Curative effect of kangfuyan capsule combined with antibiotic treatment on pelvic inflammatory disease.

This study aims to investigate the curative effect of Kangfuyan capsule in the treatment of damp-heat and blood stasis type of pelvic inflammatory disease (PID), and its influence on serum inflammatory factors IL-6, CRP and TNF-α. A total of 83 patients with PID were randomly divided into two groups: Western medicine group (control group, n=41) received oral antibiotics (azithromycin + metronidazole) alone and the traditional Chinese medicine combined with Western medicine group (experimental group, n=42) received Kangfuyan capsule based on Western medicine therapy. Clinical efficacy between these two groups and the influence of drugs in serum inflammatory factors (IL-6, CRP and TNF-α) were compared. The total effective rate was 78.05% in the control group and 97.62% in the experimental group and difference between these two groups was statistically significant (P<0.01). The symptoms and signs in the two groups significantly improved after treatment (P<0.05) and improvement rate was significantly better in the experimental group than in the control group (P<0.05). After treatment, serum inflammatory factor levels in the two groups were significantly lower than levels before treatment (P<0.05) and improvement rate was significantly better in the experimental group than in the control group (P<0.05). Kangfuyan capsule combined with antibiotics can effectively relieve the symptoms and signs of patients, improve the efficiency of treatment, provide high safety, and does not increase adverse reactions. The possible mechanism may be that this therapy suppresses chronic PID by reducing serum inflammatory factor (IL-6, CRP and TNF-α) levels.

Curative effect of Jin'gangteng capsule combined with Kangfuxiaoyan suppository in the treatment of chronic pelvic inflammatory disease.

This paper aims to analyze the curative effect of Jin'gangteng capsule combined with Kangfuxiaoyan suppository in the treatment of chronic pelvic inflammatory disease. 97 patients with chronic pelvic inflammatory disease admitted to our hospital from June 2015 to June 2016 were selected and randomly divided into observation group and control group. Patients in control group were treated with Kangfuxiaoyan suppository and patients in the observation group were treated with Jin'gangteng capsule combined with kangfuxiaoyan suppository treatment. The curative effect between the two groups was compared. The scores of symptoms and signs in the observation group after treatment were lower than those in the control group. The total effective rate of the observation group was higher than that of the control group, and there was significant difference between the two groups, P<0.05. Jin'gangteng capsule combined with Kangfuxiaoyan suppository in the treatment of chronic pelvic inflammatory disease can improve the treatment efficiency and promote the rapid and effective relief of clinical symptoms and signs.

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.

Dolor pélvico crónico en la mujer / Chronic pelvis pain in women

Introducción: el dolor pélvico es una entidad frecuente en mujeres, aunque no es un proceso exclusivo de ellas, pues también aparece en hombres. Objetivo: identificar el comportamiento del dolor crónico pélvico en mujeres en la institución sede del estudio. Método: se realizó un estudio en pacientes atendidas en la consulta de dolor crónico del Hospital Dr. Luís Díaz Soto, entre abril de 2011 y abril de 2012. Se incluyeron las pacientes remitidas a la consulta de dolor crónico, las cuales se evaluaron empleando como instrumento principal para la mensuración la escala visual análoga (EVA). Igualmente se les aplicó tratamiento multimodal con analgésicos, anti-inflamatorios, relajantes músculo liso, antidepresivos y ozono. Resultados: se incluyeron 114 pacientes. El dolor pélvico crónico apareció en 114 mujeres con una edad promedio de 26 años. De ellas 61 tenían antecedentes de enfermedad inflamatoria pélvica, y 45 cirugía ginecológica previa. Como causas contribuyentes se encontraron el empleo de monoterapia analgésica, la dosificación insuficiente y la cronofarmacoterapia inadecuada (horario). El empleo de una combinación de opioides anti inflamatorios no esteroideos antidepresivos ozono, logró aliviar a la mayoría de las pacientes (98 para el 85,96 por ciento). Los efectos indeseables asociados a los agentes empleados predominaron con el empleo de tramadol (náuseas) y antinflamatorios no esteroideos (epigastralgia), sin determinar la suspensión del tratamiento. Conclusiones: el dolor pélvico crónico es frecuente en mujeres jóvenes, asociados a la enfermedad inflamatoria pélvica, los tratamientos deficientes son una causa contribuyente frecuente y la terapia multimodal ofreció resultados adecuados con pocos efectos indeseables(AU)

Introduction: the pelvis pain is a frequent entity in women, though it is not a process only for women because men can suffer from pelvis pains. Objective: to identify the behavior of chronic pelvis pain in women from the institution where the study is carried out. Methods: a study was carried out in patients assisted in the chronic pain consultation at Dr LuÝs DÝaz Soto Hospital between April 2011 y April 2012. Patients referred to the chronic pain consultation were included in the study which was evaluated making use of a principal instrument for the measurement of the analogical visual scale (EVA). Likewise, a multimodal treatment was applied with analgesics, anti-inflammatories, smooth muscle relaxer, anti-depressive and ozone. Results: 114 patients were included. The chronic pelvis pain appeared in 114 women with an average age of 26 years. 61 had previous antecedents of the inflammatory disease and 45 with a previous gynecology surgery. As contributor causes the use of mono analgesic therapy was found, the insufficient dosage and the chrono pharmacotherapy (schedule). The use of a combination of opiums - anti inflammatories non steropids - anti depressives - ozone, managed to alleviate in most of the patients (98 for a 85,96 percent). The undesirables effects associated to agents employed prevailed the use of tramadol (nauseas) and anti inflammatories non steroids (epigastralgia), without determining the suspension of the treatment. Conclusion: the chronic pelvis pain is frequent in young women associated to the pelvis inflammatory disease, inefficient treatments are a contributing frequent cause and the multimodal therapy offered adequate results with few undesirable effects(AU)

Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis.

Balneotherapy is appreciated as a traditional treatment modality in medicine. Hungary is rich in thermal mineral waters. Balneotherapy has been in extensive use for centuries and its effects have been studied in detail. Here, we present a systematic review and meta-analysis of clinical trials conducted with Hungarian thermal mineral waters, the findings of which have been published by Hungarian authors in English. The 122 studies identified in different databases include 18 clinical trials. Five of these evaluated the effect of hydro- and balneotherapy on chronic low back pain, four on osteoarthritis of the knee, and two on osteoarthritis of the hand. One of the remaining seven trials evaluated balneotherapy in chronic inflammatory pelvic diseases, while six studies explored its effect on various laboratory parameters. Out of the 18 studies, 9 met the predefined criteria for meta-analysis. The results confirmed the beneficial effect of balneotherapy on pain with weight bearing and at rest in patients with degenerative joint and spinal diseases. A similar effect has been found in chronic pelvic inflammatory disease. The review also revealed that balneotherapy has some beneficial effects on antioxidant status, and on metabolic and inflammatory parameters. Based on the results, we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for lower back pain, as well as for knee and hand osteoarthritis.

[Efficacy observation of chronic pelvic inflammation of different differentiated patterns/syndromes treated with acupoint embedding therapy].

OBJECTIVE: To compare the clinical efficacy on chronic pelvic inflammation between the acupoint embedding therapy and acupuncture, and to compare the efficacy of different patterns/syndroms in differentiation treated with acupoint embedding therapy. METHODS: Two hundred and eighteen cases were randomized into an embedding therapy group (115 cases) and an acupuncture group (103 cases). In both groups, Shenshu (BL 23), Guanyuanshu (BL 26), Zigong (EX-CA 1), Yaoyangguan (GV 3), Guanyuan (CV 4) and Qihai (CV 6) were selected as the main points. For qi and blood stagnation pattern/syndrome, Zhongdu (LR 6), Diji (SP 8) and the others were added; for cold and damp stagnation pattern/syndrome, Diji (SP 8) and Sanyinjiao (SP 6) were added; for stasis and phlegm pattern/syndrome due to spleen deficiency, Sanyinjiao (SP 6) and Zusanli (ST 36) were added. In the embedding therapy group, the catgut was embedded at 7 - 13 acupoints each time, once every 10 days. In the acupuncture group, the conventional acupuncture therapy was applied, once a day. The symptom scores were assessed in the aspects of the lower abdominal pain severity and attack frequency, lumbosacral soreness and distention, abnormality of vaginal discharge and the others. The efficacy was compared between the two groups. RESULTS: The total effective rate was 93.0% (107/115) in the embedding therapy group, which was better than 83.5% (86/103) in the acupuncture group (P < 0.05). The symptom scores were all reduced after treatment in the two groups (all P < 0.05). In the embedding therapy group, the efficacies were not significantly different among different patterns/syndromes (all P > 0.05). CONCLUSION: The acupoint embedding therapy achieves the definite efficacy on chronic pelvic inflammation and obtains the similar efficacies among the different differentiated patterns/syndromes of the disease.

Terapia neural para el tratamiento de la EIPC / Neural therapy for chronic pelvic inflammatory disease

Se realizó un estudio descriptivo, prospectivo y longitudinal en el Hospital Gelacio Calaña de Niquero en el período comprendido entre mayo del 2007 a Marzo del 2008. La muestra estuvo constituida por 72 pacientes adolescentes y mujeres de más edad que ingresaron en el servicio de ginecología con el diagnóstico de enfermedad pélvica o que acudieron de forma voluntaria a la consulta de mnt que radica en el salón de operaciones de nuestro hospital. Se utilizaron variables como edad, calidad de la técnica, complicaciones y evolución de la enfermedad. El objetivo principal fue demostrar la eficacia de la terapia neural en el tratamiento de las EIPC. La edad predominante fue la 16 a 20 años. La técnica fue buena. El dolor con ardor fue la complicación mas frecuente y la evolución fue favorable ya que el 72,2 por ciento resultó asintomática(AU)

A descriptive-prospective and longitudinal study was performed in Gelacio Calaña Hospital from Niquero during the period May 2007-Mach 2009. The sample was constituted by 72 adolescents and women that were admitted in Gynecology Service with pelvic disease diagnostic or came to the traditional natural medicine consult in a voluntary way, some variables were used: age, technique quality, disease complication and evolution. The main objective was to show the effectiveness of neural therapy in CPID treatment. The prevailing age was from 16 to 20 years old. The technique was great. The pain with ardour was the most frequent complication and the evolution was favourable since that the 72,2 percent resulted asymptomatic(EU)

[Effect of Penqiangyan Granule on the immune function of patients with chronic pelvic inflammatory disease of blood-stasis and Shen-deficiency syndrome type].

OBJECTIVE: To explore the effect of Penqiangyan Granule (PG) on the immunity of patients with chronic pelvic inflammatory disease (CPID) of blood stasis and Shen-deficiency syndrome (BSSDS) type. METHODS: Sixty patients were randomly assigned to two groups: the treatment group treated with PG and the control group with Penyanjing Granule, 30 cases in each group. The treatment course was 4 weeks for both groups. The clinical efficacy, plasma levels of CD4 and CD8, and the serum levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) were measured before and after treatment. RESULTS: After treatment, the total effective rate in the treatment group and the control group was 96.7% and 63.3% respectively with significant difference between groups (P < 0.05); in the treatment group the plasma CD4, CD4/CD8 and serum IL-2 increased obviously, while the plasma CD8 and serum TNF-alpha decreased markedly (P < 0.05), all were significantly different with those in the control group (P < 0.05). CONCLUSION: PG can improve the immune function and alleviate inflammation in CPID patients of BSSDS type.

Health-seeking behavior of Karachi women with reproductive tract infections.

To explore the contextual factors influencing health-seeking behavior of women in Karachi regarding reproductive tract infections, 18 women with reproductive tract infections from different clinics and community settings were identified and in-depth interviews were conducted. Physicians in our study diagnosed a woman to have lower reproductive tract infection if she complained of malodorous vaginal discharge with or without perineal itching; and to have pelvic inflammatory disease or upper reproductive tract infection if she had any two of the following complaints: malodorous vaginal discharge, menstrual irregularities, lower abdominal pain or dyspareunia. Women consulted a variety of healthcare providers in their pursuit for treatment, mainly allopathic doctors and hakims. The different treatments prescribed to women ranged from oral and intravaginal medications to various home remedies including refraining from specific foods. Causes of reproductive tract infections reported were "melting bones", consuming foods with perceived hot composition, poor personal hygiene and procedures like dilatation and curettage, delivery and induced abortions. None reported sexually transmitted diseases as the perceived cause of their problem. Interference with religious activities, sexual relationships or socializing was reported as consequences of reproductive tract infections, in addition to lower abdominal pain, menstrual irregularities, backache and kamzori (weakness). Pakistani women seek care for reproductive tract infections and visit a variety of providers, though causes and treatments offered are usually not related to sexually transmitted diseases. We therefore suggest training of healthcare providers for appropriate counseling and that treatment management protocols be advocated.

[Milta-F: a magnetic infrared laser therapeutic apparatus with a photorecorder for diagnosis, prognostication and treatment of inflammatory diseases of the adnexa uteri]. / Magnitno-infrakrasnyi lazernyi terapevticheskii apparat s fotoregistratorom "Milta-F" -- pribor dlia diagnostiki, prognozirovaniia i lecheniia vospalitel'nykh zabolevanii pridatkov matki.

Laser biophotometry is an objective method to diagnose and to predict the course of inflammatory diseases of the uterine appendages. By taking into account its simplicity, reliability, and validity of findings, a MILTA apparatus should be recommended in additional studies of patients.

A multicenter study comparing intravenous meropenem with clindamycin plus gentamicin for the treatment of acute gynecologic and obstetric pelvic infections in hospitalized women.

We conducted a multicenter trial to compare the efficacy and safety of meropenem with the efficacy and safety of clindamycin plus gentamicin in the treatment of 515 hospitalized patients with acute gynecologic and obstetric pelvic infections. At the end of treatment, the rates of satisfactory clinical and bacteriologic response were high (88%) in both treatment groups: the rates of response were 90% for the meropenem group and 86% for the clindamycin/gentamicin group. No serious adverse events occurred. The most frequently reported drug-related adverse clinical events in the meropenem group were nausea and injection-site reactions (> 1% of patients), and the most common drug-related laboratory abnormality was thrombocythemia. Similar patterns of adverse events occurred in the clindamycin/gentamicin group; however, the incidence of diarrhea and eosinophilia was higher in this group. In summary, this trial demonstrated that meropenem is an effective and safe alternative to the combination of clindamycin plus gentamicin for the treatment of women with acute gynecologic and obstetric pelvic infections.

[The effect of a low-frequency magnetic field on the clinico-immunological indices of patients with chronic inflammatory diseases of the organs of the female genital system]. / Vliianie nizkochastotnogo magnitnogo polia na kliniko-immunologicheskie pokazateli bol'nykh s khronicheskimi vospalitel'nymi zabolevaniiami organov zhenskoi polovoi sistemy.

Low-frequency magnetic field generated by the vaginal inductor used in 120 females with chronic genital inflammation promoted a decrease in leukocytosis, elevation of total population of T-lymphocytes, inhibition of high proliferative activity in PHA test. However, marked immunocorrection was not reached.

Rol de la laparoscopía en el diagnóstico de los procesos inflamatorios pélvicos / Role of the laparoscopy in the diagnosis of pelvic inflammatory process

Se presentan los resultados de laparoscopías diagnósticas realizadas en 278 pacientes que ingresaron al Servicio de Ginecología y Obstetricia del Hospital Regional de Temuco, durante el período comprendido entre enero de 1993 y marzo de 1994. Se realiza laparoscopia diagnóstica y se certifica el diagnóstico de procesos inflamatorio pelviano utilizando los criterios de Hager. Se confirma el diagnóstico de proceso inflamatorio sólo en el 74 por ciento de los casos. Los hallazgos son concordantes con lo señalado en varias publicaciones en cuanto a otorgar un rol significativo a la laparoscopia diagnostica en los procesos inflamatorios pélvicos, con lo cual se logra un mejor diagnóstico diferencial. Se analizan las propiedades de sensibilidad y especificidad para los diferentes elementos clínicos y de laboratorio considerados en el diagnóstico de PIP. El test de inmunofluorescencia para Clamidias fue positivo en el 40,7 por ciento de las pacientes. Los gérmenes aerobios más frecuentemente encontrados corresponden a E. coli

[The use of the Shirsal concentrate in treating chronic inflammatory diseases of the uterine adnexa]. / Ispol'zovanie kontsentrata "Shirsal" v lechenii khronicheskikh vospalitel'nykh zabolevanii pridatkov matki.

Shirsal concentrate, mineral water salt from Shira lake, of sulfate chloride magnesium and sodium composition is suggested for therapy of women suffering from chronic inflammations of pelvic organs. Eighty-three women were administered Shirsal solution electrophoresis combined with endovaginal vibration massage or microenemas of 0.5% solution of the same agent. The treatment had an evident anti-inflammatory, analgesic, and resolving effect.

Pelvic inflammatory disease: findings during inpatient treatment of clinically severe, laparoscopy-documented disease.

OBJECTIVES: We evaluated the relationship between clinically severe pelvic inflammatory disease and laparoscopic diagnosis and grading, comparative treatment with clindamycin plus cefamandole or doxycycline, and a management protocol for inpatient pelvic inflammatory disease treatment. STUDY DESIGN: Thirty-three patients who met our clinical criteria for severe pelvic inflammatory disease underwent diagnostic laparoscopy. Pelvic inflammatory disease patients were randomized to double-blind treatment with clindamycin plus cefamandole or doxycycline within our management protocol; postdischarge oral antibiotics were omitted. RESULTS: Laparoscopy confirmed pelvic inflammatory disease in 23 (70%) patients; 10 (44%) had mild pelvic inflammatory disease by laparoscopic grading. Laparoscopic grade alone predicted necessary duration of therapy to response: mild pelvic inflammatory disease, 2.3 +/- 0.5 days; moderate pelvic inflammatory disease, 2.7 +/- 1.5 days; and severe pelvic inflammatory disease, 3.9 +/- 1.5 days (p less than 0.05). Using the management plan presented, response rates for both antibiotic regimens were 100%. CONCLUSIONS: Clinical diagnosis and grading of severe pelvic inflammatory disease has poor specificity. Laparoscopic grading of severity of pelvic inflammatory disease seems accurate. Both clindamycin plus cefamandole and clindamycin plus doxycycline are equally effective regimens for treatment of pelvic inflammatory disease and did not require supplementation after discharge. Our management plan is objective and practical; daily bimanual examination is the most sensitive indicator of persistent disease.