TCM Syndromes Of Chronic Pelvic Inflammatory Disease And Their Statiscal Analyses

Background @Chronic Pelvic Inflammatory Disease(CPID),one of most common inflammatory diseases on the genital organs of women at reproductive age. Clinically,it will result in the ectopic pregnancy,infertility and pelvic pain.With the prevalence of sexually transmitted diseases(STD)and the use of intrauterine contraceptive device(IUD),its incidence has been increasing gradually.However,the classification of these clinical syndromes into syndrome type are quite confused until today.Most of the researchs use special prescription and special medicine rather than adopt the systematic and specification of differentiation syndrome.This may hinder the further research and the application of TCM treatment in CPID.An objective method will be expected to be used for analyzing these related clinical syndromes with CPID,and this could offers scientific foundation for TCM syndrome differentiation and treatment of CPID. @Objective @To deal with the relationship between the syndromes of CPID and the clinical informations collected with four diagnostic methods,and offer an approach to classify these clinical syndromes concerning with CPID. @Method @A clinical information form concerning with the four diagnostic methods of CPID was used for the syndrome information collection based on the literature review,experts consult,clinical epidemiology investigation. Dadabase was established with these informations.By applying the factor analysis and clustering analysis,the correlation among 62 symptoms with 150 patient cases were analyzed. @Results @According to the 2379 cases reported from the 136 articles that meet the including criterias,the first ten syndromes from the total 20 syndromes are "damp heat and blood stasis"(n=954),"qi stagnation and blood stasis" (n=795),"cold damp stagnation"(n=274),"liver-stagnation and spleen-deficiency"(n=144),"deficiency in the kidney with blood stasis" (n=75),"deficiency of yin with blood stasis"(n=46),"deficiency in the spleen with damp heat and blood stasis"(n=26),"deficiency in the kidney with damp heat and blood stasis"(n=15),"phlegm and blood stasis"(n=13), "deficiency of qi with damp and blood stasis"(n=10).It is clear that the proportions of "damp heat stagnation" and "qi stagnation and blood stasis" are the highest while the stagnation of blood stasis occurs during the whole pathogenetic process.These symptoms,including pain in the inferior belly, low back pain,the increase of leucorrhea,abnormal menstruation and fatigue. Vague,distending,pricking and cold pain in the inferior belly,the increase of leucorrhea,appeared in all the syndrome types.They are the main clinical manifestations with CPID. @By experts differentiating syndromes,there are ten syndrome types in the 150 patients with CPID.53 cases in "damp heat and blood stasis"(35.3%). 32 in "qi stagnation and blood stasis"(21.3%).25 in "deficiency in the spleen with damp heat and blood stasis"(16.7%).12 in "deficiency in the kidney with blood stasis"(8%).8 in "deficiency in the kidney with damp heat and blood stasis"(5.3%).7 in "qi stagnation and blood stasis with damp heat"(4.7%).4 in "cold damp stagnation" and 4 in "qi deficiency and blood stasis"(2.7%).3 in "deficiency of qi with damp and blood stasis"(2%). 2 in "liver-stagnation and spleen-deficiency with blood stasis"(1.3%). Stagnation of blood stasis exits in all of the ten syndrome types. @By clustering analysis,150 CPID cases were divided into 4 syndrome types, including "damp heat and blood stasis"(n=52),"deficiency in the spleen with dampand blood stasis"(n=38),"qi stagnation and blood stasis"(n=34), and "deficiency in the kidney with blood stasis"(n=26). @Factor analysis was used to analyze the correlation among the 62 symptoms based on the clinical informations collected with four diagnostic methods. The first 21 principal components accounts for 70.197%of the total informations.Basedon loading value of 62 syndromes on 21 principal components (Rotated Component Matrix),a clustering analysis was carried on to reveal the relation between these symptoms.The result showed that these symptoms could be classified into 4 groups.The first group of symptoms is related with the syndrome type of "deficiency in the kidney with blood stasis".The second related with the syndrome type of "deficiency in the spleen with damp and blood stasis".The third was "qi stagnation and blood stasis".The last one was related with "damp heat and blood stasis". @Conclusion @The main syndrome types of CPID include "damp heat stagnation","qi stagnation and blood stasis","deficiency in the spleen with damp and blood st.sis","deficiency in the kidney with blood stasis".All of these are the syndromes of deficiency in origin and excess in superficiality.The primary syndrome types of excess in superficiality are "damp heat and stagnation of liver-qi",accompanied with "blood stasis".And the predominant syndrome type of deficiency in origin is "deficiency in the spleen and the kidney" The main clinical symptoms include the change of leucorrhea and menstruation, the pain in the inferior belly and the manifestation of the tongue and pulse. The distribution pattern of syndrome types with CPID displays its basic pathogenesis of TCM. @The analyzed results with factor analysis and clustering are helpful for revealing the the typical symptoms of CPID as well as their correlations.This is useful for the syndromes differentiation and standardization of the diagnosis of CPID.