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.

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.

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.

Diagnostic dilemma between intestinal Behet disease and inflammatory bowel disease with pyoderma gangrenosum

TO THE EDITOR I have read with great interest the very recent article rifled ＂Intestinal Behcet＇s disease with pyoderma gangrenosum： A case report＂ of Nakamura T et al that was published in your journal. The authors stated that they presented a very rare case of intestinal Behcet＇s disease with pyoderma gangrenosum in a 16-year old patient. However, I would like to make some important contributions and suggestions to the presented case and have a few questions to ask the authors.

Crohn's disease and clinical management today:How it does?

Crohn’s Disease(CD)is an Inflammatory Bowel Disease and is characterized by an immune-mediated nature.Its etiology results from the interaction between genetic,enviromental and microbial factors.Regarding pathophysiology,it involves high levels of interleukin(IL)-12,IL-17,and Th1 profile,along with loss of tolerance mechanisms,an increase in pro-inflammatory interleukins,beyond the possibility to affect any part of the gastrointestinal tract.Its symptoms include abdominal pain,chronic diarrhea,weight loss,anorexia,and fatigue,as well as blood in the stool or rectum.Additionally,conditions comprising musculoskeletal,cutaneous,ocular,hepatic,and hematological alterations may be associated with this scenario and extra-intestinal presentation,such as erythema nodosum,anterior uveitis,osteoporosis,and arthritis can also occur.Today,clinical history,exams as fecal calprotectin,ileocolonocopy,and capsule endoscopy can be performed in the diagnosis investigation,along with treatments to induce and maintain remission.In this sense,anti-inflammatory drugs,such as corticosteroids,immunomodulators,and biological agents,as well as surgery and non-pharmacological interventions plays a role in its therapy.The aim of this review is to bring more current evidence to clinical management of CD,as well as to briefly discuss aspects of its pathophysiology,surveillance,and associated disorders.

黄熙理教授自拟败酱汤系列方治疗慢性盆腔炎的临床疗效

目的:观察黄熙理教授自拟败酱汤系列方治疗慢性盆腔炎的临床疗效。方法:选择慢性盆腔炎患者278例,按照治疗方法的不同分为治疗A组200例和对照B组78例。A组采用黄熙理教授自拟败酱汤系列方治疗,B组采用康妇炎胶囊治疗,观察比较两组的临床疗效、下腹痛缓解时间及治疗前后主要中医证候积分。结果:A组治疗总有效率明显高于B组(P<0.05)。治疗前炎症为中度及重度的患者,下腹痛缓解时间A组明显短于B组(P<0.05)。经治疗,A组下腹痛、腰骶酸痛评分均较B组低(P<0.05)。结论:黄熙理教授自拟败酱汤系列方治疗慢性盆腔炎能有效缓解患者下腹痛、腰骶酸痛,疗效确切。

论风药在盆腔炎性疾病后遗症治疗中的应用

盆腔炎性疾病后遗症是妇科常见的慢性疾病,其成因复杂,病程长,缠绵难愈,对女性的生殖健康与正常生活都产生了严重影响。风药能祛除风疾并兼有风木属性,具有“升、行、透、窜、动”的特性,针对盆腔炎性疾病后遗症“湿、瘀、郁、虚”的病因病机,能从“助运胜湿、活血化瘀、开散气结、补而不滞”四个方面发挥协同作用。文章从盆腔炎性疾病后遗症的病因病机出发,探讨了风药在本病治疗中的机理及应用,并附验案一则,为该病的中医治疗提供参考。

以极早发型炎性肠病为表型的婴幼儿X连锁淋巴组织增生综合征2型1例并文献复习

报道1例以极早发型炎性肠病为表型的婴幼儿X连锁淋巴组织增生综合征2型患儿的临床资料,并进行文献复习。

晚期上皮性卵巢癌误诊为盆腔结核一例

盆腔结核是由结核分枝杆菌引起的女性盆腔炎症,是慢性盆腔炎和不孕症的常见原因。由于盆腔结核可引起腹盆腔钝性疼痛、腹胀等特征与晚期上皮性卵巢癌相似,加之肺外结核没有特异的临床特征或影像学表现可以明确诊断,因此盆腔腹膜结核很容易与腹膜癌和晚期上皮性卵巢癌混淆。分析1例晚期上皮性卵巢癌患者,因卵巢占位组织穿刺病理及腹水脱落细胞学检查均未查见肿瘤细胞,遂行结核鉴别检查,患者结核菌素试验和结核分枝杆菌γ干扰素均为阳性,诊断为盆腔结核,后经病理证实为上皮性卵巢癌。对本病例的诊治过程进行总结,以期为临床处理晚期上皮性卵巢癌与盆腔结核诊断困难的病例积累一定经验。

女性盆腔炎性疾病中西医结合诊治指南

盆腔炎性疾病(Pelvic inflammatory disease,PID)是指女性上生殖道的一组感染性疾病,包括子宫内膜炎、输卵管炎、输卵管卵巢脓肿、盆腔腹膜炎。炎症可以局限于一个部分,也可以同时累及几个部位。严重的PID可引起弥漫性腹膜炎、败血症、感染性休克,甚至危及生命。若PID未接受及时彻底的治疗可转为盆腔炎性疾病后遗症(Sequelae of pelvic inflammatory disease,SPID),主要包括慢性盆腔痛、PID反复发作、不孕和输卵管妊娠,严重影响了育龄期女性的身心健康。盆腔炎性疾病多归属于中医学“妇人腹痛”“带下病”和“癥瘕”等范畴,盆腔炎性疾病后遗症多归属于中医学“妇人腹痛”“带下病”“癥瘕”和“不孕”等病证范畴。

NFKBIA基因突变所致极早发型炎性肠病1例并文献复习

报道1例NFKBIA基因突变所致极早发型炎性肠病患者的临床资料,并进行文献复习。

中药外治法治疗盆腔炎性疾病后遗症所致慢性盆腔痛的循证研究及临床验证

目的获得临床医师对于盆腔炎性疾病后遗症所致慢性盆腔痛(SPID-CPP)外治中药的推荐用药。方法通过两轮德尔菲法专家问卷的形式,获得临床医师对于盆腔炎性疾病后遗症最为关注的临床问题并进行重要性积分,以获取临床问题。再通过文献检索纳入系统评价及随机对照试验,进行偏倚分析以获得证据体,得出初步推荐意见,再经过一轮德尔菲法问卷调查后得出最终推荐意见,再经过多中心临床试验加以验证。结果三轮德尔菲法的专家积极程度、专家意见集中度及专家权威系数均较高,结果可信度较好;91.11%的临床医师强推荐清热除湿、化瘀止痛类中成药用于湿热瘀结证SPID-CPP的外治;临床研究显示清热除湿、化瘀止痛类中药保留灌肠治疗湿热瘀结证SPID-CPP的总有效率为87.22%。结论临床医师对于中药外治法治疗SPID-CPP的关注度最高,在具体用药方面更倾向于使用中成药制剂,其中化瘀散结灌肠液治疗SPID-CPP湿热瘀结证的推荐意见最强。对于临床常见的湿热瘀结型SPID-CPP,清热除湿、化瘀止痛类中药保留灌肠有效率高。

慢性盆腔炎中医病因病机及辨证论治的研究进展

慢性盆腔炎是女性患者的盆腔部位结缔组织、盆腔腹膜等处的炎症性疾病,具有病程长、症状明显、疼痛程度剧烈、治疗难度大等特点。中医认为,本病属于“妇人腹痛”“癥瘕”“带下病”范畴,发病过程中受到寒、湿、热、虚、瘀等多种因素的相互作用,具体病机分型为湿热瘀结、血瘀气滞、寒湿凝滞、气虚血瘀症等,根据相应症型给予针对性的中医治疗。现从慢性盆腔炎中医病机和辨证论治两个方面对当前的研究进行综述分析。

盆底超声参数诊断产后压力性尿失禁及康复治疗疗效价值

目的:分析盆底超声参数对产后压力性尿失禁(PSUI)的诊断价值及评估运动康复治疗后疗效价值。方法:选取2020年7月-2023年7月本院妇科收治的PSUI产妇155例(PSUI组)及健康产妇155例(对照组),PSUI组施予凯格尔康复运动治疗,并依据训练是否有效分为有效组(n=123)与无效组(n=32)。采用盆底超声检查PSUI组治疗前与对照组、有效组与无效组治疗后盆底超声参数指标及尿道内口漏斗有否形成,采用多因素logistic回归分析康复治疗疗效影响因素,采用受试者工作特征曲线(ROC)分析膀胱相关参数指标评估PSUI疗效价值。结果:PSUI组治疗前盆底超声膀胱相关参数指标均高于对照组,尿道内口漏斗形成率高于对照组;PSUI组经凯格尔康复运动治疗后总有效率为79.4%,无效组治疗前盆底超声参数相关指标均高于有效组,尿道内口漏斗形成率高于有效组(均P<0.05)。经多因素logistic回归分析,盆底超声参数指标升高均是PSUI产妇接受凯格尔康复运动疗效的独立危险因素,ROC分析显示超声相关参数指标均对评估PSUI产妇凯格尔康复运动疗效有一定价值,曲线下面积0.683~0.790。结论:PSUI产妇盆底超声相关参数指标均异常升高,各超声参数指标在PSUI产妇康复治疗疗效评估中均有一定价值。

少腹逐瘀汤治疗寒湿凝滞型慢性盆腔炎的临床效果

目的观察少腹逐瘀汤治疗寒湿凝滞型慢性盆腔炎的临床效果。方法选取2020年1月—2023年1月漳州市长泰区医院与福州市中医院收治的寒湿凝滞型慢性盆腔炎患者110例,按照随机数字表法分为中药联合组和常规组,每组55例。常规组采取常规西医治疗,中药联合组在常规组基础上加用少腹逐瘀汤治疗,2组均治疗4周。比较2组治疗效果,治疗前后临床症状评分、体征评分、实验室检查指标,以及治疗后B超检查结果改善情况。结果中药联合组治疗总有效率为94.55%,高于常规组的76.36%(χ^(2)=7.314,P=0.007)。治疗4周后,2组下腹坠胀、疼痛、白带量、性生活质量评分与下腹触痛、宫颈充血、宫颈渗出物评分均低于治疗前,且中药联合组低于常规组(P<0.05或P<0.01);2组血清IL-6、TNF-α、CRP水平与WBC低于治疗前,ESR小于治疗前,且中药联合组下降幅度大于常规组(P均<0.01)。中药联合组B超检查结果改善率高于常规组(63.64%vs.41.82%,χ^(2)=10.038,P=0.007)。结论寒湿凝滞型慢性盆腔炎患者应用常规西药治疗+少腹逐瘀汤治疗的效果显著,可明显改善患者的临床症状及体征,促进炎症恢复,提高治疗有效性。

中医治疗盆腔炎性疾病后遗症进展及作用机制概述

盆腔炎性疾病后遗症(sequelae of pelvic inflammatory disease,SPID)是当今困扰我国女性生育、健康及日常生活的常见病、多发病。是由于盆腔炎性疾病(pelvic inflammatory disease,PID)未经过正确规范的诊治,迁延不愈而导致盆腔内输卵管、卵巢、盆腔结缔组织以及腹膜的慢性炎症,表现为慢性盆腔痛、不孕以及盆腔粘连。SPID后期多表现为无菌性炎症,长期炎症刺激引起组织破坏、粘连、增生以及瘢痕形成,因此控制炎症反应是治疗该病的主要方法。西医对于该病的治疗以经验性使用抗生素为主,但长期应用易产生耐药性且不良反应大,无法根除病因。中医学多认为该病与外感寒湿、内生湿热、久病体虚或情志不畅有关。传统中医药在治疗该病中发挥了独特优势,其抗炎效果显著,治疗方法包括:辨证论治的中医内治法,以其多靶点多途径的特点发挥作用;以及中医外治法,包括中药保留灌肠、中药穴位贴敷、中药离子导入、针灸和多种疗法联合治疗等。其抗炎作用机制主要与改善血液流变学、调节细胞因子表达、抗氧化应激有关。作者查阅文献后发现,中医药治疗PID已成为新的趋势,但尚缺乏对中医药治疗方法和作用机制的系统阐述。故作者通过查阅近年相关文献,对SPID的中医病因病机,中医药治疗方法及作用机制的研究进行归纳总结,以期为后续中医药防治SPID的临床研究提供一定的理论依据。

拉氧头孢钠对改善盆腔炎患者下腹痛及生活质量的效果

目的:分析注射用拉氧头孢钠对改善盆腔炎患者下腹痛及生活质量的效果。方法:选取2022年1月-2023年12月于本院诊断的盆腔炎患者104例,根据治疗方案不同分为对照组和观察组各52例,分别给予甲硝唑以及拉氧头孢钠治疗,采用视觉模拟量表(VAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和汉化版简明健康调查表(SF-36)评估患者治疗后疼痛及生活质量改善情况。结果:治疗10天后,观察组临床有效率(92.3%)高于对照组(76.9%),两组VAS评分均较治疗前降低,且观察组VAS评分(0.63±0.66分)低于对照组(1.35±0.84分);两组SDS及SAS评分均较治疗前降低,且观察组SDS(36.63±4.68分)、SAS(35.54±4.08分)评分低于对照组(41.65±5.22分、39.77±4.47分);两组SF-36中躯体健康总测量(PCS)、心理健康总测量(MCS)评分均较治疗前升高,且观察组PCS(77.37±4.64分)、MCS(80.12±3.53分)评分高于对照组(73.40±4.86分、74.56±3.44分)(均P<0.05)。结论:拉氧头孢钠治疗盆腔炎疗效确切,且能有效降低患者下腹痛程度并提高生活质量。

自拟中药方内服、中药灌肠、微波治疗联合常规西药治疗慢性盆腔炎的效果分析

目的:分析自拟中药方内服、中药灌肠、微波治疗联合常规西药治疗慢性盆腔炎的效果。方法:选取2020年3月—2023年8月东营市第二人民医院收治的慢性盆腔炎患者70例作为研究对象,采用随机数字表法分为治疗组和对照组,各35例。对照组采用常规西药治疗,治疗组在对照组基础上采用自拟中药方内服、中药灌肠、微波治疗。比较两组治疗效果。结果:治疗后,两组中医证候、局部体征积分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组治疗有效率高于对照组,差异有统计学意义(P=0.002)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:自拟中药方内服、中药灌肠、微波治疗联合常规西药治疗慢性盆腔炎的效果显著,可缓解患者临床症状,且安全性较高。

棱莪消积汤治疗急性盆腔炎临床观察

目的:观察棱莪消积汤治疗急性盆腔炎的临床疗效。方法:76例按照随机数字表法分为两组各38例,对照组用抗生素治疗,研究组用棱莪消积汤。结果:研究组总有效率高于对照组(P<0.05),中医证候积分、降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)水平和不良反应发生率及复发率低于对照组(P<0.05),下腹疼痛消失时间、阴道出血消失时间和白带消失时间短于对照组(P<0.05)。结论:棱莪消积汤治疗急性盆腔炎瘀热互阻效果较好。

蒲丁藤酱消炎汤治疗慢性盆腔炎气滞血瘀证临床研究

目的:观察蒲丁藤酱消炎汤治疗慢性盆腔炎气滞血瘀证的临床效果。方法:72例随机分为对照组和研究组各36例。对照组用西药治疗,研究组用蒲丁藤酱消炎汤加减治疗。结果:总有效率研究组高于对照组(P<0.05)。两组治疗后中医证候量化评分均降低(P<0.05),研究组治疗后主症、次症及总评分低于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。研究组疾病复发率低于对照组(P<0.05)。结论:蒲丁藤酱消炎汤治疗慢性盆腔炎气滞血瘀证效果较好。