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.

[Clinical observation of refined moxibustion for sequelae of pelvic inflammatory disease with qi stagnation and blood stasis].

OBJECTIVE: To compare the curative effect of refined moxibustion, traditional moxa box moxibustion and Chinese patent medicine on the sequelae of pelvic inflammatory disease with qi stagnation and blood stasis. METHODS: A total of 150 patients with sequelae of pelvic inflammatory disease with qi stagnation and blood stasis were randomized into a refined moxibustion group (50 cases), a box-moxibustion group (50 cases) and a Chinese medication group (50 cases, 2 cases dropped off). The patients in the refined moxibustion group were treated with refined moxibustion at Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1) and Shuidao (ST 28), 2 moxa-cones for each acupoint. The patients in the box-moxibustion group were treated with box-moxibustion on the lower abdomen and Shenque (CV 8), and the patients in the Chinese medication group were treated with penyanqing capsules orally. All groups started treatment after menstruation, moxibustion was applied once every 4 days, twice a week, and medication was taken 3 times a day for a total of 2 menstrual cycles. The TCM symptoms and body signs scores of each group were observed before and after treatment. The short form health survey (SF-36) scores of each group were observed before and after treatment and during follow-up 12 weeks after treatment. RESULTS: After treatment, the TCM symptoms, body signs and comprehensive scores of each group were lower than those before treatment (P<0.05), and those in the refined moxibustion group were lower than the box-moxibustion group and the Chinese medication group (P<0.05). The SF-36 scores of each group after treatment and during follow-up were higher than before treatment (P<0.05); during follow-up, the SF-36 scores of the box-moxibustion group and the Chinese medication group were lower than after treatment (P<0.05), while that in the refined moxibustion group was higher than after treatment (P<0.05); the SF-36 scores after treatment and during follow-up in the refined moxibustion group were higher than the box-moxibustion group and the Chinese medication group (P<0.05, P<0.01). CONCLUSION: Compared with traditional moxa box moxibustion and Chinese patent medicine treatment, refined moxibustion can better improve the symptoms, body signs and quality of life in patients with the sequelae of pelvic inflammatory disease of qi stagnation and blood stasis, and the effect is longer.

[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.

Clinical observation of refined moxibustion for sequelae of pelvic inflammatory disease with / 中国针灸

OBJECTIVE@#To compare the curative effect of refined moxibustion, traditional moxa box moxibustion and Chinese patent medicine on the sequelae of pelvic inflammatory disease with @*METHODS@#A total of 150 patients with sequelae of pelvic inflammatory disease with @*RESULTS@#After treatment, the TCM symptoms, body signs and comprehensive scores of each group were lower than those before treatment (@*CONCLUSION@#Compared with traditional moxa box moxibustion and Chinese patent medicine treatment, refined moxibustion can better improve the symptoms, body signs and quality of life in patients with the sequelae of pelvic inflammatory disease of

Analgesic effect of electroacupuncture on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease / 中国针灸

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 (@*CONCLUSION@#EA can relieve the pain symptoms in patients with chronic pelvic pain and improve their quality of life.

Moxibustion for treating chronic pelvic inflammatory disease: A protocol for systematic review and meta-analysis.

BACKGROUND: Chronic pelvic inflammatory disease (CPID) is a difficult-to-treat gynaecological disorder, which has complex etiologies, among married women. In recent years, moxibustion has gradually shown its clinical advantages and been more and more widely used In China. The protocol is try to synthesize and assess the effectiveness and safety of moxibustion for patients with CPID. METHODS: Seven databases as following: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WangFang Database, Chinese Scientific Journal Database, Chinese Biomedical Literatures Database will be searched from their inception to May 2020. No restrictions about language and status. Study selection, data collection, and quality assessment will be respectively conducted by 2 researchers. Based on the heterogeneity test results, the fixed-effects or random-effects model will be selected to synthesize data. The effective rate, Pelvic inflammatory mass diameter and Pelvic fluid depth will be the primary outcomes. Patient reported outcome scale, visual analog scale, C-reactive protein, transforming growth factor ß1 =  transforming growth factor ß, incidence of any adverse events will be the secondary outcomes. Revman 5.4 software will be implemented for data synthesis. Dichotomous data will be represented by risk ratio for efficacy and safety of CPID treated with moxibustion, while continuous data will be represented by mean difference with a 95% confidence interval. RESULTS: The results of this study will be published in a peer-reviewed journal. This study will provide a comprehensive review of the available evidence for the treatment of moxibustion with CPID. CONCLUSIONS: This study expects to provide high-quality, evidence-based recommendations on further treatment for clinical guidance of CPID. TRIAL REGISTRATION NUMBER: CRD42020158744 in PROSPERO 2020.

Uso de ozonoterapia en las pacientes con enfermedad inflamatoria pélvica aguda Etapa III / Ozone Therapy in Patients with Acute Pelvic Inflammatory Disease Stage III

Introducción: La ozonoterapia es un proceder terapéutico que ha resultado ser eficaz en el tratamiento de diferentes enfermedades. Tiene efectos como bactericida, virucida, fungicida y parasiticida, por lo que la enfermedad inflamatoria pélvica, es tributaria de este tratamiento. Objetivo: Determinar evolución de pacientes con absceso tubo ovárico, tratadas con ozonoterapia asociada al tratamiento convencional. Métodos: Estudio observacional, longitudinal, prospectivo. Se determinó evolución de pacientes con diagnóstico de absceso tubo ovárico, tratadas con ozonoterapia asociada al tratamiento convencional en el período comprendido entre marzo 2014 y marzo 2018. El universo fue constituido por las pacientes ingresadas con la entidad. La selección de la muestra fue aleatoria, y se conformó por 63 casos en dos grupos de estudio, Grupo I (se administró ozonoterapia), y Grupo II (no se administró). Resultados: A los 7 días de tratamiento con ozono, la eritrosedimentación persistía elevada por encima de 3 cifras en 41,9 por ciento de las pacientes, y 35,4 por ciento presentaba dolor pélvico en el grupo I; en contraste con el grupo II que mantenía la eritrosedimentación elevada en 75 por ciento de ellas, y 53,1 por ciento tenía dolor. Al mes se constata disminución de las dimensiones de la tumoración en ultrasonido en 61,2 por ciento de las pacientes del grupo I, y 34,3 por ciento del grupo II. Conclusiones: Las pacientes tratadas con ozonoterapia, tuvieron reducción de la masa pélvica y remisión más rápida de los síntomas clínicos y los complementarios, que las que no recibieron esta alternativa de tratamiento(AU)

Introduction: Ozone therapy is a therapeutic procedure that has proven to be effective in the treatment of different diseases. It has effects such as bactericidal, virucidal, fungicidal and parasiticidal, so pelvic inflammatory disease is tributary to this treatment. Objective: To determine the evolution of patients with ovarian tube abscess, treated with ozone therapy associated with conventional treatment. Methods: Observational, longitudinal, prospective study. Evolution of patients diagnosed with ovarian tube abscess was determined, who were treated with ozone therapy associated with conventional treatment from March 2014 to March 2018. The universe was constituted by patients admitted with the institution. The sample selection was randomized, and 63 cases in two study groups made up the sample. Group I (ozone therapy was administered), and Group II (no ozone therapy was administered). Results: At 7 days of ozone treatment, erythrosedimentation remained high above 3 figures in 41.9 percent of the patients, and 35.4 percent had pelvic pain in group I; in contrast to group II that maintained erythrosedimentation elevated in 75 percent, and 53.1 percent had pain. A month after the treatment, a decrease in the size of the ultrasound tumor was observed in 61.2 percent of the patients in group I, and 34.3 percen t in group II. Conclusions: Patients treated with ozone therapy had pelvic mass reduction and faster remission of clinical symptoms and complementaries, than those who did not receive this treatment alternative(AU)

[Discussion on opposing needling combined with dragon-tiger fighting needling for chronic pelvic inflammation].

Opposing needling is an acupoint selection method of acupuncture recorded in Huangdi Neijing (Yellow Emperor 's Internal Classic). And the first record of dragon-tiger fighting needling is found in the Zhenjiu Daquan (Great Compendium on Acupuncture and Moxibustion), it is a compound reinforcing and reducing manipulation of tonification-purgation method. Both of them are widely used in the treatment of pain syndrome, which are mainly for nerve system and musculoskeletal diseases and seldom for gynecological diseases. By analyzing the pathogenic characteristics of chronic pelvic inflammation, the clinical application of opposing needling combined with dragon-tiger fighting needling for chronic pelvic inflammation is expounded based on the theory of treating different diseases with the same treatment in TCM.

Ozone therapy: a potential therapeutic adjunct for improving female reproductive health.

Ozone is emerging as a new adjunct therapeutic agent for female infertility. We here present a review of the literature, to date, pertaining to the effect of ozone therapy on tubal, ovarian, endometrial, and vaginal factors that could potentially affect female fertility. It also presents data pertaining to the relationship of ozone therapy on pelvic adhesion formation. Most data were performed on animals and very few human studies existed in the literature. Results suggested that ozone therapy could have beneficial effect on tubal occlusion, could protect from endometritis and vaginitis, might protect ovaries from ischemia and oocyte loss and finally might lead to less formation of pelvic adhesions. There is a critical need for human studies pertaining to ozone therapy, especially using safe methods of administration, such as transdermally or intravaginally, on female fertility.

Acupuncture for chronic pelvic inflammatory disease: A systematic review protocol.

BACKGROUND: Chronic pelvic inflammation disease (PID) is a difficult-to-treat gynecological disorder with complex etiologies. Acupuncture has been applied widely for treating chronic pelvic inflammation or chronic pelvic pain symptoms in China. The aim of this review is to undertake a systematic review to estimate the effectiveness and safety of acupuncture on chronic PID. METHODS: A literature search will be conducted electronically with date up to October 2018 in MEDLINE, Cochrane Library, EBASE, and CNKI databases, using combination subject terms of chronic pelvic pain (or chronic pelvic inflammation, and chronic pelvic pain symptoms, etc.) and acupuncture related treatment. Also duplicates will be removed. The primary outcomes consisted of improvement rate and pain relief. Secondary outcomes include the recurrence rate and side effects, such as pneumothorax, bleeding, serious discomfort, subcutaneous nodules, and infection. Systematic reviews and databases will be searched for randomized controlled trials on acupuncture for chronic PID with acupuncture treatment will be included. Cochrane RevMan V5.3.5 risk of bias assessment tool will be implemented for risk of bias evaluation, data synthesis, meta-analyses, and subgroup analysis while condition is met. Mean difference (MD), standard mean difference (SMD), and dichotomous data will be used to present continuous outcomes. RESULTS: This study will generate a comprehensive review of current evidence of acupuncture for chronic pelvic inflammation diseases. CONCLUSION: The study will provide updated evidence to evaluate the effectiveness and side effects of acupuncture for chronic pelvic inflammation disease. PROSPERO REGISTRATION NUMBER: CRD42018087950.

[Effect of Acupuncture on Inflammatory Cytokines in Patients with Acute Pelvic Inflammatory Disease].

OBJECTIVE: To observe the effect of acupuncture on inflammatory indices and symptoms in patients with acute pelvic inflammatory disease, and investigate its mechanism. METHODS: Seventy-nine patients with acute pelvic inflammatory disease were randomly assigned to a control group (n＝37) given conventional treatment and an observation group (n＝42) given conventional treatment and acupuncture therapy. In the observation group, acupionts of Zhongji(CV 3), Guanyuan(CV 4), Zigong(EX-CA 1), Zusanli(ST 36), Sanyinjiao(SP 6), etc. were selected. Each group received treatment once daily, for a total of 7 days. Tumor necrosis factor (TNF)-α， interleukin (IL)-10 and C-reactive protein (CRP) in the serum, white blood cell (WBC) and neutrophil counts, size of pelvic mass and depth of pelvic effusion, and clinical symptoms were assayed pretreatment and on days 3 and 7. RESULTS: WBC and neutrophils were significantly decreased after treatment in both groups (P<0.05), and more in the observation group than in the control group (P<0.05). After treatment, the size of pelvic mass and depth of effusion were less in both groups (P<0.05), and the efficacy in the observation group was superior to that in the control group (P<0.05). In the observation group, serum TNF-α， and CRP on day 3 and day 7 were significantly lower than those before treatment (P<0.05). Se-rum TNF-α and CRP were significantly down-regulated in the observation group compared with those in the control group on both day 3 and day 7 (P<0.05). In the observation group, serum IL-10 was higher on both day 3 and day 7 than that before treatment (P<0.05), and was statistically different from that in the control group on both days (P<0.05). The clinical efficacy in the observation group was superior to that in the control group (95.24% vs 81.08%, P<0.05). CONCLUSION: Acupuncture can regulate the levels of inflammatory markers in patients with acute pelvic inflammatory disease, and improve clinical symptoms.

[Advantages and evidences research on Chinese medicine for treatment of pelvic inflammatory disease].

Pelvic inflammatory disease is an infectious disease. At present, Western medicine is mainly treated with antibiotics. However, the situation of antibiotics abuse is so grim that the potential risks such as the imbalance of bacteria, the resistance of bacteria, the production of super bacteria and the increase of adverse reactions are becoming more and more serious. Therefore, it is urgent to find a way to supplement or substitute antibiotics for the treatment of this disease. Traditional Chinese medicine treatment of the disease is effective and has its unique advantages. This paper mainly discusses the advantages and evidences of traditional Chinese medicine (TCM) treatment of pelvic inflammatory disease, to further prove the effectiveness and safety of TCM treatment and to provide medical evidence of reducing antibiotics use.

Hemorheological study and treatment with enema retention of Li Chong Tang combined with moxibustion in women suffering from chronic pelvic inflammatory diseases.

The study was undertaken to investigate the blood stasis of chronic pelvic inflammatory disease (PID) with scientific method, hemorheology. The whole blood viscosities of chronic PID increased significantly compared with normal level, which was consistent with the blood stasis of Traditional Chinese Medicine (TCM) theory. Moreover, sixty women suffering from chronic PID were treated with Enema Retention of Li Chong Tang Combined with Moxibustion (ERM) for 6 weeks. The chronic PID score and the whole blood viscosity were evaluated before and after the ERM. The parameters of whole blood viscosities at low, median and high shear rate of chronic PID group decreased from 12.32±0.31, 6.66±0.13 and 5.15±0.52, to the normal levels, 9.19±0.13, 5.42±0.56 and 4.34±0.43 (p<0.05) after therapy of ERM and the symptoms score decreased from 13.73±3.7 to 3.8±1.4 (p<0.05), which shows that the ERM is an effective therapy method to treat chronic PID.

Smoking, poor nutrition, and sexually transmitted infections associated with pelvic inflammatory disease in remote North Queensland Indigenous communities, 1998-2005.

BACKGROUND: Indigenous women in remote North Queensland have a high prevalence of unhealthy lifestyle behaviors and associated health conditions such as sexual transmitted infections (STI). The association of severe pelvic inflammatory disease (PID) with these factors has not been studied. The purpose of this study is to associate the factors with severe PID, as indicated by hospitalization in a high risk population in North Queensland Indigenous communities. METHODS: A cross-sectional association of 1445 Indigenous women using linked hospital separation and survey data during 1998-2005. RESULTS: The mean age of participating women was 37.4 years, 60% were of Aboriginal and 40% were Torres Strait Island (TSI) people. More than half of them (52.5%) were smokers, 9.3% had chlamydia and 2.6% had gonorrhoea with the overall prevalence of STI among those less than 25 years of age being 23.9%. Among the 47 participants diagnosed with PID in the study period, 42.5% were under 25 years and 95.7% (45 cases) were under 55 years (OR 2.5, 95% CI 1.2-4.1 among women younger than 25 compared to those 25 years and over). PID was strongly associated with smoking (OR 3.1, 95% CI 1.4-9.2) independent of age, ethnicity, STI and folate status. Low red cell folate increased PID hospitalization by 4 times (95% CI 1.5-13.2 of lowest quartile compared to the highest quartile) regardless of age. Having a STI significantly increased the likelihood of severe PID by 2.2 times (95% CI: 1.03-4.5) in Indigenous women younger than 45 years, independent of smoking and folate level. The risk of PID hospitalization was higher for gonorrheal infections (OR 3.2, 955 CI 1.1-9.6) compared to chlamydial infections (OR 1.5 95% CI 0.7-3.5). CONCLUSIONS: Young Indigenous women in North Queensland communities are at very high risk for STI and PID. Smoking, low folate, and STI are clustered, and are associated with PID hospitalizations. Much of this can be prevented with improved nutrition and access to preventive services, especially tobacco control, regular STI screening and treatment, as well as more investment in sexual health education and awareness.

Acupuncture for chronic pelvic inflammatory disease: a qualitative study of patients' insistence on treatment.

BACKGROUND: Acupuncture is an effective complement to pharmacological therapy in the alleviation of chronic pelvic inflammatory disease (PID). It has mild or no side effects; however, a minimum of 3 months of therapy is required to guarantee a beneficial outcome. This study investigates why patients insist on acupuncture therapy to aid recuperation. METHODS: The study included a purposive sample of 15 participants diagnosed with chronic PID who had received a course of acupuncture therapy at least twice a week for a minimum of 3 months. Semi-structured interviews were conducted, recorded, transcribed, coded and analyzed using systematic text condensation. RESULTS: Four overarching themes were identified from the participants' reasons for insisting on lengthy, but in their view important, acupuncture courses. The four overarching themes were: (1) the patients' characteristics, including pregnancy aspiration and the fear of serious gynecological disease; (2) the patient-practitioner relationship, including the acupuncturist's attitude towards the patients and the explanation of the disease from a traditional Chinese medicine (TCM) perspective; (3) the characteristics of acupuncture, including the diversification of treatment modes, the synthetical effect, and no side-effects; and (4) the clinical environment, including the exchange of experience between patients and the well-equipped setting. CONCLUSIONS: There were mixed reasons for patients diagnosed with chronic PID maintaining acupuncture treatments. Knowledge and understanding about the acupuncture-disease relationship were conducive to the patients' preference for acupuncture. Acupuncture as a complement to Western medicine should be further developed while maintaining these positive features. Participants reported feeling hope, confidence, and a sense of responsibility for their treatment during the process, although the treatments did not always have the expected outcome.

Efectividad de la acupuntura en el tratamiento de la inflamación pélvica / Effectiveness of acupuncture in the treatment of pelvic inflammation

Se realizó un estudio experimental con el objetivo de evaluar la efectividad de la acupuntura en el tratamiento de la inflamación pélvica crónica, por déficit o exceso, según el diagnóstico de la medicina tradicional, en pacientes atendidas en el policlínico Julio Antonio Mella de la provincia de Camagüey, Cuba. El período estudiado fue de enero a diciembre de 2013. El universo de estudio lo constituyeron todas las pacientes atendidas en la consulta de ginecología de la institución con diagnostico certero de inflamación pélvica crónica, seleccionándose como muestra a 80 de ellas, que cumplían los criterios de inclusión y exclusión, atendidas en la consulta de medicina natural y tradicional. Éstas se dividieron en dos grupos, de acuerdo al diagnóstico tradicional, el A (déficit de energía) y el B (exceso de humedad y calor), con 40 pacientes cada uno. A ambos grupos se les indicó tratamiento acupuntural, según esquema confeccionado para la deficiencia de energía o exceso de humedad y calor, en sesiones de 30 minutos por 30 días, divididos en dos ciclos de tratamiento, de 15 sesiones cada uno. Se pudo corroborar que los síntomas y signos existentes al inicio del tratamiento se eliminaron en un 72,5 por ciento al finalizar el tratamiento, demostrándose la efectividad de esta terapéutica en ambos grupos en el 88,7 por ciento de las pacientes, con una mejor evolución en el grupo de la deficiencia de energía, al obtenerse un 92,5 por ciento de efectividad al tratamiento, seguido con el 85 por ciento en el grupo con diagnóstico de exceso de humedad y calor(AU)

An experimental study was carried out to assess the effectiveness of acupuncture in the treatment of chronic pelvic inflammation, either by deficiency or excess, according to the diagnosis of traditional medicine on patients treated at Julio Antonio Mella polyclinics of Camaguey, Cuba. The period of study was from January to December, 2013. The universe of study included all the patients diagnosed with such condition who were treated at the polyclinics´ gynecology consultation, and the sample-chosen at random- was formedby 80 patients who applied to the inclusion and exclusion criteria and were treated with natural and traditional medicine. According to the traditional diagnosis the patients were divided into two groups of 40 patients each: A (with energy deficiency) and B (with excess of humidity and heat). Both groups were treated with acupuncture following a scheme for energy deficiency or humidity and heat excess, in 30-minutes sessions for 30 days, divided into two cycles of 15 sessions each. It was evident and corroborated that the symptoms and signs preset at the beginning of the treatment were eliminated in 72,5 percent of the cases at the end, showing its effectiveness in both groups, represented by 88,7 percent of the patients. The group with energy deficiency showed an evolution of 92,5 percent and 85 percent of the other group evolved too(AU)

[A meta-analysis on effectiveness of acupuncture and moxibustion for chronic pelvic inflammatory disease].

OBJECTIVE: To evaluate the clinical effect of acupuncture and moxibustion therapies for chronic pelvic inflammatory disease (CPID) by Meta-analysis. METHODS: Randomized controlled trials of acupuncture and moxibustion in the treatment of CPID were searched from Databases of China National Knowledge Infrastructure (CNKI), Chinese Scientific and Technological Journals (VIP), WanFang, China Biomedicine (CBM) and PubMed up to 15 October, 2012. Two researchers independently selected the eligible literature according to the designed selection and exclusion criteria, extracted data and made an evaluation on the quality of the included studies by using the Jadad 5-point scale. The Meta-analysis was carried out using software Stata 11.0. RESULTS: A total of 26 studies involving 2 280 patients were included. Results of Meta-analysis showed significant differences between acupuncture-moxibustion intervention group and control group in terms of total effective rate [OR = 5.63, 95% CI (4.24, 7.47), P < 0.0001], cure rate [OR = 3.18, 95% CI (2.59, 3.89), P < 0.0001], and recurrence rate [OR = 0.11, 95% CI (0.03, 0.47), P < 0.05]. CONCLUSION: Acupuncture-moxibustion is effective in the treatment of CPID. Due to the Jadad scores of these included studies are low, high quality studies are definitely needed to confirm the conclusion.

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.