Application of Chinese Medicine Nursing Techniques in the Sequelae of Pelvic Inflammatory Diseases: A Review

Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, traditional Chinese medicine (TCM) in China has gradually shown its clinical advantages in the treatment of SPID. Therefore, the present review summarizes the etiology and pathogenesis of SPID, the evidence typology, and the clinical application effects of moxibustion, herbal retention enema, acupoint compresses, external application of traditional Chinese medicine, auricular pressure beans, tuina massage, traditional Chinese medicine gongfu, and other commonly used Chinese medicine nursing techniques, with the aim of providing references and experiences for the subsequent related studies.

Effects of Wuwei Xiaodu Decoction on Uterine Energy Metabolism and Serum Inflammatory Factors in Rats with Acute Pelvic Inflammatory Disease

[Objectives]To observe the effects of Wuwei Xiaodu Decoction on uterine energy metabolism and serum inflammatory factors in the acute pelvic inflammatory disease(APID)model.[Methods]75 Wistar rats(females)were randomly divided into control group,model group and Wuwei Xiaodu Decoction low,medium and high dose groups(n=15).Except for the control group,the rat APID model was established by right uterine inoculation.On the fifth day after inoculation,the low,medium and high dose groups of Wuwei Xiaodu Decoction were administered at 4,8 and 16 g/kg,and the control group and model group received normal saline.Rats were killed 12 h after nondose administration,blood was collected from the abdominal aorta and measured by ELISA for serum interleukin-6(interleukin-6,IL-6),IL-8,and C-reactive proteins(CRP);the right uterus of rats was tested for high-energy phosphate adenosine phosphate(AMP),adenosine diphosphate(ADP),adenosine triphosphate(ATP)and total adenine nucleotides(TAN)level to evaluate the uterine energy metabolism.[Results]AMP,ADP,ATP and TAN were significantly higher in the Wuwei Xiaodu Decoction of low,medium and high dose than the model group,while the serum IL-6,IL-8 and CRP were significantly lower than the model group,and the difference between the low,medium and high doses(P<0.05).[Conclusions]The Wuwei Xiaodu Decoction can dose-dependent promote uterine energy metabolism and inhibit inflammatory response in APID model rats.

Ruptured teratoma mimicking a pelvic inflammatory disease and ovarian malignancy:A case report

BACKGROUND We report a case of ruptured ovarian teratoma mimicking pelvic inflammatory disease(PID)and ovarian malignancy.The case indicates the need for reviewing the information on ovarian teratomas,as the symptoms are vague,and,therefore,diagnosis and treatment had to be structured accordingly.CASE SUMMARY A 60-year-old woman was admitted to the emergency department with acute lower abdominal pain.She experienced weight loss and increased abdominal girth.Pelvic ultrasound and computed tomography revealed a 14-cm pelvic tumor.Laboratory examination revealed leukocytosis(white blood cell count:12620/μL,segment:87.7%)and high levels of C-reactive protein(18.2 mg/dL).Elevated levels of the tumor marker cancer antigen 19-9(367.8 U/mL,normal value<35 U/mL)were also noted.Due to the impression of a ruptured tuboovarian abscess or a tumor with malignancy,she immediately underwent an exploratory laparotomy.A ruptured ovarian tumor with fat balls,hair strands,cartilage,and yellowish fluid was observed on the right side.Right salpingooophorectomy was performed.A pathological examination revealed a mature cystic teratoma.The patient recovered after surgery and was discharged on postoperative day three.No antibiotics were administered.CONCLUSION This case illustrates the differential diagnosis of an ovarian tumor.Therefore,surgery is the mainstay for treating a ruptured teratoma.

How inflammation influences psychiatric disease

Recent studies highlight the strong correlation between infectious diseases and the development of neuropsychiatric disorders.In this editorial,we comment on the article“Anti-infective therapy durations predict psychological stress and laparoscopic surgery quality in pelvic abscess patients”by Zhang et al,published in the recent issue of the World Journal of Psychiatry 2023;13(11):903-911.Our discussion highlighted the potential consequences of anxiety,depression,and psychosis,which are all linked to bacterial,fungal,and viral infections,which are relevant to the impact of inflammation on the sequelae in mental health as those we are observing after the coronavirus disease 2019 pandemic.We focus specifically on the immune mechanisms triggered by inflammation,the primary contributor to psychiatric complications.Importantly,pathophysiological mechanisms such as organ damage,post-injury inflammation,and infectioninduced endocrine alterations,including hypocortisolism or autoantibody formation,significantly contribute to the development of chronic low-grade inflammation,promoting the emergence or development of psychiatric alterations in susceptible individuals.As inflammation can have long-term effects on patients,a multidisciplinary treatment plan can avoid complications and debilitating health issues,and it is crucial to recognize and address the mental health implications.

Progress in nursing methods for chronic pelvic inflammatory disease

Chronic pelvic inflammatory disease is a highly common gynecological disease.It is often caused by the failure to completely treat acute pelvic inflammatory disease or persistent disease due to the poor physique of patients.This paper provides a summary of the recent research studies on chronic pelvic inflammatory disease.

A Metabolomics Study of the Volatile Oil from Prunella vulgaris L.on Pelvic Inflammatory Disease

Objective Pelvic inflammatory disease(PID)is one of the most common gynaecological diseases.Here,this thesis aims to investigate the therapeutic effects of Prunella vulgaris L.oil on the PID by using metabolomics based on gas chromatographymass spectrometry(GC-MS)to address this challenge.Methods First,measurements of pro-inflammatory cytokines and histological analysis of the uterus were conducted to validate the successful generation of a PID rat model.Furthermore,the volatile oil from Prunella vulgaris L.was administered to treat PID rats.Serum samples were collected before and after treatment and analyzed by GC-MS to generate metabolite profiles for each sample.The information generated from the qualitative and quantitative analysis of these metabolites was applied to distinguish between the PID model and normal control groups.Results Some metabolites,such as acetic acid,succinic acid,glyceric acid,(R*,S*)-3,4-dihydroxybutanoic acid,3-hydroxyphenylacetic acid,D-ribose and myo-inositol showed a higher contribution in the classification model;thus,they can be considered as potential biomarkers.Furthermore,the therapeutic effect of the volatile oil extracted from Prunella vulgaris L.could also be visualized using GC-MS-based metabolomics.Conclusions The results show that metabolomics studies are invaluable for disease diagnosis and therapeutic effect estimation.

Treatment of Chronic Pelvic Inflammation with Acupuncture and TDP Irradiation—A Report of 23 Cases

With electro-acupuncture, red-hot needling and TDP irradiation, we have successfully treated 23 cases of chronic pelvic inflammation. A report follows.

Anesthetic Treatment in Operations of Small Pelvic Organs Pathology

The article presents data on the surgical treatment of 405 patients with pelvic organ surgical and gynecological diseases. When using regional anesthesia during operations in the lower abdominal cavity of patients with pelvic pathology, a smoother operation course and early postoperative period were observed compared with general anesthesia use. In this work, 405 patients with surgical and gynecological diseases of pelvic organs, operated in the surgical and gynecological departments were analyzed. When using regional anesthesia, it was observed that intraoperative blood loss in patients and consumption of narcotic analgesics in the postoperative period decreases.

Effect of Zhuang Yi Liu Fang Teng Fang on the Expression of TNF-αand NF-κB in Chronic Pelvic Inflammatory Disease(CPID)Model Rats

Objecrive:To investigate the expression of TNF-αand NF-κB in the uterus of chronic pelvic inflammatory disease(CPID)model rats.Methods:40 female rats that adaptive fed for 5 days were randomly divided into normal group,model group,high dose group,medium dose group and low dosegroup.In addition to the normal group:the rats in each group were made chronic pelvic inflammatory model by mechanical injuuy combined with implantation of bacteria.The rats in each group were administrated by gavage for 20days.After the last administration,the level of TNF-αand NF-κB in serum was measured by ELASA method.Results:(1)after the establishment of the model,the uterus of the chronic pelvic inflammatory model rats showed the pathological damage of chroic infilammation;the levels of lNF-αand NF-κB inserum were higher than those in the normal group,the difference was statistically significant(P<0.05).(2)After the drug intervention,the uterine tissue morphology of the rats in the Zhuang Yi Liu Fang Teng Fang Group was basically restored to normal,with only a small amount of inflammatory cell infiltration and other pathological changes;compared with the rats in the model group,the TNF-αin serum of the rats in each treatment group was lower,the difference was statistically significant(P<0.05).The expression of NF-κB in serum of each treatment group was lower fthan that of the model group(P<0.05).Conclusion:Zhuang Yi Liu Teng Fang can efectively improve the endometrial histomorphology of CPID model rats,and regulate the levels of TNF-αand NF-κB in the uterus of chronic pelvic inflammatory model rats.

Application of Preventive Treatment Theory in the Treatment of Pelvic Inflammatory Disease

With a history of more than two thousand years, the theory of preventative treatment has been closely followed by the development of modern medical theories on the basis of inheritance by medical experts in the past dynasties, which has been constantly improved and enriched, and deeply applied in the prevention and treatment of serious and multiple diseases. It has achieved great benefits. For women with gynecological diseases, pelvic inflammatory disease patients accounted for a large proportion. Due to the lack of specificity in diagnosis and treatment, the condition is lingering and difficult to cure, so it seriously reduces the quality of life of women, thus affecting the harmony of family and society. From the perspective of prevention, according to the characteristics of each stage of the disease, this paper put forward substantive prevention suggestions and targeted treatment methods, ensuring preventing before disease, preventing progress after disease, and preventing reoccurring after recovery. It has important practical significance for the prevention and treatment of pelvic inflammatory diseases, as well as the development and inheritance of traditional Chinese medicine.

Clinical Efficacy of Western Medicine Combined with Chinese Medicine for Pelvic Inflammatory Disease(Damp-Heat and Stasis Type)

Objective:This study was undertaken to evaluate the clinical efficacy of Western medicine combined with Chinese medicine for pelvic inflammatory disease(damp-heat and stasis type).Methods:Seventy-four patients who were diagnosed with pelvic inflammatory disease(damp-heat and stasis type)by our hospital during July 2021 to July 2022 were randomized into two groups:the participants in the control group received conventional Western medicine treatment,and the participants in the study group received Western medicine combined with Chinese medicine.Results:After treatment,the total effectiveness of the control group(72.98%)was significantly lower than that of the study group(94.59%),(P<0.05);the whole blood viscosity high cut,whole blood viscosity low cut,fibrinogen and plasma viscosity of the control group were all lower than those of the study group(P<0.05);the levels of CRP,IL-6,and TNF-αin the control group were higher and IL-2 levels in the control group were lower than those in the study group(P<0.05).Conclusion:Western medicine combined with Chinese medicine is more effective in curing damp-heat and stasis-type pelvic inflammatory disease by improving the blood rheological indexes and lowering the level of inflammatory factors.

Characterization of the Attended Surgical Patients in the Assisted Reproduction Territorial Centre, Cienfuegos 2015-2016

Introduction: Infertility is a health problem that does not cause death, disability or physical pain;however, it is a crisis for couples who see their life plans threatened and suffer not only at the time of diagnosis and during treatments, but in multiple daily situations. Scientific Problem: There are no published studies on the characteristics of the infertile patient who has required surgical treatment, which is attended at the Territorial Center for Assisted Reproduction, Cienfuegos. Objective: To characterize the patients with infertility diagnosis who underwent surgical treatment and were treated at the Territorial Center for the care of the infertile couple in the province of Cienfuegos. Methodological Design: A descriptive, prospective, cross-sectional study of a series of cases was carried out at the Territorial Center for Assisted Reproduction, inserted in the Department of External Consultation of the General University Hospital, Dr. “Gustavo Aldereguía Lima” in Cienfuegos, in the period from January 2015 to December 2016. The variables studied were: age, skin color, pelvic inflammatory disease, personal pathological history, number of pregnancies, number of deliveries, number of abortions, age of the first sexual relations, cause of infertility, time attending the consultation, previous pelvic surgery, preoperative diagnosis, type of surgery, type of treatment and results of the surgery. Results: A predominance of age was obtained between 26 and 35 years of previous pelvic inflammatory disease, Bronchial Asthma as a personal pathological antecedent, previous pelvic surgery, number of pregnancies between 1 and 2, induced abortion among other results.

Clinical Observation on Abdominal Cluster-Needling for Treatment of Chronic Annexitis

Chronic annexitis is a frequently encountered disease at clinic. According to clinical experience in acupuncture treatment of annexitis, the author has developed an effective acupuncture method called abdominal cluster-needling, with quite good therapeutic results as reported in the following.Clinical DataThere were altogether 66 cases of chronic annexitis in this series, which were divided randomly into the treatment group and control group. The treatment group consisted of 36 cases, ranging in age from 20-40 years, and duration of illness from 0.5-9 years. The control group consisted of 30 cases, ranging in age from 21-38 years, and duration of illness from 1-8 years.

Clinical Analysis of 32 Cases on Treatment of Infertility with Laparoscopic Hysteropexy

The diagnosis and treatment for 32 patients suffering from infertility, were established with the aid of laparoscopy. Among them, 14 cases were found to be of chronic pelvic inflammatory disease, 13 cases endometriosis and 2 cases simple habitual abortion. After performing conservative operative procedures for the treatment of the primary diseases, all of the 32 patients underwent the laparoscopic hysteropexy. This operative technique is simple and is easily mastered by experienced laparoscopists who are familiar with the pelvic anatomy and ready to deal with intra-or post-operative complications. Follow-up study of these 32 cases for 2 to 6 years showed an overall pregnancy rate of 56.3% (18/32), a live birth rate of 53.1% (17/32) and an abortion rate of 3.1% (1/32). The pregnancy rate alter operation in the patients suffering from endometriosis was 85% (11/13), which was much higher than that of the patients with chronic inflammatory disease who had a pregnacy rate of 42.8% (6/14). The difference was highly significant (P< 0.01).These results indicate that in patients suffering from infertility due to various etiological causes, after treatment of the primary diseases, ventrohysteropexy, in selected cases, can be mphed as a fertility-promoting measure.

Laparoscopy in the Diagnosis and the Treatment of Infertility（Analysis of 340 consecutive cases）

Three hundred and jorty patients suffering from primary and secondary infertility were investigated by laparoscopy with the following results. 1. The substantial and most common causes of infertility were related to chronic pelvic inflammatory disease and pelvic endometriosis. 2. Comparison of the result of chromopertubation under direct vision during loparoscy with the preoperative results with hysterosalpingography and phenolphthaline tubal instillation test showed significant difference (P<0.01). In the tubal patent group the compatibility of the results was 90.2% and 79% respectively whereas in the obstructed tubal group the discrepancy between the results was 50.5% and 59% respectively. 3. With the aid of laparoscopic investigation, the underlying cause of infertility could be verified in 97.6% of the patients. In 53.2% of the cases 14 different kinds of operations were performed directly under the laparoscope, while 12.9% of the cases required loparotomy. In 58.5% of the patients laparoscopy was performed in combination with hysteroscopy and 26 operations,consisting of uterine septum resection and intrauterine adhesiolysis were completed undder the monitoring of the loparoscope.

Effect of Psychological Intervention on Emotion of Patients with Tumor Radiotherapy

Objective:To explore the emotional impact of psychological nursing intervention on patients with malignant tumor radiotherapy,and further verify the specific application value of this nursing model in the oncology department.Methods:A total of 129 patients with tumor radiotherapy admitted to our hospital from June 2018 to June 2021 were selected as subjects,and they were divided into control group and observation group by random number method.Among them,64 cases in the control group received routine clinical nursing.65 cases in the observation group received psychological nursing intervention.Then,the clinical nursing effect,self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,immune function level change condition and clinical nursing satisfaction were compared under the two nursing modes,in order to fully verify the clinical application value of psychological nursing intervention mode for patients with cancer radiotherapy.Results:Comparing the clinical indexes of the two groups,SDS and SAS scores of the observation group were significantly lower than those of the control group.In terms of nursing satisfaction,the observation group is 96.92%and the control group is 90.62%,the difference was significant,and had clinical statistical significance(P<0.05);After the comprehensive evaluation of the immune function of the two groups,it was found that the observation group was significantly better than the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:In the mode of psychological nursing,medical staff can carry out precise psychological nursing intervention and nutritional nursing for patients according to the specific conditions and treatment process of patients,which can greatly promote the psychological stability of patients,significantly reduce patients5 negative emotions.In addition,the scientific implementation of psychological nursing intervention in the treatment of tumor radiotherapy patients can effectively strengthen the improvement of the immune function of patients,which has a very important application value to improve the physical function of patients,promotes the patienfs body rehabilitation,and is worth in the field of widespread application.

Effectiveness of Jinying capsule on pelvic inflammatory disease in patients with symptom pattern of damp and heat accumulation: a double-blinded, multicenter, randomized, placebo-controlled clinical trial

OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Traditional Chinese Medicine(TCM).METHODS: We conducted a double-blinded, multicenter, randomized, placebo-controlled clinical trial which included 155 patients diagnosed with PID and identified as symptom pattern of damp and heat accumulation. They were randomly divided into experimental group(n = 78) and control group(n = 77) according to a random number table. The treatment lasted for a period of 28 d. The experimental group was given Jinying capsules and oral levofloxacin plus oral metronidazole for first 7 d.They continued with Jinying capsules and levofloxacin placebo and metronidazole placebo for another 7 d. For the remaining 14 d, they continued with Jinying capsules only. Whereas, the control group was treated with oral levofloxacin and metronidazole and Jinying capsule placebo for the first 14 d in the same way as the experimental group and then continued with Jinying capsule placebo only for the remaining 14 d. The clinical efficacy was assessed using McCormack scale, TCM symptom pattern scores, physicochemical indexes including white blood cell and erythrocyte sedimentation rate, C-reaction protein, smear of vaginal discharge,and pelvic ultrasound.RESULTS: Comparing McCormack scale between both groups after treatment, the difference in curative effect between both groups was significant (P = 0.0269). The cure rate of the experimental group and control group is 76.32% and 59.46% respectively at week 4. Comparing TCM symptom pattern scores between both groups before and after treatment, the differences in total effective rate were both significant(P < 0.05). The curative effect rate of experimental group is 2.63% and 13.70% of the control group at week 1(P = 0.0131), and73.33% of the experimental group and 56.94% of the control group at week 4(P = 0.0369). No significant differences were found between the two groups on the Physicochemical indexes(all P >0.05). No adverse events or reactions occurred in the experimental groups.CONCLUSION: Jinying capsule can reduce the dosage of antibiotics needed for PID treatment, and improve the symptoms in PID patients.

Effect and Safety of Kangfuyan Capsules(抗妇炎胶囊)for Relieving Chronic Pelvic Pain:A Multicenter,Randomized,Controlled,Double-Blind,Parallel-Group Clinical Trial

Objective To evaluate the effect and safety of Kangfuyan Capsules(抗妇炎胶囊)for treating pelvic inflammatory disease(PID)in patients with chronic pelvic pain(CPP)in a multicenter,randomized,controlled,double-blind,parallel-group clinical trial.Methods Totally,240 PID patients with CPP were randomized into 2 groups using a computer generated random number at a 1:1 ratio from 10 hospitals in China between September 2014 and November 2015.Patients received either oral Kangfuyan Capsules or Gongyanping Capsules(宫炎平胶囊,control);the regimen for both groups comprised 4 capsules(3 times daily)for 12 weeks,with follow-up visit 4 weeks after treatment.The visual analogue scale(VAS)scores,clinical responses,remarkable cure rates for each symptom,and quality of life scores were assessed at baseline,and after 1,2,and 3 months.Adverse events were also recorded.Results The VAS scores were significantly lower(P<0.05),whereas the clinical responses,remarkable cure rates for lower abdominal pain,uterine tenderness,adnexal mass,and adnexal tenderness,and Health-related quality of life(EQ-5D)scores were higher in the Kangfuyan group than in the control group at 3 months(P<0.05).Common treatment-related adverse events included high hepatic enzyme levels,reduced hemoglobin levels,and elevated platelet counts,although all the adverse events were either mild or moderate in severity.Conclusion Compared with Gongyanping therapy,Kangfuyan therapy yielded markedly better analgesia effects for CPP caused by PID,with obvious long-term efficacy and good safety.(Registration No.ChiCTR190022732)

Therapeutic observation of acupuncture plus heat-sensitive moxibustion for chronic pelvic inflammatory disease

Objective：To observe the therapeutic efficacy of acupuncture plus heat-sensitive moxibustion in treating chronic pelvic inflammatory disease （CPID）, for selecting an effective acupuncture-moxibustion method in treating chronic pelvic inflammation. Methods：Eighty CPID subjects were enrolled and divided into two groups by randomized single-blind method, 40 in each group. The observation group was intervened by acupuncture plus heat-sensitive moxibustion, while the control group was by acupuncture plus box-moxibustion, once every other day, 10 sessions as a treatment course, but the period time was skipped. The therapeutic efficacy was observed after 3 treatment courses. Results：The recovery rate was 45.0% and the total effective rate was 95.0% in the observation group, versus 20.0% and 80.0% in the control roup. There were significant differences in comparing the recovery rate and the total effective rate between the two groups （P〈0.05）. Conclusion：Acupuncture plus heat-sensitive moxibustion can produce a higher therapeutic efficacy in treating CPID than acupuncture plus box-moxibustion, and this is an easy-to-operate and safe method without adverse effect.

Identification of major compounds of total flavonoids from Smilax china and evaluation of anti-inflammatory effect on phenol mucilage-induced pelvic inflammation in rats

As a Chinese medicinal plant,Smilax china is traditionally used in the treatment of pelvic inflammatory disease(PID).Flavonoids have been identified as the anti-inflammatory bioactive fraction.However,the high content of total flavonoids has not been extracted from S.china.The therapeutic effects and mechanisms of total flavonoids are still unknown.In the present study,we aimed to obtain the effective parts of flavonoids in S.china,and elucidate the mechanism of action on PID.The anti-inflammatory effect was evaluated on phenol mucilage-induced pelvic inflammation in rats.This was the first time that total flavonoids in high concentration(up to 55.6%)were obtained in S.china.A total of 15 compounds were separated and identified by NMR,and the total flavonoids were detected with HPLC.TFSC caused a reduction in serum levels of IL-6 and IL-1β.These results suggested that TFSC had a significant anti-PID effect,probably due to inhibition of the inflammatory reaction.