Acupuncture and Chronic Pelvic Inflammation

Progress on Clinical Study of Acupuncture Treatment for Chronic Pelvic Inflammation
ZHAO Wen-jie 
Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai 200011, R R. China

[ Key Words ] Acupuncmre-Moxibustion Therapy; Pelvic Inflammatory Disease; Literature Review
[CLC Number] R246.3
[Document Code] A
  
Chronic pelvic inflammation is mostly caused by incomplete treatment of acute pelvic inflammation or by transference from pathologic condition due to poor body constitution, including chronic endometritis, chronic salpingo-oophoritis and chronic inflammation of connective tissue,  and is  a commonly and frequently encountered disease in the gynecology department.  Due  to  long  duration,  intractable condition and high recurrent rate, it is also a commonly encountered reason to induce heterotopic  pregnancy, sterility, pelvic pain and pelvic adhesive diseases. In the investigative study on the domestic literature about acupuncture treatment of chronic pelvic inflammation in the recent five years, the author hopes to summarize the information for reference in the clinical treatment and to point out some issues existing in the current clinical study.

1 Acupuncture Therapy

1.1 Acupuncture therapy
  LI Hui, et al selected Sanyinjiao (SP 6), Zhongji (CV 3), Xingjian (LR 2) and Ciliao (BL 32) and treated 30 cases of chronic pelvic inflammation, by even needling technique. During the needles were retained, TDP was used to radiate the lower abdomen. Acupuncture was given once every day and the total effective rate was 86.7%[1]. MENG Fan-yan, et al. treated this disease by acupuncture plus TDP in predominance, with Shimen (CV 5), Zhongji (CV 3), Xiafujie (Ex), Zigong (Ex-CA 1) and Sanyinjiao
(SP 6), by even needling technique. The needles were retained for 30 min. Acupuncture was given once every day. After acupuncture, TDP was used to radiate the abdomen. After ten sessions, the total effective rate was 100%[2]. YU Zi-fang treated 105 cases of this disease by acupuncture, with Guanyuan (CV 4), Ciliao (BL 32), Sanyinjiao (SP 6), plus Xialiao(BL 34) and Yinlingquan (SP 9) for damp-heat pattern (dampness worse than heat), plus Shenshu (BL 23), Pishu (BL 20) and Zusanli (ST 36) for pattern of cold accumulation and qi stagnation, plus Ganshu (BL 18), Xuehai (SP 10) and Taichong (LR 3) for pattern of qi stagnation and blood stasis, by mountain-burning fire method  for deficient pattern, and heavenpenetrating  cooling method  for deficient pattern. After acupuncture, moxibustion was applied for 20 min. Treatment was given once every day. The therapeutic effects were observed after ten sessions. The results showed total effective rate in 97.1%[3]. WANG En-xin treated 58 cases of this disease by acupuncture plus moxibustion, with Zhongji (CV 3), Guanyuan (CV 4), Shuidao (ST 28), Zusanli (ST 36), Zigong (Ex-CA 1), Sanyinjiao (SP 6), by the even needling technique. The needles were retained for 30 min. After the needles were taken out, ultrashort wave was used to radiate the acupoints for 15 min. The treatment was given once every day. After twenty four sessions, the therapeutic effects were observed and the total effective rate was 100%[4].
   LI Hui, et al. treated 31 cases of chronic pelvic inflammation by ironing moxibustion, by Guanyuan (CV
4), Zhongji (CV 3), Zusanli (ST 36), Sanyiniiao (SP 6),  Zigong (Ex-CA 1), plus Shenshu (BL 23), Ciliao (BL 32) and Weizhong (BL 40) for soreness in the lower back, plus Diji (SP 8) and Yinlingquan (SP 9) for profuse leukorrhea, and plus Qihai (CV 6) and Taichong (LR 3) for abdominal distension and
pain. The needles were manipulated by the even needling technique and retained for 30 min. After the needles were taken out, moxibustion with warming box was applied for 20 min. The total effective rate was 93.5%[5]. CHEN Xiu-hua, et al. treated chronic pelvic inflammation by acupuncture plus Zhao style thunder-fire miraculous moxibustion, by Qihai (CV 6), Guanyuan (CV 4), Shuidao (ST 28), Sanyinjiao (SP 6) and Zusanli (ST 36). The needles were manipulated by the even needling technique and retained for 30 min. After the needles were taken out, thunder-fire moxibustion was applied on the abdominal sides and back side of the pelvic region. The acupuncture treatment was given once every and the total effective rate was 100%[6]. XIE Ai-ze, et al. selected Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3),  Zigong (Ex-CA 1), Xuehai (SP 10), Zusanli (ST 36) and Sanyinjiao (SP 6) to treat 47 cases of this disease by line-dot moxibustion of Zhuang minority medicine and the total effective rate was 91.5%[7].

1.2 Acupoint-injection method
GUO Guo-tian, et al. treated 56 cases of chronic pelvic inflammation by the acupoint injection method, with Zhongji (CV 3) and Sanyinjiao (SP 6), in combination of Diji (SP 8) and Ciliao (BL 32) (two acupoints used in alternation). Angelica injection and Houttuynia injection were used in alternation. The treatment was given once every day. After fourteen sessions, the therapeutic effects were observed. The total effective rate was 98.2%[8].GUO Xian-hui, et al. injected Houttuynia injection into Zigong (Ex-CA 1). The treatment was given once every day. After ten sessions, the therapeutic effects were observed. The results showed the total effective rate was 97.7%[9]. L1N Ling-ling, et al. treated 100 cases by the acupoint injection of tobranmycin, with Zigong (Ex-CA 1). The treatment was given once every day and Zigong (Ex-CA 1) on the two sides was used in alternation. The results showed the effective rate was 98.0%[10]. XU Jia treated this disease by the acupoint-injection method, with placenta tissue fluid injected into Zigong (Ex-CA 1), Guanyuan (CV 4), Zhongji (CV 3), Guilai (ST 29), Shuidao (ST 28), Sanyinjiao (SP 6), Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33) and Xialiao (BL 34), plus Yinlingquan (SP