Clinical observation on inverted T-shaped herb-separated moxibustion for chronic pelvic pain in sequelae of pelvic inflammatory diseases. / 倒Tå­—å½¢éš”è¯ç¸æ²»ç–—ç›†è ”ç‚Žæ€§ç–¾ç— åŽé—ç—‡æ ¢æ€§ç›†è ”ç—›ç–—æ•ˆè§‚å¯Ÿ.

OBJECTIVES: To compare the clinical effect between inverted T-shaped herb-separated moxibustion combined with western medication and simple western medication on chronic pelvic pain(CPP)in sequelae of pelvic inflammatory diseases. METHODS: A total of 60 patients with CPP in sequelae of pelvic inflammatory diseases were randomly divided into an observation group and a control group, 30 cases in each group. The control group was given ibuprofen tablets 10 days before menstruation, 0.2 g each time, once a day for 10 days. After menstruation, the medication was stopped, and the treatment was given for 3 menstrual cycles.On the basis of the treatment in the control group, the observation group was treated with inverted T-shaped herb-separated moxibustion at the connection between Zhongwan(CV 12)and Zhongji(CV 3), and the connection between Zigong(EX-CA 1)on both sides.The treatment was performed once a week, with an interval of 6 days. The moxibustion was stopped during the menstrual period, the treatment was given for 3 menstrual cycles.Before and after treatment, the visual analogue scale(VAS)score of lower abdominal and lumbosacral pain, local symptom (uterine tenderness, adnexal tenderness and uterosacral ligament tenderness) score and quality of life assessment (QOL) score of the two groups were observed. RESULTS: After treatment, the lower abdominal and lumbosacral pain VAS scores, the local symptom scores of uterine tenderness, adnexal tenderness, uterosacral ligament tenderness and total scores in the two groups were lower than those before treatment(P<0.01).The lower abdominal and lumbosacral pain VAS score in the observation group was lower than that in the control group(P<0.01),and the changes of local symptom scores of uterine tenderness, adnexal tenderness and uterosacral ligament tenderness and total score in the observation group were greater than those in the control group(P<0.01). After treatment, the QOL scores of the two groups were higher than those before treatment(P<0.01), and the score in the observation group was higher than that in the control group(P<0.01). CONCLUSIONS: Inverted T-shaped herb-separated moxibustion combined with western medication can effectively reduce the pain in patients with CPP in sequelae of pelvic inflammatory diseases, relieve the local symptoms, improve the quality of life, and the curative effect is better than western medication alone.

Acupuncture therapies for relieving pain in pelvic inflammatory disease: A systematic review and meta-analysis.

BACKGROUND: Studies investigating the effectiveness of acupuncture therapies in alleviating pain in pelvic inflammatory disease (PID) have gained increasing attention. However, to date, there have been no systematic reviews and meta-analyses providing high-quality evidence regarding the efficacy and safety of acupuncture therapies in this context. OBJECTIVE: The objective of this review was to assess the efficacy and safety of acupuncture therapies as complementary or alternative treatments for pain relief in patients with PID. METHOD: A comprehensive search was conducted in eight databases from inception to February 20, 2023: PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and Chinese Biomedical Literature Database. Randomized controlled trials (RCTs) investigating acupuncture therapies as complementary or additional treatments to routine care were identified. Primary outcomes were pain intensity scores for abdominal or lumbosacral pain. The Cochrane risk of bias criteria was applied to assess the methodological quality of the included trials. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to evaluate the quality of evidence. Data processing was performed using RevMan 5.4. RESULT: This systematic review included twelve trials comprising a total of 1,165 patients. Among these, nine trials examined acupuncture therapies as adjunctive therapy, while the remaining three did not. Meta-analyses demonstrated that acupuncture therapies, whether used alone or in combination with routine treatment, exhibited greater efficacy in relieving abdominal pain compared to routine treatment alone immediately after the intervention (MD: -1.32; 95% CI: -1.60 to -1.05; P < 0.00001). The advantage of acupuncture therapies alone persisted for up to one month after the treatment (MD: -1.44; 95% CI: -2.15 to -0.72; P < 0.0001). Additionally, acupuncture therapies combined with routine treatment had a more pronounced effect in relieving lumbosacral pain after the intervention (MD: -1.14; 95% CI: -2.12 to -0.17; P < 0.00001) in patients with PID. The incidence of adverse events did not increase with the addition of acupuncture therapies (OR: 0.56; 95% CI: 0.21 to 1.51; P = 0.25). The findings also indicated that acupuncture therapies, as a complementary treatment, could induce anti-inflammatory cytokines, reduce pro-inflammatory cytokines, alleviate anxiety, and improve the quality of life in patients with PID. CONCLUSION: Our findings suggest that acupuncture therapies may effectively reduce pain intensity in the abdomen and lumbosacral region as complementary or alternative treatments, induce anti-inflammatory cytokines, decrease pro-inflammatory cytokines, alleviate anxiety, and enhance the quality of life in patients with PID, without increasing the occurrence of adverse events. However, due to the low quality of the included trials, the conclusion should be interpreted with caution, highlighting the need for further high-quality trials to establish more reliable conclusions.

[Professor SHENG Can-ruo's experience of acupuncture for chronic pelvic pain of sequelae of pelvic inflammatory diseases].

Professor SHENG Can-ruo proposes that the pathogenesis of chronic pelvic pain of sequelae of pelvic inflammatory diseases is "kidney deficiency and cold coagulation, obstruction of the governor vessel and the belt vessel". For the treatment, attention is paid to warming yang and tonifying kidney, dredging and regulating the governor vessel and the belt vessel; the acupoints of Sanyinjiao (SP 6), Fuliu (KI 7), Taixi (KI 3) etc. are selected. With the method of treating yang for yin disorder and mao-acupuncture, professor SHENG emphasizes the importance of syndrome differentiation-based treatment. The main point of treatment is to balance yin-yang and to maintain both sides of the symptoms and root causes.

[Kidney-tonifying and blood-activating in treatment of infertility due to pelvic inflammatory disease:clinical experience of Professor MA Kun].

Pelvic inflammatory disease(PID) has become one of the leading causes of female infertility, with an increasing incidence in recent years. Modern medicine believes that risk factors of PID will affect the formation of eggs and embryo implantation, especially on the encounter of gametes, fertilization, and transport of fertilized eggs to the uterine cavity. Therapies for infertility due to PID include medication, sonographic hydrotubation, surgery, and assisted reproductive technology. Professor Ma Kun believes that the disease is located in the uterus with appendages with the main pathogenesis of kidney deficiency and blood stasis. Blood stasis is the pathological basis, and kidney deficiency is the fundamental pathogenesis, which exhibits deficiency-excess in complexity. Kidney deficiency will cause blood stasis over time, while blood stasis will aggravate kidney deficiency in turn, making PID-induced infertility refractory. In clinical practice, basic therapies follow the principles of kidney-tonifying and blood-activating, removing blood stasis, dredging collaterals, and coordinating thoroughfare and conception vessels. The oral administration of Chinese medicine combined with enema, external application, and external washing displays better efficacy in improving the pelvic microenvironment and increasing the pregnancy rate and pregnancy success rate in the treatment of PID-induced infertility.

[Analgesic effect of electroacupuncture on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease. METHODS: A total of 144 patients with chronic pelvic pain were randomly divided into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). The patients in the control group were treated with ibuprofen sustained-release capsules 10 days before menstruation, 0.3 g each time, once a day. On the basis of the treatment of the control group, the patients in the observation group were treated with EA at Guanyuan (CV 4), Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32), disperse-dense wave, 2 Hz/15 Hz of frequency, once a day. The patients in both groups were treated for 10 days per menstrual cycle for 3 menstrual cycles. The visual analogue scale (VAS) scores of lower abdomen and lumbosacral area, local sign score, quality of life scale score and pain disappearance rate were compared between the two groups before and after treatment. RESULTS: The VAS scores of lower abdomen and lumbosacral area as well as each item score and total score of local signs in the observation group after treatment were significantly lower than those before treatment and those in the control group (P<0.05). Compared before treatment, the scores of physiological, psychological, social and environmental domains of the quality of life scale in the observation group were significantly increased after treatment (P<0.05); the score of physiological domain in the control group after treatment was significantly higher than that before treatment (P<0.05); the score of physiological domain in the observation group was higher than that in the control group (P<0.05). The pain disappearance rate was 87.1% (54/62) in the observation group, which was higher than 46.0% (29/63) in the control group (P<0.05). CONCLUSION: EA can relieve the pain symptoms in patients with chronic pelvic pain and improve their quality of life.

Acupuncture for chronic pelvic pain in patients with SPID: A protocol for systematic review and meta-analysis.

BACKGROUND: Chronic pelvic pain (CPP) is one of the common sequela of pelvic inflammatory disease, the pathological factors are adhesions, scarring and pelvic congestion which caused by inflammation, often cause abdominal pain and lumbosacral soreness, and aggravated after fatigue, sexual intercourse and during menstruation. It is difficult to treat because special pathological changes. Although acupuncture has gained increased popularity for the management of CPP, evidence regarding its efficacy is lacking. Therefore, a systematic review of acupuncture for chronic pelvic pain in patients with SPID is required to provide available evidence for further study. METHODS AND ANALYSIS: We will conduct a systematic review of randomized controlled trials (RCTs) that investigate the effect and safety of acupuncture for the treatment of chronic pelvic pain patients with SPID. We will electronically search the literature in the databases of PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, the Web of Science, China National Knowledge Infrastructure (CNKI), Wan-fang Digital Periodicals, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP) and select eligible articles. Data extraction will be conducted by 2 researchers independently, and risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcomes will be total effective rate and VAS pain score, and the secondary outcomes include the recurrence rate and adverse reaction. All data analysis will be conducted by software Review Manager V.5.3. RESULTS: This study will provide the latest analysis of the currently available evidence for the efficacy of acupuncture for chronic pelvic pain in patients with SPID. PROSPERO REGISTRATION NUMBER: CRD42020193826.

Terapia Su Jok en pacientes con diagnóstico de hidrosalpinx / Su Jok therapy in patients with hydrosalpinx diagnosis

Se realizó un estudio cuasiexperimental de 56 pacientes con diagnóstico de hidrosalpinx, que acudieron a la consulta de Medicina Natural y Tradicional del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba - remitidas de las consultas de Ginecología e Infertilidad -, desde septiembre de 2014 hasta diciembre de 2015, para evaluar la respuesta a la terapia Su Jok. Entre las variables analizadas figuraron: edad, factores de riesgo, manifestaciones clínicas, síndromes tradicionales, evolución clínica y respuesta al tratamiento. En la casuística predominaron las féminas de 30-39 años, la enfermedad inflamatoria pélvica y las infecciones de trasmisión sexual como antecedentes patológicos (71,4 por ciento), el dolor y la secreción vaginal como síntomas principales, así como el estancamiento de Qi de hígado, Qi de riñón no firme y frío-humedad en bazo como síndromes más frecuentes. Finalmente, se logró una evolución favorable y una respuesta adecuada al tratamiento

A quasi-experiment of 56 patients with hydrosalpinx diagnosis that went to the Natural and Traditional Medicine Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba - referred from the Gynecology and Infertility Services -, was carried out from September, 2014 to December, 2015, to evaluate the response to Su Jok therapy. Among the analyzed variables there were: age, risk factors, clinical features, traditional syndromes, clinical course and response to the treatment. In the case material there was a prevalence of women aged 30-39, pelvic inflammatory disease and sexually transmitted infections as pathological history (71.4 percent), pain and vaginal secretion as main symptoms, as well as Qi liver stagnation, not firm Qi kidney and coldness-humidity in spleen as most frequent syndromes. Finally, there was a favorable clinical course and an appropriate response to the treatment

The approach to chronic pelvic pain in the adolescent.

Adolescents present to outpatient and acute care settings commonly for evaluation and treatment of chronic pelvic pain (CPP). Primary care providers, gynecologists, pediatric and general surgeons, emergency department providers, and other specialists should be familiar with both gynecologic and nongynecologic causes of CPP so as to avoid delayed diagnoses and potential adverse sequelae. Treatment may include medications, surgery, physical therapy, trigger-point injections, psychological counseling, and complementary/alternative medicine. Additional challenges arise in caring for this patient population because of issues of confidentiality, embarrassment surrounding the history or examination, and combined parent-child decision making.

Risk and protective factors in the origin of atrial septal defect secundum--national population-based case-control study.

The aim of this study was to assess the risk factors in the origin of lethal or surgically corrected isolated atrial septal defect secundum. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities (conducted between 1980 and 1996) comprised 472 atrial septal defect secundum cases, 678 matched controls and 38,151 available controls without any defects; in addition, 21,022 malformed controls with other isolated defects. Medically recorded chronic disorders in the prenatal maternity logbook were evaluated, while acute maternal diseases, drug treatments and pregnancy supplements were analyzed on the basis of both prospective medically recorded data and retrospective maternal information. Acute pelvic inflammatory disease, paroxysmal supraventricular tachycardia and phenolphthalein treatment due to severe constipation of mothers were shown to contribute to the development of atrial septal defect secundum of their children. High doses of folic acid in early pregnancy had positively influenced a minor part of isolated atrial septal defect secundum in foetuses. In conclusion, the obvious genetic predisposition for atrial septal defect secundum is connected with maternal paroxysmal supraventricular tachycardia and triggered by acute pelvic inflammatory diseases and phenolphthalein treatment, while the manifestation of atrial septal defect secundum can be reduced by high doses of folic acid supplementation in early pregnancy.

[Dermoid cyst with thyroid follicle perforated into bladder and ileum: a case report].

A 64-year-old woman was admitted to our hospital on August 19, 1996 with the chief complaint of microscopichematuria. A solid mass was found in her lower abdomen. An abdominal CT scan suggested a large intrapelvic cystic mass and the existence of a fistulous connection between the mass and the small intestine. The existence of a fistula was confirmed by a preoperative barium enema and a cystscopic study. On September 25, 1996, a suprapubic partial cystectomy and total hysterectomy were performed since an intrapelvic abscess was suspected. The cystic mass was observed to adhere to the hollow viscus (uterus, rectum, appendix, ileum and bladder). As a result a part of the ileum and bladder were also removed with the mass. The contents of the cyst included a foul smelling gas and white-green pus. Using a probe, we found two fistulous openings to the ileum and bladder. The histopathological findings indicated a dermoid cyst of the left ovary with thyroid follicles, which are known as "Struma ovarii".

[The effect of acupuncture in dysmenorrhea]. / Efekt ot akupunkturata pri dismenoreia.

The author assumed the task study the effect of treatment dysmenorrhoea by acupuncture. Object of the study were 48 women in reproductive age divided in 2 groups: 1st group--24 women with primary dysmenorrhoea, 2nd group--24 women with secondary dysmenorrhoea. Acupuncture treatment included acupuncture points: LI4, SP6, 10, S30, 36 CV2, 3, CX5, 6, B20, 23 applied via torment method for 30 min. RESULTS. In the 1st group effect was very well after one course of 2-4 acupuncture procedures before menstruation. In the 2nd group effect was satisfactory in 50% of the cases after two courses acupuncture treatment. In conclusion effect of acupuncture treatment on dysmenorrhoea depend on its kind--primary dysmenorrhoea is influenced very well, while secondary dysmenorrhoea is influenced satisfactory.

Extensive colonic stricture due to pelvic actinomycosis.

A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively.

Extensive colonic stricture due to pelvic actinomycosis

A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively.

Adjuvant intraperitoneal chromic phosphate therapy in a woman with early ovarian carcinoma and pelvic infection with resulting catastrophic complications.

Women diagnosed with early stage ovarian cancer may be considered for adjuvant therapy. Intraperitoneal chromic phosphate (P-32) is commonly used in these patients with few complications. A woman found to have early stage ovarian cancer was given intraperitoneal P-32 in the presence of a lingering pelvic infection, which is usually not mentioned as a contraindication to its use. Radiation damage to the small bowel and cecum developed as did damage to the ureter and bladder, which then required surgery.

Infertility, infection, and iatrogenesis in Egypt: the anthropological epidemiology of blocked tubes.

In this article, we integrate medical anthropological and analytical epidemiological methods, forms of data analysis, and interpretive insights to examine the culture-specific behavioral factors that place poor, urban Egyptian women at risk of tubal-factor infertility (TFI). Such risk factors include biomedically and ethnomedically produced iatrogenesis, including the consequences of the practice of female circumcision, and male sexual behavior leading to sterilizing sexually transmitted diseases (STDs) in their female sexual partners. We examine the socio-cultural and political-economic context in which infertility-producing behavioral risk factors are maintained, and we explore the ways in which these risk factors are perceived by biomedically trained Egyptian gynecologists.

Pelvic actinomycosis with colo-ileo-vesical fistula formation: report of a case.

Pelvic actinomycosis with multiple fistular formation is rarely reported in the literature. We herein present a case of pelvic actinomycosis with sigmoid colo-ileovesical fistulae in a 36-year-old intrauterine device (IUD) user. She was admitted to the hospital because of general malaise, weight loss and bilateral palpable adnexal masses. Sonography showed bilateral adnexal masses which contained many echolucent spots. A barium enema examination revealed sigmoid colo-ileo-vesical fistulae. A computed tomographic scan showed bilateral cystic adnexal masses, bilateral hydronephrosis and hydroureter. Preoperatively, pelvic malignancy was suspected. An exploratory laparotomy was performed. Bilateral tubo-ovarian abscesses with extensive adhesions were found. Pathologic examination of the operative specimen revealed pelvic actinomycosis. The patient was treated with penicillin for 14 weeks and had a stable clinical course.

Case report: pelvic actinomycosis with the development and resolution of a recto-sigmoid stricture.

Actinomycosis is an unusual intra-abdominal infection, often mistaken for other conditions. We report a case associated with bilateral ureteric obstruction in which a recto-sigmoid stricture developed in previously normal bowel, followed by its complete resolution after treatment with antibiotics, as demonstrated by serial barium enema examinations.

Rectal stricture due to actinomycosis.

PIP: A 45-year-old Italian woman, who was admitted to the Royal Free Hospital in London, England, with a 14-day history of general malaise, lethargy, epigastric pain after meals, and night sweats, had had an IUD inserted 13 years earlier which had not been changed. The patient was pyrexial on examination; she had a temperature of 38 degrees Centigrade but no jaundice or enlarged lymph nodes. There was mild epigastric tenderness, and a tender indurated rectal stricture involving the posterior fornix of the vagina was palpable on pelvic examination. The rectal stricture was confirmed on sigmoidoscopy. The biopsy revealed a chronic inflammatory cell infiltrate with lymphocytes, extending from the submucosa through to the muscularis mucosae. A preoperative barium enema showed a long irregular rectal stricture. A large mass of inflammatory tissue was found adherent to the uterus, rectum, fallopian tubes, and ovaries at laparotomy. Bilateral retrograde ureterograms showed complete obstructions of the left ureter at 5 cm and a long irregular stricture was seen at the same level on the right. The histological examination revealed actinomycosis of the uterus, fallopian tubes, and ovaries. 12 weeks postoperatively the patient was well; sigmoidoscopy to 25 cm showed complete resolution of the rectal stricture. The antibiotic treatment was stopped. The most likely source of this patient's actinomycosis was the IUD for the relationship between the two is well established. In this patient a prolonged course of antibiotics proved effective in treating the infection.^ieng