| [objective]Chronic Pelvic Inflammation sequela is clinical frequently-seen and encountered disease. Its clinical symptons are abdominal pain, morbid leucrrhea, tissue incrassation in pelvic cavity, accretion and the formation of enclosed mass, which may cause chronic pain in pelvis cavity, ectopic pregnancy and infertility. The disease lasts long time, hard to cure and easy to relapse, which may affect the physical and psychological health of the patients. With the disease increasing year by year, the prevention of it has become a worthwhile issue. The priority is to improve cure rate in treating Chronic Pelvic Inflammation sequela. Through reviewing the literature and studying clinically, the paper is to sum up the remedial experience of national famous herbist doctor Liuyunpeng for the treatment of Pelvic Inflammation sequela and provide theoretical basis for the application and dissemination of the remedial experience of national famous herbist doctors[Method]1practice with Liyunpeng clinically Practicing along with Liuyunpeng clinically can help to learn about his clinical thought and to sum up his clinical experience and his herb administration in treating pelvis Inflammation.2clinical studyThe study is to observe the clinical effect of Fuyanqing granule on Chronic Pelvic Inflammation of Damp-Heat blood stasis type and the clinical effect of Fuyanqing granule on serum IL-2and T-cell subsets (CD4+,CD8+)of the patients, further discuss the safety and efficacy and mechanism of Fuyanqing granule.(1) source of patients70patients with Chronic Pelvic Inflammation of Damp-Heat blood stasis type are selected based on screening standards from the clinical and hospitalized patients who came to Jingzhou hospital of Tranditional Chinese Medicine during the August of2010and the Feburary of2011(2)Dignostic standards1) Dignostic standard of western medicineThe dignostic standard of Chronic Pelvic Inflammation refers to the guidance principle of clinical study on new drug of traditional Chinese medicine (2002)2) Dignostic standard of chinese medicineThe dignostic standard of Damp-Heat blood stasis type refer to the guidance principle of clinical study on new drug of traditional Chinese medicine (2002)3) Grading and quantitation standard of symptonIt refers to Grading and quantitation standard of sympton of chronic pelvic inflammation in the guidance principle of clinical study on new drug of traditional Chinese medicine (2002)(3)Therapautic method70patients are divided randomly into into treating group (orally taking one package of Fuyanqing granule with lukewarm water three times a day) and contrast group (orally taking4capsules of Jinggangteng with lukewarm water three times a day) for4weeks. All the subject patients do not take any other antibiotics or other medicine for treating Chronic Pelvic Inflammation.(4)Evaluation standards of curative effect1) Evaluation standard of clinical effectIt refers to the guidance principle of clinical study on new drug of traditional Chinese medicine (2002)2) Syndrom evaluation standardIt refers to the guidance principle of clinical study on new drug of traditional Chinese medicine (2002)(5) Index observation1) clinical sympton and physical signs will be observed and recorded before beginning treatment, on the8th day after medicine treatment, after4-week medicine treatment,and after4-week medicine withdrawal.2) test IL-2、CD4+、CD8+before treatment and after4-week medicine treatment.3) normal physical examination will be done before and after treatment.4) examine electrocardiogram, ALT, BUN before and after treatment.5) record all adverse events during treatment(6)Statistic methods All data will be analyzed by SPAA18.0. For measurement data, x±s, min,max,M will be used and comparison between groups is made by t test, Wilcoxon rank sum test is used to get abnormal distribution. For enumeration data, constituent ratio and rate will be used, and comparison between group will be made by t2test, comparison between ranked data is made by Wilcoxon rank sum test.[Result]1The study sums up Liuyunpeng’s prescriptions of treating Chronic Pelvic Inflammation, his drug administration and his dignostic key points. Three articles are published about Liuyunpeng’s experience of treating Chronic Pelvic Inflammation and one book is published about his cases and his thoughts.2curative effect of Fuyanqing granuleThe result shows that Fuyanqing has better efficacy. The effective rate of Fuyanqing is equal to that of Jinggangteng capsule and cure rate of Fuyanqing is markedly higher than that of Jinggangteng. The effective rate is100%in treating group and contrast group. The cure rate is31.4%for treating group and11.4%for contrast group and the two groups are significantly different (P <0.05); It has remarkable effect on eliminating the sympton of hypogastric pain, lumbago,abnormal morbit leukorrhea, in both groups than before treatment (P<0.01)3Effect of medicine on immune system (1) effect on PB T cell subsetsBefore beginning treatment, the comparison of CD4+、CD8+、CD4+/CD8+between groups shows they are unremarkeablly different(p>0.05) and they have comparablity. After treatment, CD4+rises and CD8+falls and CD4+/CD8+rises in treating group and they are significantly different (P<0.01) compared with before treatment. In contrast group, CD4rises and CD8falls and CD4+/CD8+rises and they are significantly different (P<0.05) compared with before treatment.(2) Effect on IL-2Before beginning treatment, comparison of IL-2in both groups shows that they are unremarkably different (P>0.05) and they have comparablity. After beginning treatment, IL-2rises in both groups compared with before treatment and the difference is highly significant for treating group (P<0.01) and the difference is significant for contrast group (P<0.05)[Conclusion] Liuyunpeng practices medicine for over80years and forms a systematic dignostic and prescriptive thought for gychaecological disease. The paper is to sum up his academic thought, including his understanding about Chronic Pelvic Inflammation sequela, his dignostic and prescriptive feature. Liuyunpeng stresses tongue and pulse parameters and treatment based on syndrom differentiation. He stresses liver, speen and kidney in the treament of gychaecological disease stresses. He thinks that the pathogenic factor for pelvic inflammation is dampness together with stagnation. So, he stresses harmonizing liver and speen and regulating vital energy and blood to strengthen body resistence while eliminating pathogenes. Fuyanqing granule and another experienced prescription of eliminating dampness and eliminating blood stasis are his prescriptions obtained in his clinical life. Clinical study shows that Fuyanqing can eliminate clinical Pelvic Inflammation syndrom, regulate body immunity, strengthen body resistance and promote the absorption of inflammation. Clinical study shows that Fuyanqing has good effect on pelvic inflammation of Damp-Heat blood stasis type. With limited conditions, the study adopts random comparison rather than more objective blinding, so the non-objective factors can not be excluded absolutely in the study. Due to the limitation of cost and time, the pathology of pelvic inflammation need to be further studied in the future. |
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