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.

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.

Effect of Danzhi decoction on expression of angiogenesis factors in patients with sequelae of pelvic inflammatory disease

Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and explore the role of Danzhi decction in improving the blood stasis microenvironment of SPID.Methods:A three-dimensional(3D) co—culture system including human vascular endothelial cells(VECs),endometrial stromal cells and glandular epithelial cells was established in vitro and treated with Danzhi decoction,sterilized water and aspirin respectively.A Milliplex multifunctional liquid chip technique was used to measure the expression levels of vascular endothelial growth factor(VEGF)—A/C/D,fibroblast growth factor-1/2.angiopoietin-2.epidermal growth factor(EGF) HB-EGF,bone morphogenetic protein-9.endoglin.endothehn-l.granulocyte colony stimulating factor,hepatocyte growth factor,interleukin-8,follistatin.placenta growth factor and leptin.The location of angiogenesis factors was monitored by immunofluorescence labeling and confocal laser scanning microscope3 D reconstruction.Results:Endometrial stromal cells and glandular epithelial cells were isolated and primary cultured for establishing a 3D co-culture system.The levels of VEGF—A/C/D in Danzhi decoction group and aspirin group were significantly lower than those in mock group(P<0.05).while there was no significant difference between Danzhi decoction group and aspirin group(P>0.05).Furthermore,the alterative location of VEGF—A/C/D was observed in the cytoplasm of endometrial glandular epithelial cells.Conclusions:Danzhi decoction mav inhibit the expression of VEGF in the blood stasis microenvironment of SPID by targeting the cytoplasm of endometrial glandular epithelial cell.

Evidence-Based Medicine Research on Prescriptions in Synopsis of the Golden Chamber in the Treatment of Pelvic Inflammatory Disease

Purpose: Based on the National Natural Science Foundation of China, we collect and sort out the literature published in approximately the last 30 years, which use prescriptions in Synopsis of the Golden Chamber to treat pelvic inflammatory disease (PID). This study provides theoretical basis for the treatment of PID;we recommend this achievement to colleagues. Method: Firstly, we searched and collected the literatures from last three decades in CNKI, Wanfang and VIP databases, which are about classical prescriptions treating endometriosis. Then, by screening all the literatures, we obtained the clinical research literatures and individual case reports. Finally, we went through the internal quality of the two categories of literatures to get the dominant prescriptions. Using a retrospective study of evidence-based medicine research, we comprehensively collect literature, standardize the disease spectrum, classify the evidence, and then evaluate the internal quality. Results: We refine 4 prescriptions which commonly are used in the treatment of PID;in other words, they are also the clinical symptoms of PID: Gui Zhi Fu Ling Wan symptom, which manifests blood stasis and cold-damp stagnancy;Dang Gui Shao Yao San symptom, which manifests disharmony of liver and spleen, qi-blood stasis and damp obstruction;Da Huang Mu Dan Tang symptom, which manifests the gathering toxic heat and qi-blood stasis;Yi Yi Fu Zi Bai Jiang San symptom, which manifests the internal toxic heat and qi-blood injury. Conclusion: This study is gospel for the patients with recurrent episodes of PID who can’t often use antibiotics. At the same time, it is also a green therapeutics which Chinese ancients dedicated to human medicine.

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.

Presence of Obstetrical Conditions among Women with Pelvic Inflammatory Diseases: Experience of 50 Cases in Bangladesh

Background: Pelvic Inflammatory Diseases can be associated with the different obstetrical condition. Objectives: The purpose of the present study was to see the Presence of Obstetrical Conditions among Women with pelvic inflammatory diseases (PID). Methodology: This cross-sectional of study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College, Dhaka from January 2007 to June 2007 for a period of six (6) months. Women with the age group of 15 - 45 years presented with lower abdominal pain, tenderness, per vaginal discharge and cervical motion tenderness were included in this study. A pre-designed data collection sheet was used to record the history of different obstetrical condition. Result: A total number of 50 women presented with PID were recruited for this study of which majority was in para 2 to 5 which was 30 (60.0%) cases. Majority of the patients had given the history of home delivery (74.0%) which was performed by untrained birth attendance (60.0%). The history of induced abortion was given by 24.0% cases. History of more than 2 times menstrual regulation (MR) and 2 to 5 times were performed in 20 (40.0%) cases in each. Among 50 cases majority used intrauterine device (IUCD) which were 20 (40.0%) cases. Conclusion: In conclusion majority of the women presented with PID have given the history of para 2 to 5, home delivery with untrained birth attendance, induction abortion and history of more than two times MR.

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.

Traditional Chinese medicine nursing protocols for leukorrheal disease( pelvic inflammatory disease)

Leukorrheal disease is an ascending infection of the female genital tract,with high morbidity among reproductive age women. Antibiotics are usually used to treat leukorrheal disease in clinic,but they can lead to a variety of side effects if improper use or long-time use. In recent years,traditional Chinese medicine( TCM) has shown its unique advantages in the treatment of leukorrheal disease. This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of leukorrheal disease in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.

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.

Research progress of traditional Chinese medicine nursing for pelvic inflammatory disease sequelae

Pelvic inflammatory disease refers to a group of female genital tr act on infec tious disease, mainly including endometritis, tubal phlogistic, oviduct ovarian abscess, if not 廿mely tr eatment of the disease is easy to become chr onic, now called pelvic inflammatory disease sequelae, clinical manifestations in chronic pelvic pain, recurrent pelvic inflammatory disease, affect women's physical and mental health. TCM nursing based on the basic theory of TCM, apply the overall view, the nursing method of syndrome differentiation, the traditional Chinese medicine nursing technique is widely used in the disease, such as traditional Chinese medicine enema, Chinese medicine external treatment, moxibustion, ear acupuncture point buries a seed, methods of modern nursing, has the characteristics of simple and cheap effect, can reduce the swelling fights, promoting blood circulation to remove blood stasis, relieve the pelvic congestion, promote drainage in abdominal and pelvic cavity and the absorption of bag piece, adjust the viscera function, obvious effect and has unique advantages, further prove the uniqueness of TCM nursing and safety, provide the basis for clinical treatment.

Effects of smilax bockii warb polysaccharide on inflammatory mediators, apoptosis and immune cell function in rats with chronic pelvic inflammatory disease

Objective:To study the effects of smilax bockii warb polysaccharide on inflammatory mediators, apoptosis and immune cell function in rats with chronic pelvic inflammatory disease.Methods:Female SD rats were chosen as experimental animals and divided into control group, pelvic inflammation group and smilax bockii warb group, pelvic inflammation group and smilax bockii warb group were made into pelvic inflammation models, and smilax bockii warb group were given intragastric administration of smilax bockii warb. The contents of inflammatory mediators and the expression of apoptosis genes in uterine muscle as well as the contents of immune cells in peripheral blood were determined 21 d after molding and intervention.Results:TLR4, NF-κB, TNF-α, ICAM-1 and IL-8 levels as well as Fas, TNFR-1, GRP78, CHOP and Caspase-3 mRNA expression in uterine muscle tissue and CD3+CD8+T cell in peripheral blood of pelvic inflammation group were higher than those of control group whereas peripheral blood CD3+CD4+T cell, red blood cell C3b receptor rosette rate and erythrocyte immune complex rosette were lower than those of control group;TLR4, NF-κB, TNF-α, ICAM-1 and IL-8 levels as well as Fas, TNFR-1, GRP78, CHOP and Caspase-3 mRNA expression in uterine muscle tissue as well as CD3+CD8+T cell in peripheral blood of smilax bockii warb group were lower than those of pelvic inflammation group whereas peripheral blood CD3+CD4+T cell, red blood cell C3b receptor rosette rate and erythrocyte immune complex rosette were higher than those of pelvic inflammation group. Conclusion:Smilax bockii warb polysaccharide for chronic pelvic inflammatory disease intervention can inhibit the inflammatory mediator secretion, apoptosis and regulate the immune cell function.

Research on the effect of kunfukang capsule on improving uterine microcirculation in patients with sequelae of pelvic inflammatory disease and its influence on levels of crp, gm-csf and mcp-1 in peripheral blood

Objective:To investigate the clinical effect of kunfukang capsule on improving uterine microcirculation in patients with sequelae of pelvic inflammatory disease, and to observe its influence on levels of CRP, GM-CSF and MCP-1 in peripheral blood.Methods: 126 patients with pelvic inflammatory disease sequelae admitted to our hospital from January 2017 to June 2018 were selected and divided into control group and observation group with 63 cases in each group according to the random number table method. Patients in the control group were given azithromycin tablets orally, while patients in the observation group were treated with kunfukang capsule on the basis of control group,7days for a course of treatment, 4 courses of continuous treatment. The purpose of this study was to compare the clinical effects of treatment between the two groups, evaluate the TCM syndrome score, observe the levels of CRP, GM-CSF and MCP-1 in uterine microcirculation and peripheral blood, and record the adverse reactions of patients during treatment.Results: The effective rate of 90.48% in the observation group was significantly higher than that in the control group of 77.78%(P<0.05). After treatment, the total score of TCM syndromes was significantly lower than that in the control group (P<0.05). The improvement of uterine microcirculation was more obvious, and the PI and RI were significantly decreased compared with the control group, while Vs, Vd and Vm were increased compared with the control group (P<0.05). The levels of CRP, GM-CSF and MCP-1 in peripheral blood were significantly lower than those in the control group (P<0.05). During the treatment, the adverse reaction rate of 7.94% in the observation group was significantly lower than that of the control group of 25.40% (P<0.05).Conclusion: Kun fu kang capsule combined with azithromycin is beneficial to reduce pelvic mass in sequelae of pelvic inflammatory disease and alleviate clinical symptoms. The mechanism may be related to improving the status of uterine microcirculation and inhibiting CRP, GM-CSF and MCP-1 levels in peripheral blood to reduce inflammatory infiltration of pelvic tissue, which is safe and reliable.

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.

Functional gastrointestinal disorders in inflammatory bowel disease: Time for a paradigm shift?

Recent advances in biological therapies have revolutionalised and redefined treatment targets in inflammatory bowel disease(IBD).There is now a stronger emphasis on achieving the more stringent therapeutic goals of mucosal and histological healing,rather than clinical remission alone.Consequently,the treatment of refractory“functional”gastrointestinal symptoms,often attributed as the aftermath of previous inflammation,has recently become more prominent in quiescent disease.With further expected advances in anti-inflammatory treatments on the horizon,the burden of such symptoms in quiescent disease,which have been relatively neglected,is set to become an even bigger problem.In this article,we highlight the current state of research and understanding in this field,including recent developments and clinical practice guidelines on the diagnosis and management of functional gastrointestinal symptoms,such as irritable bowel syndrome and functional anorectal and pelvic floor disorders,in patients with quiescent IBD.These disorders are not only highly prevalent in these patients,they are often misdiagnosed,and are difficult to treat,with very few evidence-based therapies.Moreover,they are associated with substantial impairment in quality-of-life,considerable morbidity,and psychological distress.There is therefore an urgent need for a change in emphasis towards earlier recognition,positive diagnosis,and targeted treatment for patients with ongoing functional gastrointestinal symptoms in the absence of active IBD.This article also highlights the need for further research to develop much needed evidence-based therapies.

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.

康妇炎胶囊灌肠治疗急性盆腔炎性疾病(PID)后遗症疗效观察

目的:观察康妇炎胶囊灌肠治疗急性PID后遗症的疗效。方法:选取急性PID后遗症患者180例随机分为两组:治疗组采用康妇炎胶囊灌肠治疗;观察组采用抗生素治疗。治疗2个疗程,分别比较两组的起效时间、治疗效果。结果:治疗组的起效时间快于观察组;治疗组的总有效率高于观察组(P<0.05)。两组治疗期间均未发现明显的不良反应。结论:应用康妇炎胶囊灌肠治疗急性PID后遗症效果好,疗程短,见效快,是一种安全、经济、有效、方便的治疗方案。

热敏点灸与中医验方并用治疗CPID临床观察

目的:探讨热敏点灸与中医验方少腹逐瘀汤并用治疗慢性盆腔炎的临床疗效。方法:选择2013年3月-2014年5月期间我院收治的64例慢性盆腔炎患者随机分为观察组和对照组,各32例,观察组热敏点灸与少腹逐瘀汤合并治疗,对照组单纯热敏点灸治疗,观察比较两组患者治疗前后的临床症状、中医证侯评分、血液流变学指标等变化。结果:观察组总有效率为93.75%明显高于对照组78.12%,差异具有统计学意义(P<0.05);与治疗前相比,治疗后两组中医症候评分均有所降低,治疗后观察组评分较对照组明显降低,差异均有统计学意义(P<0.05);两组治疗后组间血液流变学比较,全血低切粘度、血浆黏度及血沉三项差异有统计学意义(P<0.05)。结论:热敏点灸与少腹逐瘀汤合并治疗CPID临床疗效显著。

妇炎舒胶囊对SPID模型大鼠TLR9/MyD88信号通路的影响

目的观察妇炎舒胶囊对盆腔炎性疾病后遗症(sequelae of PID,SPID)模型大鼠抗炎疗效及对TLR9/MyD88信号通路的影响。方法36只大鼠采用随机数字表法分为空白组、模型组、康妇炎胶囊组(KFY组)、妇炎舒胶囊高剂量组(FYS高剂量组)、妇炎舒胶囊中剂量组(FYS中剂量组)、妇炎舒胶囊低剂量组(FYS低剂量组)。采用混合菌液注射配合机械损伤法建立SPID动物模型,操作结束后常规饲养14 d。空白组以蒸馏水灌胃,其余各组以相应药物混悬液灌胃21 d。病理切片HE染色观察子宫组织形态变化,ELISA法检测子宫组织IL-6、IL-1β的表达水平,Western Blot检测子宫组织TLR9、MyD88蛋白的表达,RT-PCR检测子宫组织TLR9、MyD88 mRNA的表达。结果与模型组比较,FYS高剂量组IL-6、IL-1β显著降低(P<0.01或P<0.05),FYS低、中剂量组有降低趋势(P>0.05)。FYS高剂量组TLR9、MyD88蛋白表达显著降低(P<0.01),FYS高剂量组MyD88 mRNA显著降低(P<0.05),FYS低、中剂量组TLR9 mRNA、MyD88 mRNA有降低趋势(P>0.05)。结论妇炎舒可能通过调控TLR9/MyD88信号通路关键因子TLR9、MyD88、IL-6、IL-1β表达发挥抗炎作用。