Researches find acupuncture effective for the treatment of chronic pelvic inflammatory disease (PID). A total of 70 female patients were randomly assigned to two groups and the results were compared. Group 1 received acupuncture and group 2 received Fu Ke Qian Jin Pian for oral intake. The group receiving acupuncture had a 91.43% total effective rate and the Fu Ke Qian Jin Pian herbal medicine group had a 74.29% total effective rate.

Acute PID is often treated with antibiotics and surgery; however, chronic PID is often unresponsive to multiple regimens of antibiotics and exploratory surgery. This research indicates that acupuncture and herbal medicine are both effective for the alleviation of chronic PID. Acupuncture outperformed the herbal tablets by 17.14%. The 91.43% total effective rate produced by acupuncture indicates that it is a viable treatment option for patients with chronic PID.

Chronic PID is characterized by persistent low-grade subclinical inflammation. According to Traditional Chinese Medicine (TCM) principles, chronic pelvic inflammatory disease is categorized under the scope of abdominal pain, vaginal discharge (leukorrhea), and infertility. PID involves the pernicious influence of fire-poisons (i.e., infection) in the lower abdomen, specifically in the uterus, broad ligaments, fallopian tubes, cervix, or ovaries. Scarring may cause infertility and long-term inflammation damages the qi (energy), thereby causing deficiency of the body’s constitution.

Primary Acupoints:
Guanyuan (CV4)
Zhongji (CV3)
Zigong (extra point)
Xuehai (SP10)
Sanyinjiao (SP6)
Tianshu (ST25)

Guanyuan (CV4) and Zhongji (CV3) are Ren meridian acupoints, which regulate the Chong and Ren meridians. The researchers selected these acupoints for the treatment protocol for their ability to dissipate blood stasis, dredge the meridians, and to relieve pain. Zigong (extra point) and Xuehai (SP10) acupoints are used to eliminate blood stasis, relieve pain, and dredge uterine vessels. Sanyinjiao (SP6) is an acupoint located at the intersection of the liver, spleen, and kidney meridians. In TCM, it is used for nourishment of yin. Tianshu (ST25) benefits the lower jiao, intestines, and stimulates qi circulation.

Secondary Acupoints:
Shuidao (ST28)
Yinlingquan (SP9)
Hegu (LI4)
Taichong (LV3)
Diji (SP8)
Qihai (CV5)
Zusanli (ST36)

Secondary acupoints were chosen for each participant based on differential diagnostics. Shuidao (ST28) and Yinlingquan (SP9) eliminate blood stasis and damp-heat. Hegu (LI4) and Taichong (LV3) acupoints regulate Qi and blood circulations. Hegu (LI4) and Diji (SP8) dissipate cold, dredge meridians, and enhance blood circulation. Qihai (CV5) and Zusanli (ST36) enrich Qi and promote blood circulation.

Treatment
Both groups were provided with 4 courses of treatment, each course of treatment consisted of 5 days of continuous treatment. After each treatment course, patients were allowed to rest for 2 days prior to the next course of treatment. The acupuncture point prescription was based on the Zhen Jiu Xue (Acupuncture and Moxibustion) text and the clinical findings of Professor Li Yue Mei from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. Secondary acupoints were chosen based upon differential diagnostics:

Damp-heat stasis: Shuidao and Yinlingquan acupoints.
Qi stagnation and blood stasis: Hegu and Taichong acupoints.
Cold-damp stagnation: Hegu and Diji acupoints.
Qi deficiency and blood stasis: Qihai and Zusanli acupoints.

Patients were instructed to first urinate and then rest in a supine position. Stainless steel acupuncture needles (30 gauge, 1 – 1.5 inches in length) were used. Tianxie brand disposable sterile needles were used to perform the acupuncture therapy with single-handed needle insertion techniques or hold-and-insert techniques. Upon deqi arrival, primary acupoints were manipulated with mild reinforcing and attenuating techniques. Additional acupoints were manipulated with pressing, rotating, reinforcing, and attenuating techniques. The needle retention time was 30 minutes per acupuncture session. Needles were manipulated once per session.

Patients in the herbal medicine group did not receive acupuncture but received administration of Fu Ke Qian Jin Pian. The herbal medicine Fu Ke Qian Jin Pian (0.32 g/tablet) is manufactured by Zhuzhou Qianjin Pharmaceutical Co, Ltd. Fu Ke Qian Jin Pian was taken orally with warm water, 6 tablets each time, 3 times per day. The patients were asked to avoid spicy, raw, cold, oily, or greasy food. The tablets were comprised of the following ingredients:

Dioscorea japonica
Fructus rosae laevigatac
Radix angelicae sinesis
Radix codonopsis
Herba andrographitis

Indicators
According to the researchers from Guangzhou, CRP (C-reactive protein) was observed as a degree indicator of low-grade inflammation in chronic pelvic inflammatory disease. The researchers selected the monitoring of CRP for several reasons. CRP indicates inflammatory responses. Tissue injury often rapidly increases concentrations of CRP, usually within 4–6 hours. CRP is not affected by gender, age, hypergammaglobulinemia, anemia, pregnancy, and other factors. CRP activates the complement system, which is a cascade of biochemical responses in the immune system that promote inflammation. CRP activates the complement cascade via the C1q (an 18 polypeptide chain) protein complex. Hence, C-reactive protein was observed in this study as an indicator of the degree of low-grade inflammation in chronic pelvic inflammatory disease.

Results
Acupuncture produced a 91.43% total effective rate. The breakdown is as follows: 10 completely healed, 16 had excellent results, 6 had significant improvements, 3 had no improvement. Fu Ke Qian Jin Pian produced a 74.29% total effective rate. A total of 7 completely healed, 12 had excellent results, 7 had significant improvements, 9 had no improvements.

The results of the investigation indicate that acupuncture and herbal medicine are effective for the treatment of chronic PID.

References
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