Pelvic Inflammatory Disease (PID)

Pelvic inflammation is a clinical syndrome caused by inflammation of the female reproductive organs above the cervix (including the uterine body, ovarian tubes, and ovaries) and its neighboring connective tissues.

Pelvic Inflammatory Disease (PID)

Related Health Condition
Introduction
Pelvic inflammation is a clinical syndrome caused by inflammation of the female reproductive organs above the cervix (including the uterine body, ovarian tubes, and ovaries) and its neighboring connective tissues. The disease is also referred to as pelvioperitonitis or inflammation of the pelvic reproductive organs. Inflammation of the pelvic reproductive organs often results from a retrograde infection. Due to the proximity of the female reproductive organs to one another, infection of any one organ is prone to spread to the other organs, resulting in simultaneous inflammation of multiple organs. According to its progress and clinical manifestations, the disease is classified as acute or chronic types. In traditional Chinese medicine, it belongs to the categories of "abdominal pain", "lumbago", "gynecological diseases", "abdominal mass", etc.
Etiology/Pathogenesis
Pelvic inflammation often is the result of damp heat invading the pelvic cavity, causing qi and blood stagnation. When toxic pathogens, such as damp heat, invade the uterine collaterals, they interact with the lochioschesis causing pathogenic heat accumulation. To combat this pathogenic heat, the body's defense mechanism kicks into action, sometimes resulting in severe abdominal colic pain accompanied by a high fever and chills. If the pathogenic heat is somehow retained in the intestinal canal, the resulting stagnation of visceral qi could lead to vomiting and diarrhea.
Primary Treatments with Chinese Medicinal Herbs
Li treated 60 cases of chronic pelvic inflammation with Xue Fu Zhu Yu Tang (decoction for removing blood stasis in the chest). The formula consisted of Dang Gui (Chinese Angelica Root), Bai Shao (White Peony Root), Chi Shao (Peony Red), Chai Hu (Bupleurum), Tao Ren (Persica), Jie Geng (Platycodon Root), Chuan Xiong (Cnidium), Yan Hu Suo (Corydalis Tuber), Niu Xi (Achyranthes), Gan Cao (Licorice), and Mo Yao (Myrrh). The formula was modified according to the individual patients' symptoms. The results were: 24 cases (54%) significantly improved, 31 cases (8%) had improved, and the remaining 5 cases (8%) did not respond to the treatment, with a total effectiveness rate of 92%.(1)
Other Treatments with Chinese Medicinal Herbs
Tan et al. treated 82 cases of acute pelvic inflammation with Fu Ke Qian Jin Pian. A comparison group of 37 cases was treated with Yin Qiao Hong Jiang Jie Du Tang (prepared by Shanghai Traditional Chinese Medicine Institute). The results of the study showed that: In the treatment group, 22 cases significantly improved, 31 cases demonstrated great improvement, another 24 cases showed slight improvement, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate of 95.1%; of the comparison group, the corresponding numbers were 6, 12, 16, 3, and 91.9%.(2)
Wang treated 128 cases of both acute and chronic pelvic inflammation with Jin Gui Da Huang Mu Dan Tang. The formula consisted of Da Huang (Rhubarb), Mu Dan Pi (Moutan), Tao Ren (Persica), Dong Gua Zi (Benincasa Seed), Mang Xiao (Mirabilitum), Cang Zhu (Atractylodes), and Huang Bo (Phellodendron). The formula was modified to suit the individual patients' symptoms. One dose of the formula was decocted in water for internal administration daily. After the first three doses, the proportions of Da Huang and Mang Xiao were reduced by 50%, and those of Cang Zhu and Huang Bo were increased by 50%. After the first week, the proportions of Da Huang and Mang Xiao were further reduced by 50%. One course of treatment lasted 2-4 weeks. The results: 86 cases greatly improved, another 30 cases improved, and the remaining 12 cases did not respond to the treatment, with a total effectiveness rate of 90.6%.(3)
Lin et al. treated 100 cases of chronic pelvic inflammation with Liu Huang Tang. The formula consisted of Huang Qi (Astragalus Root), Shu Di Huang (cooked Rehmannia), Huang Jing (Polygonatum Root), Huang Qin (Scutellaria), Da Huang (Rhubarb), and Pu Huang (Bulrush). The formula was modified to suit the individual patients' symptoms. A comparison group of 50 cases was treated with penicillin sodium, cephazolin, metronidazole, etc. One course of treatment lasted for 15 days for both groups. The results: of the treatment group, 60 cases greatly improved, another 36 cases improved, and the remaining 4 cases did not respond to the treatment, with a total effectiveness rate of 96%; of the comparison group, the corresponding numbers were 25, 13, 12, and 76%.(4)
Other Treatments
External treatment
Ren et al. treated 96 cases of pelvic inflammation by a retention enema with Hong Teng Tang (a common modern formula). One comparison group of 40 cases was treated by a traditional enema with Hong Teng Tang, and a second comparison group of 44 cases was treated with antibiotics and medication made from placenta tissue. The results: the treatment group had superior therapeutic effects than either of the two comparison groups (P<0.05).(5)

Zheng et al. treated 30 cases of chronic pelvic inflammation by a retention enema with Shuang Dan Tang. The formula consisted of Jin Yin Hua (Lonicera Flower), Mu Dan Pi (Moutan), Lian Qiao (Forsythia), Pu Gong Ying (Dandelion), San Leng (Burreed Tuber), E Zhu (Zedoariae Rhizoma), Chi Shao (Peony Red), Huang Bo (Phellodendron), Zi Hua Di Ding (Viola), Bai Jiang Cao (Thlaspi), Zao Jiao Ci (Gleditsia Spine), etc. A comparison group of 30 cases was treated with the same formula but by oral administration. The results: the treatment group had a total effectiveness rate of 96.67%, while the comparison group had a total effectiveness rate of 86.64% (P<0.05).(6)

Li et al. treated 480 cases of chronic pelvic inflammation by a retention enema with the following herbs: Huang Bo (Phellodendron), Long Dan Cao (Gentiana Root), Yan Hu Suo (Corydalis Tuber), Chuan Lian Zi (Melia), Xiang Fu (Cyperus), E Zhu (Zedoaria), Yi Yi Ren (Coix), and Rou Gui (Cinnamon Bark). The treatment was conducted once daily, and one course of treatment lasted 10 days. The treatment was discontinued during menstruation. The results; 380 cases significantly improved, another 60 cases improved, and the remaining 40 cases did not respond to the treatment, with a total effective rate of 91.7%.(7)

Iontophoresis with Chinese herbs
Fan et al. treated 92 cases of chronic pelvic inflammation through iontophoresis with the following herbs: Ru Xiang (Mastic), Mo Yao (Myrrh), Xue Jie (Dragon's Blood), Hong Hua (Carthamus), Dang Gui (Dang Gui), Chi Shao (Peony Red), Xiang Fu (Cyperus), Gui Zhi (Cinnamon Twig), Hua Jiao (Zanthoxylum Peel), Bai Hua She She Cao (Oldenlandia), Pu Gong Yin (Dandelion), Bai Jiang Cao (Thlaspi), and Dan Shen (Salvia). The results: 49 cases significantly improved, 25 cases showed great improvement, another 16 cases improved, and the remaining 2 cases did not respond to the treatment, with a total effectiveness rate of 97.9%.(8)

Physiotherapy
Zhao treated 15 cases of chronic pelvic inflammation by ultra-shortwave therapy. The results: 8 cases (53.33%) greatly improved and the remaining 7 cases improved, with a total effectiveness rate of 100%.(9)

Simultaneous internal and external treatments
Ling treated 92 cases of chronic pelvic inflammation by simultaneous internal and external treatments. The formula prescribed for internal administration was aimed at cleansing heat, dispelling dampness to promote qi circulation, and remove stasis, and consisted of the following herbs: Bai Jiang Cao (Thlaspi), Huang Qin (Scutellaria), Xiang Fu (Cyperus), Chai Hu (Bupleurum), Chuan Lian Zi (Melia), Dan Shen (Salvia), and Chi Shao (Peony Red). Externally, the patients were treated by an enema with the decoction of the following herbs: Bai Jiang Cao (Thlaspi), Hong Teng (Sargentodoxa Cuneata Rhixoma), Pu Gong Ying (Taraxaci Herba), Jin Yin Hua (Lonicerae Flos), Dan Shen (Salvia), Chi Shao (Peony Red), San Leng (Sparganii Rhizoma), E Zhu (Zedoariae Rhizoma), and Ye Ju Hua (Chrysanthemi Indici Flos). This treatment had a total effective rate of 97.8%.(10)

Combined treatment with Chinese and Western medicine
Zhu treated 120 cases of chronic pelvic inflammation with Western antibiotics, a retention enema, and external application using Chinese herbs. Herbs used for the enema were a decoction of the following three herbs: Pu Gong Ying (Dandelion), Zi Hua Di Ding (Viola), and Jin Yin Hua (Lonicera Flower). The external medication used the following herbs: Wu Jia Pi (Acanthopanax Root Bark), Ru Xiang (Mastic), Mo Yao (Myrrh), Dang Gui Wei (Dang Gui Tail), Fang Feng (Siler), Qiang Huo (Notopterygium Root), Sang Ji Sheng (Loranthus), Chi Shao (Peony Red), Ai Ye (Artemesia), Hua Jiao (Zanthoxyli Pericarpium), Xue Jie (Dragon's Blood), Hong Hua (Carthamus), Tou Gu Cao (Impatiens), Du Huo (Pubescent Angelica Root), and Qian Nian Jian (Homalomena). A comparison group of 50 cases was treated with Western medicine only. The results: the treatment group had a superior therapeutic effect than the comparison group.(11)

Comprehensive therapies
In treating 127 cases of pelvic inflammation, Bao combined internal administration and a retention enema using Chinese herbs, microwave therapy, and external application with an analgesic paste designed to treat swelling and inflammation. The herbs used for internal administration and the retention enema were the following, which had the properties of cleansing heat and toxins, and removing stasis: Bai Hua She She Cao (Oldenlandia), Ban Zhi Lian (Barbat Skullcap), Hong Teng (Sargentodoxa Cuneata Rhixoma), Bai Jiang Cao (Thlapsi), Mu Dan Pi (Moutan), San Leng (Burreed Tuber), E Zhu (Zedoaria), Yan Hu Suo (Corydalis Tuber), and Mo Yao (Myrrh). The treatment lasted 10-20 days. The results: 66 cases significantly improved, another 48 cases improved, and the remaining 13 cases did not respond to the treatment.(12)

Wu et al. treated 48 cases of pelvic inflammation with an oral administration of Chinese herbs, enema, and GL-148B light quantum blood therapy. The herbs used for the oral administration had the properties of promoting qi and blood circulation, dissipating stasis and mass, and removing dampness; and the herbs used for enema were known for their effectiveness in regulating qi, dredging collaterals, eliminating blood stasis, and removing dampness. The results: after the treatment, patients no longer experienced clinical symptoms, and 97.9% of the patients improved.(13)

References
  1. Li Zheng Qing. 60 cases of chronic pelvic inflammation treated with Xue Fu Zhu Yu Tang (Decoction for removing blood stasis in the chest). Gansu Journal of TCM. 1995;8(4):34.
  2. Tan Pu Yun, et al. 82 cases of acute pelvic inflammation treated with Fu Ke Qian Jin Pian. Hunan Journal of TCM. 1999;15(5):44.
  3. Wang Yu Xia. Treating pelvic inflammation with Jin Gui Da Huang Mu Dan Tang. Journal of Traditional Chinese Medicine Information. 1999;16(6):41-42.
  4. Lin Ying Ling, et al. 100 cases of chronic pelvic inflammation treated with Liu Huang Tang. Journal of Zhejiang College of TCM. 1999;23(6):33.
  5. Ren Su Xia, et al. Treating chronic pelvic inflammation by retention enema with Hong Teng Tang. Journal of Nursing. 2000;15(7):428-429.
  6. Zheng Song, et al. Treating chronic pelvic inflammation by retention enema with Shuang Dan Tang. Hubei Journal of TCM. 2000;22(2):10-12.
  7. Li Ya Ping, et al. Treating 480 cases of chronic pelvic inflammation with retention enema using Chinese herbs. Journal of Modern TCM. 1999;12(4):11-12.
  8. Fan Mei Xia, et al. Treating 92 cases of chronic pelvic inflammation by iontophoresis with Chinese herbs. Shanxi Journal of TCM. 2000;16(2):60.
  9. Zhao Jian Chang. 15 cases of chronic pelvic inflammation treated with microwave therapy. Journal of Zhangjiakou Medical College. 1990;16(2):110.
  10. Ling Chun Bo. 92 cases of chronic pelvic inflammation treated with a combination of oral administration and external application of Chinese herbs. Shaanxi Journal of TCM. 1999;20(12):531.
  11. Zhu Xiu Xia. 128 cases of pelvic inflammation treated with a combination of Chinese and Western medicine. Journal of Guiyang College of TCM. 2000;22(1):27-29.
  12. Bao Shi Ping. A comprehensive approach to treating 127 cases of chronic pelvic inflammation. Inner Mongolia Journal of TCM. 2000;19(1):15-16.
  13. Wu De Xia, et al. A comprehensive for 48 cases of pelvic inflammation. Jiangsu Journal of TCM. 2000;21(1):16-17.
This information is educational in context and is not to be used to diagnose, treat or cure any disease. Please consult your licensed health care practitioner before using this or any medical information.
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