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Abstract: Inflammatory pelvic disease can mainly lead to tubal lesions, which can cause infertility. In this article, a 31-year-old female patient with a history of pelvic inflammatory disease came to the clinic after treatment for 1 year without contraception and before she became infertile. After completing relevant examinations, the patient was gradually diagnosed as having pelvic inflammatory disease, which led to infertility, and was treated with a combination of internal herbal medicine and herbal preserved enema with remarkable efficacy, and conception was successfully achieved after treatment.
Basic information】Female, 31 years old
Disease Type】Pelvic inflammatory disease, infertility
Hospital】The Affiliated Hospital of Shanxi University of Traditional Chinese Medicine
Date of consultation】September 2020
Treatment Plan】Oral Chinese medicine (Formula 1: Radix Angelicae Sinensis, Chuanxiong Ligusticum, Chrysanthemum Vulgaris, Lutong, Che Qianzi, Coix Coix Seed, Fried Atractylodes; Formula 2: Fried Atractylodes, Fried Yam, Eucommia, Radix et Rhizoma, Sang Sang Sang, Epimedium, Radix Codonopsis, Radix Paeoniae Alba, Chai Hu, Chrysanthemum Vulgaris, Lutong) + Chinese medicine enema (Safflower, Trigonella, Curcuma, Salviae Miltiorrhizae, Turbellariae)
Treatment Period】12 months of comprehensive treatment
The effect of the treatment is that the hydrosalpinx on the left side of the fallopian tube has become smaller than before, and the right side of the fallopian tube is open, and the patient has successfully conceived.
I. Initial consultation
The patient, Ms. Wang, 31 years old, visited the clinic on September 20, 2020. She complained that she had been married for 2 years, without contraception for 1 year, and was not pregnant. The patient usually has regular menstruation with a 7-day period and a 28-day cycle, medium menstrual volume, red color, dysmenorrhea (++), and a small amount of blood clots. Last menstrual period September 9, 2020. The patient reported severe lower abdominal cramps and increased amount of leucorrhea with yellow color due to overexertion in preparation for a wedding in 2018, which was treated with antibiotics for 7 days after visiting the hospital for improvement and the above symptoms disappeared. After that, she experienced lower abdominal cramps and discomfort whenever she was tired. G0P0, the patient was advised to have a hysterosalpingogram on 3-7 days after menstruation, and the results showed that the patient had fluid in the left fallopian tube and the right fallopian tube was not open. Gynecologic examination revealed bilateral tubal pressure pain (+), red tongue, thick and greasy coating, and slippery pulse. The patient was considered to be suffering from infertility caused by pelvic inflammatory disease of the damp-heat type.
II. Treatment history
Based on the diagnosis, we explained to the patient and her family that infertility caused by pelvic inflammatory disease is more common in clinical practice. First of all, contraception was administered for 3-6 months, during which oral herbal medicines were given to clear heat and dampness, including Angelica sinensis, Chuanxiong rhizome, Chrysanthemum rhizome, Lutong, Plantago lanceolata, Coix seeds, and fried Atractylodes. At the same time, she gave herbal enemas, including safflower, trigonella, curcuma, danshen, dilaemon and turtle worms, to eliminate fluid in the fallopian tubes and to open the fallopian tubes, but stopped using them during menstruation. 6 months later, she rechecked whether the fallopian tubes were open and then prepared for pregnancy.
III. Treatment effect
After 6 months of treatment, the patient reported that the discomfort of lower abdominal cramping had basically disappeared. The repeat hysterosalpingogram showed that the fluid in the left fallopian tube had become smaller than before and the right fallopian tube was patent. In May 2021, she started to prepare for pregnancy, monitored her follicles and took herbal medicines to regulate her flushing and warm the uterus to help her conceive, mainly fried Atractylodes, fried yam, Eucommia, sequestra, mulberry, Epimedium, Radix Codonopsis, Radix Paeoniae Alba, Radix Bupleurum, Chrysanthemum and Lutong.
IV. Notes
We are glad that the patient’s pelvic inflammatory disease was controlled and she got pregnant successfully after the herbal treatment. However, patients should be reminded that they should combine work and rest in their daily life and should not overexert themselves; at the same time, they should pay attention to their diet, avoid eating cold, spicy and stimulating food, quit smoking and drinking, eat more fruits and vegetables, take vitamins and exercise properly to improve their immunity. In addition, dressing should pay attention to local hygiene, change underwear regularly, do not wear tight chemical fiber pants, to avoid local stuffiness aggravate the disease.
In addition, you should also pay attention to regular maternity check-ups at the hospital. If you have any uncomfortable symptoms in the course of pregnancy, you should go to the hospital promptly and do not delay your condition to avoid adverse consequences.
V. Personal insight
Clinically, infertility caused by tubal lesions due to pelvic inflammatory diseases accounts for 20%-40%. In this case, the infertility was caused by pelvic inflammatory disease after exertion. The treatment mainly takes a combination of internal and external methods, including the internal use of Chinese herbal medicine to clear heat and dampness, and the external use of Chinese herbal medicine to promote the absorption and elimination of tubal effusion, so as to shorten the healing time of pelvic inflammatory disease, enhance the therapeutic effect, improve the pelvic inflammatory environment, control the upstream infection of inflammation, and enable the patient to conceive as soon as possible.
In addition, we need to remind you that whether in daily life or during the preparation for pregnancy, if you feel unwell and do not feel relieved for a long time, you must go to the hospital for examination in time to clarify whether there are lesions in the body and treat the symptoms to avoid delaying the disease.