Study On The Standardization Of The Common Syndromes Of Chronic Pelvic Inflammatory Disease Of TCM And PRO Scale

Objective:Based on the literature and clinical research of chronic pelvic inflammatorydisease, this study investigated the distribution of syndromes, calculated the diagnosticthreshold of syndrome and diagnostic criteria and classification to develop objectivity,applicability and operability foundation for clinical diagnostic criteria;formulated PROassessment Scale, evaluated it, and explore methods to assess the efficacy of medicaltreatment of chronic pelvic inflammatory disease.Methods:1,the literature study: through collecting the relevant literature of chronicpelvic inflammatory disease, this study discussed the distribution of TCM Syndromes ofchronic pelvic inflammatory disease to establish the diagnostic information collectionquestionnaire of chronic pelvic inflammatory disease.2, clinical research:to investigate therules of syndromes in large sample and multi-center by completing the TCM fourdiagnostic information questionnaires of chronic pelvic inflammatory disease.Thesurvey data were analyzed by cluster analysis and factor analysis; taking patients as thecenter, this study followed the making guidelines of the PRO scale (FDA2009) to foundthe scale model. Through the methods of documentation and interview, establishing itemspool draft of chronic pelvic inflammatory disease PRO scale. To establish the PRO scaledraft by screening, optimizing of the items pool, and quantifying the items. Taking presurvey and using statistical methods for item selection to found the final selection of scale,and then evaluate it.Results:1, The damp heat and blood stasis syndrome and qi stagnation and bloodstasis was the main syndrome of chronic pelvic inflammatory disease through the literatureanalysis. Lower abdominal pain, lumbosacral pain, leucorrhea, menstrual disorders andother symptoms could be seen in each syndrome.2,510cases of patients were divided into9differentiation of syndromes by experts. The dampness heat and blood stasis, qi stagnation and blood stasis and kidney deficiency and blood stasis type were accounted forthe largest proportion (70.59%),the blood stasis syndrome could be seen inmost syndromes. The many quantity of leucorrhea, dark and red tongue, dysmenorrhea,white fur, menorrhagia, lassitude, swelling or tingling pain in lumbosacral, swelling ortingling pain in abdominal, greasy fur, petechia ecchymosis tongue were the topten symptoms.3, variables were clustered into four categories: cold dampness stasissyndrome, kidney deficiency and blood stasis syndrome, damp heat and blood stasis and qistagnation and blood stasis syndrome.510cases by sample cluster were divided into fivegroups, according to the number of cases from more to less as follows: Damp heat andblood stasis type in150cases (29.41%), qi stagnation and blood stasis type in120cases(23.53%), kidney deficiency and blood stasis type in115cases (22.55%), Qi deficiencyand blood stasis type (spleen dampness and blood stasis in65cases (12.75%)), cold dampstagnation type in60cases (11.76%). The results were consistent with the clinicalsyndrome differentiation and proportion.4, Using factor and cluster analysis, the fivecategories to reflect the510cases of patients with chronic pelvic inflammation groupbased symptom group category. The set of first group TCM symptoms consistent withdamp heat and blood stasis syndrome, the main symptoms were abdominal pain,leucorrhea with abnormal color, thick quality and odor, red or dark red blood, low-gradefever, yellow urine, yellow or greasy fur tongue, string and slippery pulse; The set ofsecond group TCM symptoms consistent with blood stasis and kidney deficiencysyndrome, the main symptoms were bearing-down pain in lower abdomen, lumbosacralpain, soreness and weakness of waist and knees, tinnitus, pale and dull face, frequenturination, sunken pulse; the set of third groups of TCM symptoms were qi stagnation andblood stasis, the main symptoms were swelling or tingling pain in lower abdomen,lumbosacral, breast, chest and hypochondrium, sigh, irritability, string and unsmooth pulse;the fourth were cold damp stasis syndrome, the main symptoms were cold pain inlumbosacral, lean leucorrhea, cold limbs, pale and moss white tongue; the fifth were Qideficiency and blood stasis syndrome, the main symptoms: abdominal pain, multiplequantity leucorrhea, dysmenorrhea, menstrual volume with menstruation, shortness ofbreath, lassitude, anorexia, dark red and petechia ecchymosis tongue.5, according to thefifth percentile (P5) score of each type syndrome as diagnostic threshold; developing scorestandard of light (5%-25%),(25%-75%), heavy (75%-95%) with percentile method.6,developing the chronic pelvic inflammatory disease PRO assessment scale:①the scale properties: self assessment scale;②the scale structure: containing26entries, wascomposed of4dimensions,6aspects. Completing the scientific evaluation of the scale:①the scale acceptance rate was100%, completion rate was95.45%, the completion time was(10.38±2.42) min;②reliability: the total scale, physical dimensions, psychologicaldimension, social dimension and the Cronbach ’s alpha coefficients of satisfaction were:0.977,0.952,0.969,0.945,0.899; the split half reliability of scale was0.942.③validity:items by factor analysis consisted with the theoretical construct of the scale.④degree ofreaction: P values of all dimensions and total score in five kinds of people were less than0.01by variance analysis.Conclusions:1,Chronic pelvic inflammatory disease is syndrome of deficiency inorigin and excess in superficiality, including damp heat stasis syndrome, qi stagnation andblood stasis syndrome, blood stasis syndrome of kidney deficiency, dampness stasissyndrome, qi deficiency and blood stasis syndrome, etc. Deficiency in origin is mainlyabout spleen and kidney deficiency. Excess in superficiality is mainly about damp heat, qistagnation, cold-dampness, and with blood stasis; lower abdominal pain, lumbosacral pain,changes in leucorrhea, menstrual, tongue and pulse are the main clinical symptoms. Thedistribution pattern of syndrome types reflects the basic pathogenesis of chronic pelvicinflammatory disease. Acquiring main clinical symptoms and correlate degree ofsymptoms of TCM Syndromes of chronic pelvic inflammatory disease by using clusteranalysis and factor analysis, calculating syndrome diagnosis threshold andclassification standard of diagnosis by percentile method to lay the foundation for clinicalsetting the objectivity, applicability and operability syndrome diagnosis standard.2, Thechronic pelvic the inflammation of PRO assessment scale is comprehensive index systemwhich is based on the PRO scale production process of FDA and guided by TCM theory, toassess the quality of life in patients with chronic pelvic inflammatory disease; this scale hasgood feasibility, reliability, validity and responsiveness for assessing the application effectin the TCM treatment of chronic pelvic inflammatory disease, it can be further applied.