Study On The Influencing Factors Of Chronic Pelvic Pain Casused By Sequelae Of Pelvic Inflammatory Disease

Objective: To understand the current situation of chronic pelvic pain caused by sequelae of pelvic inflammatory disease(Sequelae of Pelvic Inflammatory Disease,SPID-CPP),analyze the influencing factors of SPID-CPP,build a risk prediction model,and provide scientific basis for medical staff to implement intervention measures as soon as possible,and carry out early detection,early prevention and early intervention on the risk indicators of SPID-CPP,so as to improve the quality of life of patients.Methods: Using the convenient sampling method,we selected SPID patients from the gynecological outpatient department and ward of Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine and the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January 2022 to October 2022 as the study subjects.370 subjects who met the inclusion and exclusion criteria were investigated with general information questionnaire,visual analogue scale(VAS),Pittsburgh sleep quality index(PSQI),Chinese medicine constitution classification and judgment scale,and hospital anxiety and depression scale(HADS).SPSS26.0 software was used to carry out statistical description,single factor analysis,multiple factor analysis,construction of risk prediction model,test of model discriminant validity(discrimination)and conformity(calibration),model validation(internal validation).Results: 1.A total of 377 questionnaires were distributed in this study,and 370 valid questionnaires were recovered,with an effective rate of 98.14%.Among the 370 SPID patients included,the incidence of CPP was 56.4%.2.There were statistically significant differences between the non-CPP group and the CPP group in terms of age,education level,number of sexual partners,contraceptive measures,number of PID attacks,number of uterine cavity operations,history of pelvic adhesion,eating cold food,eating sour and spicy food,perceived pressure,menstrual cohabitation,cleaning before and after sexual life,average number of sanitary napkin changes during menstrual period,PSQI score,Chinese medicine constitution,anxiety and depression(P<0.05).3.Binary logistic analysis showed that: age(26～33 years old)[OR=2.363,95% CI(1.011-5.525)],PID attack times(≥ 2 times)[OR=3.682,95% CI(1.352-10.027)],uterine cavity surgery times(≥ 3 times)[OR=4.852,95% CI(1.211-19.449)],eating cold food(sometimes)[OR=3.069,95% CI(1.157-8.137)],eating cold food(often)[OR=4.637,95%CI(1.676-12.827)],eating spicy food(sometimes)[OR=2.9666,95% CI(1.196-7.358)] Perceived stress(frequent)[OR=4.422,95% CI(1.768-11.058)],PSQI score [OR=1.103,95% CI(1.019-1.193)],Chinese medicine constitution(yang deficiency)[OR=4.035,95% CI(1.347-12.082)],Chinese medicine constitution(damp heat)[OR=2.742,95% CI(1.158-6.491)],anxiety and depression(anxiety)[OR=3.644,95% CI(1.563-8.498)],anxiety and depression(anxiety combined with depression)[OR=3.249,95% CI(1.305-8.091)] are the risk factors;Education(college/undergraduate or above)[OR=0.404,95% CI(0.181-0.901)],contraceptive measures(condoms)[OR=0.354,95% CI(0.164-0.763)],contraceptive measures(contraceptives)[OR=0.257,95% CI(0.084-0.788)],and the average number of sanitary napkin changes(>9 times/day)[OR=0.365,95% CI(0.164-0.809)] are the protective factors.4.The binary logistic regression prediction model was constructed based on the above variables.The Omnibus test showed P<0.001,and the P value after Hosmer Lemeshow(H-L)test was 0.981>0.05.The overall accuracy rate of predicting the incidence was 78.6%,indicating that the model was meaningful and the fitting effect was good;The AUC of the area under the curve was 0.875>0.7,95% CI [0.841-0.909],yoden index was0.593,sensitivity was 0.804,and specificity was 0.789,indicating that the model has good discrimination ability and strong prediction effect.Conclusion: 1.The incidence of CPP in SPID patients is high.2.The binary logistic regression analysis of CPP of SPID patients found that age(26～33 years old),PID attack times(≥ 2 times),uterine cavity surgery times(≥ 3 times),cold and cold food(sometimes),cold and cold food(often),sour and spicy food(sometimes),perceived stress(often),PSQI score,Chinese medicine constitution(yang deficiency),Chinese medicine constitution(damp heat),anxiety and depression(anxiety)Anxiety and depression(anxiety combined with depression)are the risk factors,while education(college/undergraduate or above),contraceptive measures(condoms,contraceptives),and the average number of sanitary napkins changed during menstruation(>9 times/day)are the protective factors.3.Build a CPP risk prediction model for SPID patients,and the prediction effect is good after internal verification.It can provide scientific basis for gynaecological medical staff to identify the risk of CPP in patients with SPID as early as possible,to detect and prevent early,and to improve the quality of life of patients.