Observation on Curative Effect of Kangfu Decoction in Treating Chronic Pelvic Pain after Pelvic Inflammatory Disease

Release time:

2017-04-27

Observation on Curative Effect of Kangfu Decoction in Treating Chronic Pelvic Pain after Pelvic Inflammatory Disease

Liu Zhaohui, Liao Qinping, Xue Fengxia, Sui Long, Fan Shangrong, Liu Hongwei, Li Shuxia, Zhang Dikai, Cui Manhua

Abstract: Objective To investigate the curative effect of Kangfu Xiaoyan suppository in the treatment of chronic pelvic pain after treatment of damp-heat stasis-type pelvic inflammatory disease (PID).

METHODS: A total of 224 patients with chronic pelvic pain were enrolled in eight hospitals, including the First Hospital of Peking University in 2011. The patients were enrolled in this study. The patients were followed up and treated regularly. Methods: Kangfu Xiaoyan suppository, 1 day, 1 time, even in February.

Results There were 187 patients (83.5%) with symptom score of 7.73 ± 4.51 (0 ~ 24) in patients with age (35.95 ± 7.77 years) (21 ~ 56 years); patients with subjective score: 5.57 ±

2.30 (1 ~ 10); TCM syndrome score: 11.86 ± 4.05 (3 ~ 24). (R = 0.695, P <0.01), and the score of TCM syndrome (11.86 ± 4.5) was positively correlated with subjective score (r = 0.455, P <0.001), and there was a significant correlation between symptom score and subjective score ). After the application of drug treatment 30,60,90 d various symptoms (such as abdominal pain, anus bulge, sexual intercourse pain, dysmenorrhea, vaginal discharge abnormalities) have improved, and medication symptoms improved in February were better than medication in January (P < 0.05). Conclusion Kang Yu anti-inflammatory suppository in February for continuous treatment of chronic pelvic pain after PID to improve the symptoms more meaningful.

Key words: Kang Fu Xiaoyan bolt; pelvic inflammatory disease; pelvic pain

CLC number: R711.33 Document code: A

Study on Kangfuxiaoyan Shuan's therapeutic efficacy of pelvic pain which is caused by pelvici nflam- matory disease.LIU Zhao-hui *, LIAO Qin-ping *, XUE Feng-xia, SUI Long FAN Shang-rong LIU Hong-wei LI Shu-xia, ZHANG Di-kai, CUI Man-hua. * Peking University First Hospital, Beijing 100034, China

Abstract: Objective To investigate Kangfuxiaoyan Shuan's therapeutic efficacy of pelvic pain which is caused by pelvic inflammatory disease. Methods 224 pelvic pain patients which is caused by pelvic inflammatory disease from Peking University First Hospital etc.8 hospital were performed. Kangfuxiaoyan Shuan were used By anus at bedtime, once per day, 1 pill per time course of treatment: 2 month.Results The average age of the patients was (35.95 ± 7.67) y. 83. 5% of the patients had the history of pelvic inflammatory disease.Symptoms & signs score (7.73 ± 4.51) of the patients had good consistent with the subjective scoring (5.57 ± 2.30) The syndrome scores of traditional Chinese medicine (11.86 ± (R = 0.455, P <0.001) .Total therapeutic efficacy afer 30 days, 60 days and 90 days improved improved.ymptoms & signs score of 60 days were improved better than that of 30 days (P <0.05) .Conclusion Kangfuxiaoyan Shuan 60-days therapeutic efficacy of pelvic pain is confirmed. Drug combination of Kangfuxiaoyan Shuan can relief the pelvic pain of pelvic inflammatory disease more efficaciously. Keywords: Kangfuxiaoyan shuan; pelvic inflammatory disease; pelvic pain

 

Pelvic inflammatory disease (PID) refers to the upper genital tract and its surrounding tissue infection [1-2]. root

According to the Chinese PID diagnosis and treatment norms [3], antibiotic treatment of PID has a good effect, but the PID can cause sequelae, chronic pelvic pain is one of them. Chronic pelvic pain (chronic pelvic pain, CPP) refers to non-periodic, pain lasting up to 6 months, non-opioid invalid pelvic pain [4]. The treatment of chronic pelvic pain has been the clinical problem that gynecologists are constantly exploring. Whether the motherland medicine can have the therapeutic effect on the pelvic pain after PID is the exploration goal of this study. By the Peking University First Hospital and other eight hospitals for clinical observation, to explore the traditional Chinese medicine Kang Fu anti-inflammatory suppository in pelvic inflammatory disease after CPP treatment of the effect.

1 Materials and methods

1.1 Research objects

1.1.1 selected standard 8 hospitals for the selected hot and humid stasis type PID after chronic pelvic pain in patients with: a clear history of the previous PID; have continued for more than 6 months repeated abdominal pain; according to TCM classification will meet the hot and humid stasis Conclusion of the case into the study of [5]: the main symptoms with 2 or more, secondary disease 2 or more, combined with tongue and pulse, you can dialectical syndrome for the damp heat stasis. Main symptoms: (1) lower abdominal pain or tingling, pain fixed. (2) lumbosacral pain. (3) take the amount of large, yellow color or odor. Times: (1) increased menstrual pain. (2) menstrual extension or menstrual flow. (3) mouth tired or poor appetite. (4) yellow urine (5) loose stools and cool or dry stool. Tongue veins: red or dark red tongue, or see the edge of the tip of the point or eczema, yellow greasy moss or greasy, slippery pulse or string number. A total of 224 patients were included in the study, including 8 cases of Peking University First Hospital, 6 cases of Tianjin Medical University General Hospital, 48 cases of obstetrics and gynecology hospital affiliated to Fudan University, 29 cases of Shenzhen Hospital of Peking University, 2 of Huaxi Second Hospital of Sichuan University Cases, 56 cases of Tianjin Center for Maternity Hospital, Sun Yat-sen University, the sixth hospital and 28 cases of Jilin University, the second hospital 47 cases.

1.1.2 exclusion criteria there are other causes of pelvic pain; there is a clear pelvic inflammatory disease, cervicitis, vaginitis; nearly 2 months without antibiotics, nearly 1 month has not used other Chinese medicine.

1.2 Research methods

1.2.1 Registration, treatment and regular follow-up of selected patients in selected hospitals.

1.2.2 study drug Kang Fu anti-inflammatory suppository [sunflower Pharmaceutical Group (Yichun) Co., Ltd., each box 7], before going to bed, 1 d1 times, 1 time, once every 2 months. Menstrual disabled.

1.2.3 follow-up The first follow-up: start treatment for 1 month. Second follow-up: start treatment for 2 months. The third follow-up: start treatment for 3 months.

1.2.4 Evaluation of the efficacy of the main indicators: the subjective score (the degree of pain is divided into 10 grades, the patient should determine their own pain symptoms are the first few grades): 0 to 10 points; TCM rating score: 0 ~ 28 points, Reference [5]. Secondary observation: Patient symptom score (using McCormack score), reference [6].

1.3 Statistical methods SPSS10.0 software package analysis data, the application of χ 2 test, Friedman test, McNemar test, paired t test analysis of medication 1 month, 2 months and 1 month after stopping (ie medication began to 3 Month) when the clinical efficacy. Pearson correlation analysis to understand the consistency of symptoms and signs score and subjective score.

2 results

2.1 The general condition of 224 patients (35.95 ± 7.77 years) (21 to 56 years), clinical symptoms such as the main manifestations of lower abdominal pain (97.3%), anal bulge (49.5%), (4%), dysmenorrhea (47.7%), constipation (39.0%), bloating (50. 9%) and so on.

2.2 Subjective Score: 5.57 ± 2.30 (1 ~ 10); TCM Symptom score: 11.86 ± 4.05 (3 ~ 24). The scores of the three criteria were: 7.73 ± 4.51 (0 ~ 24) Symptomatic signs were correlated with subjective scores (r = 0.695, P <0.001). There was a correlation between TCM score and subjective score (r = 0.455, P <0.001).

2.3 30, 60, 90 d after treatment of clinical symptoms and signs of whether the symptoms and signs from the score, TCM syndrome score, subjective assessment of patients, or from the various symptoms to improve the situation, 2 months medication than 1 month medication significantly effective. See Table 1.

 

2.4 The efficacy of treatment 60 d of the efficacy was significantly better than 30 d after treatment (McNemar test, P = 0.001).

3 Discussion

The main causes of chronic pelvic pain in gynecology include: pelvic inflammatory disease sequelae, endometriosis, pelvic venous stasis syndrome and pelvic adhesions, residual ovarian syndrome, the first three are the most common reasons [6]. Chronic pelvic pain disease clinical manifestations are not the same, but there are pelvic pain performance, severe cases need drugs and surgical treatment, even those can cause infertility and other functions of incomplete. For pelvic pain after PID, mainly due to tissue destruction, adhesions, hyperplasia and scar, the use of traditional Chinese medicine blood circulation method of treatment, help to restore broken

Bad tissue, release adhesions, slow down the proliferation and scar formation [7].

    Kang Fu anti-inflammatory suppository in pelvic inflammatory disease and other gynecological diseases have a significant effect in clinical applications still found that it has a good anti-inflammatory effect, in 2009, Peking University First Hospital, four hospitals at the same time on the PID treatment As well as PID pelvic pain in the clinical observation also showed a very good application prospects for pelvic inflammatory disease caused by pelvic pain, 1 month of traditional Chinese medicine treatment can be a good reduction and relieve pain. In this study, we investigated the efficacy of the treatment after 2 months of treatment, found that the effect of 2 months of medication is better than medication for 1 month, it is recommended for such patients to give 2 months of continuous treatment (menstrual period Disabled). The clinical results show that: with the extension of the treatment cycle, the role of traditional Chinese medicine also played a significant upward trend, through 14 months of clinical patients to collect and diagnosis and treatment found: pelvic inflammatory disease after CPP treatment using Kang anti- Suppository 2 months (menstrual disabled) can get more accurate clinical efficacy.

In this study, we also found that: Symptomatic signs and subjective scores have some consistency. TCM syndrome score and subjective score have a certain relevance. Therefore, the application of symptoms and signs score can well reflect the patient's situation, the proposed future research used.

For the treatment of chronic pelvic pain should pay attention to Fuzheng Quxie, internal and external treatment, multi-way treatment [7]. For Western medicine is sometimes difficult to deal with chronic pelvic pain, the beneficial trial of the motherland medicine may make up for the treatment of defects are very helpful.

references

[1] Ross JD.European guideline for the management of pelvic inflammatory disease and perihepatitis [J]. Int J Std Aids, 2001, 12 (SUPPL 3): 84-87.

[2] ROSS J.Pelvic inflammatory disease [J] .BMJ, 2001, 322 (7287): 658-659.

[3] Chinese Medical Association of Obstetrics and Gynecology Branch of the infection group. Chinese pelvic inflammatory disease diagnosis and treatment guidelines [J]. Chinese Journal of Obstetrics and Gynecology, 2008,43 (7): 556-558.

[4] Cao Zeyi. Chinese Obstetrics and Gynecology [M] .2 version. Beijing: People's Health Publishing House, 2006: 1466-1476.

[5] Zheng Xiaoyu. Traditional Chinese medicine clinical research guidelines [M]. Beijing: China Medical Science and Technology Press, 2002: 243-252.

[6] Ross JDC, Cronjé HS, Paszkowski T, et al. Moxifloxacin versus ofloxacin plus metronidaz