting mixed bacteria of Staphylococcus aureus and Escherichia coli into the uterine cavity plus mechanic injury.Compared with the normal control group,the body weight,food intake and water intake of model rats were decreased after moding and gradually recovered 3 days later.After the uterus anatomy,the swelling of uterus were obvious and the majority of the uterus were tortured and expanded.Moreover,the results of HE staining showed that glands in lamina propria disappear,obvious hyperemia and edema,mucosal epithelial cell proliferation was papillary protruding into the uterine cavity.However,normal control group uterus was not found obvious abnormalities.Part ?: The PID model rats were randomly divided into two groups and were respectively azithromycin(10 mg/kg),azithromycin(10 mg/kg)combined with FKQJP(1.6 g/kg)by stomach perfusion.After 7 days,collecting plasma samples at different time points and the concentration of azithromycin in plasma was determined by HPLC-MS.ADAPT5.1 software was used to calculate the pharmacokinetic parameters of each group by Inverse Gaussian Function model.SPSS was used for the statistical analysis of data in each group.The main pharmacokinetic parameters of azithromycin including CLt ? CLd ? MIT and F have no significant differences(P > 0.05)between two groups.Part ?: The PID model rats were randomly divided into: model group,azithromycin group,azithromycin combined with FKQJP.In addition,the normal rats were used as the normal control group.The dose is the same as the part II.Collecting blood samples and detecting hemorheology and inflammatory factors in the first,the third,the fifth and the seventh day after intragastric administration.The results showed that the two treatment groups can significantly improve the "blood stasis" state,reduce blood viscosity,improve blood flow,reduce the release of inflammatory factors of PID rats.In the meantime,compared with the azithromycin group,azithromycin combined with FKQJP could better decrease the whole blood viscosity,plasma viscosity,and NO and TNF-?concentration without significant difference(P>0.05).Conclusion:FKQJP does not affect the pharmacokinetics of azithromycin when it was gavaged combined with azithromycin simultaneously in PID rats,so that there is no incompatibility between FKQJP and azithromycin in pharmacokinetics.As for pharmacodynamics,on the one hand,there is no antagonistic effect of FKQJP on anti-inflammatory and promoting blood circulation effects of azithromycin in PID rats,on the other hand,azithromycin combined with FKQJP can further reduce the release of inflammatory factors,improve blood viscosity in PID rats.Therefore,activating immunocytes and enhancing the body immunity maybe the important way to advancing treatment effectiveness of PID during FKQJP plus azithromycin for pelvic inflammation treatment. |
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