| Objective:Pelvic inflammatory disease (PID) refers to a group of diseases caused by the inflammation of the upper genital tract among the females, including endometritis, salpingitis, tubo-ovarian abscess, pelvioperitonitis, etc, which is equivalent to the sequela of pelvic inflammatory disease in modern medicine and is commonly seen in the gynecological department among the females with frequent sexual activity and menstruation. With the development of the society, the changes of the concepts, the disorder of the sexual activity, the widely-spread of the sexually transmitted diseases, the manipulations on the uterine cavity after the reoccurred abortions, the widely application of intrauterine devices and the quicken pace of the modern life and pressure around, the occurrence rate of PID has the tendency of apparent increasing. With a series of family and social problems such as the long-term chronic pain of the pelvic cavity, sterility, ectopic pregnancy, etc, it seriously affects the quality of life among the patients and threatens the reproductive health of the females, which at present is paid much attention at home and abroad. How to effectively treat the chronic inflammation of pelvic cavity, reduce the rates of the complications such as ectopic gestation, sterility, chronic pain of the pelvic cavities, etc, and enhance the quality of life are of significance afterwards, and there is one important research direction, that is, explore the effective methods and improve the clinical therapeutic efficacy with the advantages, holism concepts and syndrome differentiation and treatments of TCM. Hence, in the present study, the correlations among the etiologies and the quality of life among the patients with different kinds of syndromes of chronic pelvic inflammation were summarized. With the statistical management, the TCM syndromes of chronic pelvic inflammation were firstly explored, which consequently provided the references for the further studies of the rules of TCM syndrome differentiation of chronic pelvic inflammation and the improvement of quality of life and the basis for the clinical syndrome differentiation, treatment and therapeutic efficacy evaluation.Methods:With the controlled study methods, among those patients who visited the out-patient and in-patient gynecological departments, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, from August,2010 to February,2011, those who were accordance with the diagnostic, inclusive and exclusive criteria were enrolled,105 cases in total. According to the criteria of syndrome differentiation, they were classified into 4 groups, namely, Group of damp-heat-blood stasis accumulation, Group of qi stagnation and blood stasis, Group of cold-dampness stagnation and Group of qi deficiency and blood stasis. With the questionnaires survey, the basic information of the patients such as the disease duration, ages, occupations, diet habits, characteristic, sanitation habits, ages of the first sexual life, amounts of the sex partners, frequency of sexual life, formats of contraception, numbers of abortion, manipulation on the uterine cavity, the history, etc, was collected, and the difference of the etiologies of the chronic pelvic inflammation among the different categories of syndromes were compared. With the SF-36 scale table, the quality of life (QOL) of the patients was tested and the difference of QOL scores of different syndromes of chronic pelvic inflammation was compared.Results:1. With X2test, Syndrome:The distribution of the commonly seen syndromes of chronic pelvic inflammation successively was syndrome of damp-heat-blood stasis accumulation (accounting for 33.33%), syndrome of qi stagnation and blood stasis (accounting for 32.38%), syndrome of cold-dampness stagnation (accounting for 18.10%) and syndrome of qi deficiency and blood stasis (accounting for 16.19%), with the former two groups the highest occurrence rate and significant difference between the former two and the latter two groups (P<0.01)。Disease duration:The disease duration of the qi deficiency and blood stasis syndrome was apparently longer than that in the other three groups, with significant difference (P<0.05).2. With X2test, Find out the differences between the different syndromes are more significant factors of life, and make the above factors with Logistic regression analysis. Results:The damp-heat-blood stasis accumulation syndrome was closely related with the physical labor, diet preference, irritation, anxiety, or many sex partners (≥3), frequent sexual life (≥9 times per month), etc. The qi stagnation and blood stasis syndrome was closely related with the young age (26 to 30), mental labor, diet preference, short tempers, young age for the first sexual life (15 to 18), etc. The cold-dampness stagnation syndrome was related with the physical labor, diet preference, anxiety, large number of sex partners (≥3), etc. The qi deficiency and blood stasis syndrome was related with the anxiety and large number of abortion, with significant difference (P<0.05). Among the other factors, the bad sanitary habits, non-contraception, placement of intrauterine device (IUD), manipulation on the uterine cavity (≥3 times), history of inflammation (particularly the gynecological inflammation), etc, could increase the occurrence rate of the chronic pelvic inflammation, without significant difference among the different categories of syndromes (P>0.05).3. With F-test, QOL:There was significant difference of the physiological functions, body pain, life activity, emotional function, mental health and the total scores (P<0.05), but there was no statistical difference of the scores of the physiological functions, general health situation and social functions (P>0.05). In the damp-heat-blood stasis accumulation syndrome, the score of the body pain was obviously lower than that in the other 3 syndromes and the score of the mental health was apparently lower than that in the cold-dampness stagnation and qi deficiency and blood stasis syndromes. In the qi stagnation and blood stasis syndrome, the scores of the emotional functions, mental health and the total scores were obviously lower than that in the other three syndromes and the score of body pain was apparently lower than that in the qi deficiency and blood stasis syndrome. In the cold-dampness stagnation syndrome, the score of body pain was obviously lower than that in the qi deficiency and blood stasis and qi stagnation and blood stasis syndromes, and the scores of life activity was apparently lower than that in the damp-heat-blood stasis accumulation and qi stagnation and blood stasis syndromes. In the qi deficiency and blood stasis syndrome, the scores of physiological functions and life activity were apparently lower than that in the other three groups, with significant difference (P<0.05).Conclusion:1. The damp-heat-blood stasis accumulation syndrome and the qi stagnation and blood stasis syndrome are commonly seen among the patients suffering from chronic pelvic inflammation, and there was long disease duration in the qi deficiency and blood stasis syndrome.2. The factors affecting the distribution of the syndromes include age, occupation, diet habits, characteristics, age for the first sexual life, number of the sex partners, frequency of the sexual life, numbers of abortion, etc.3. The QOL among the chronic pelvic inflammation patients was generally low, and the scores of the six items such as physiological functions, body pain, life activity, emotional functions, mental health and total scores among the different categories of syndromes were obviously different, with the QOL among the patients with the qi stagnation and blood stasis syndrome lowering the most apparently. |
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