Chinese medicinal composition for treating pelvic inflammatory disease and infertility caused thereby

Abstract

The invention discloses a Chinese medicine composition for treating infertility caused by pelvic inflammatory disease and a preparation method thereof, comprising the following Chinese medicinal materials by weight: 30g of Sargentodoxae, 30g of Patriniae, 30g of Hedyotis diffusa, 15g of Angelica sinensis, 15g of Salvia miltiorrhiza, 15g of Tripterygium wilfordii, 15g of Curcuma zedoariae, 15g of Rhizoma Corydalis, 9g of Gleditsia sinensis, 15g of Fructus Liquidambaris, 12g of Astragalus, 15g of Dioscorea opposita, 6g of Rhizoma Chuanxiong, 9g of Eupolyphaga sinensis, and 3g of Polygonum multiflorum. The Chinese medicine composition of the invention has suitable compatibility of selected medicinal materials, refined formula, complementary functions, and aims at clearing away heat and dampness, promoting blood circulation and removing blood stasis, and dispersing knots and unblocking collaterals. The combination of various medicines has targeted curative effect on infertility caused by pelvic inflammatory diseases such as salpingitis and endometritis; the various medicines are mutually restrained and complementary in medicinal properties, have few toxic and side effects, and are safe to take.

Description

Technical Field

[0001] The invention relates to a traditional Chinese medicine composition for treating pelvic inflammatory disease and infertility caused by the disease, and a medicine prepared from the composition. Background Art

[0002] Pelvic inflammatory disease refers to a group of infectious diseases of the female upper reproductive tract, mainly including endometritis, salpingitis, tubo-ovarian abscess, pelvic connective tissue inflammation, and pelvic peritonitis. Inflammation can be confined to one site or involve several sites at the same time. Pelvic inflammatory disease mostly occurs in women who are sexually active and menstruating.

[0003] Pelvic inflammatory disease is often caused by infection during childbirth, abortion or other gynecological surgery, sexual intercourse or poor daily local hygiene conditions. The pathogens that cause pelvic inflammatory disease are endogenous and exogenous. Pathogens from both pathways can exist alone or in mixed infections. Endogenous pathogens come from the flora that live in the vagina, including anaerobic and aerobic bacteria, commonly Escherichia coli, hemolytic streptococci, Staphylococcus aureus, Bacteroides fragilis, Peptococcus, and Peptostreptococci. Exogenous pathogens are mainly pathogens of sexually transmitted diseases, such as Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma. Its symptoms are mostly high fever (acute onset), lower abdominal pain or mass, menstrual disorders, dysmenorrhea, increased vaginal discharge, and the color of the discharge may be white, yellow, or purulent. Pelvic inflammation often causes infertility due to inflammatory exudation in the uterine cavity and pelvic cavity, and adhesions formed by hyperplasia of fibrous tissue. Studies have reported that there is a nearly 21% chance of infertility after the first attack of pelvic infection, and the occurrence of infertility is significantly correlated with the number of attacks of pelvic inflammatory disease in patients.

[0004] With the increase in gynecological surgeries, the incidence and detection rates of a series of pelvic inflammatory diseases such as chronic endometritis and salpingitis are increasing. Infertility caused by pelvic inflammatory diseases is also attracting more and more attention.

[0005] According to traditional Chinese medicine, pelvic inflammatory disease is mostly caused by injuries from swords, careless sex, unclean sexual intercourse, etc., which lead to the invasion of dampness, heat and toxic evils into the body, which accumulate in the lower part of the body and the uterus and uterus. The guest does not go away, the toxic evils accumulate, the qi and blood do not work, and the masses are generated, blocking the meridians, affecting the function of the internal organs, and causing the blockage of the fallopian tube. The toxic evils and qi and blood are mutually entangled in the uterus and Chong and Ren. The positive energy is insufficient, the qi and blood are not smooth, the uterus has nothing to nourish, and it is impossible to capture sperm to become pregnant or the gestational sac cannot be implanted in the uterus, and finally it becomes infertility. This disease starts with dampness and heat with blood stasis. If it is not treated properly, it will turn into a chronic disease. It will not heal over time, and it is easy to consume the positive energy, causing the disease to be lingering and difficult to heal. Common symptoms include qi stagnation and blood stasis, irregular menstruation, abdominal pain and leucorrhea, and accumulation of symptoms. The pathogenesis is mostly due to the dampness and heat toxic evils gathering in the uterus and uterus, the qi and blood are not smooth, and the Chong and Ren are not adjusted. At the beginning, it is usually an acute attack of excess syndrome. If it persists for a long time, it will turn into a chronic disease and the vital energy will gradually decline. Clinically, mixed symptoms of deficiency and excess are also seen. Treatment should take both deficiency and excess into consideration, replenishing the deficiency, removing blood stasis, and unblocking the meridians.

[0006] The common clinical syndromes of this disease include damp-heat and blood stasis type, qi stagnation and blood stasis type, qi deficiency and blood stasis type, and kidney deficiency and blood stasis type.

[0007] At present, most Chinese medicine formulas are for pelvic inflammatory disease or infertility, and there are few Chinese medicine formulas specifically for infertility caused by pelvic inflammatory disease. In addition, Chinese medicine formulas for the treatment of pelvic inflammatory disease are mainly heat-clearing and detoxifying, blood-activating and blood-stasis-removing Chinese medicines. Cold and cool products are easy to hurt the spleen and stomach, and often cause loose stools, diarrhea and other discomforts after use, which reduces patient compliance. In addition, this disease is a mixture of deficiency and excess, and it is difficult to achieve good results by clearing heat and detoxifying, blood-activating and blood-stasis-removing alone. Summary of the invention

[0008] The purpose of the present invention is to overcome the deficiencies of the prior art and provide a Chinese medicine composition for treating pelvic inflammatory disease and the infertility caused thereby. The composition adds Chinese medicines for invigorating qi and strengthening spleen to the compatibility of drugs for clearing away heat and dampness, promoting blood circulation and eliminating convulsions, so as to prevent the stimulation of the spleen and stomach by cold products, greatly reducing the incidence of gastrointestinal intolerance after use by patients, and strengthening the function of strengthening the body and eliminating evil; and adding a small amount of insect medicine to enhance the effect of regulating local blood microcirculation. The composition is mainly aimed at pelvic inflammatory disease of damp-heat stasis type, qi stagnation and blood stasis type, qi deficiency and blood stasis type and the infertility caused thereby.

[0009] If the composition of the present invention is made into an enema solution and administered in the form of retention enema, it is more conducive to exerting the medicinal effect.

[0010] The medicinal raw materials constituting the composition include: red vine, patrinia, herba scutellariae, angelica, salvia miltiorrhiza, sparganium, zedoaria, corydalis, thorn of honeysuckle, fennel, astragalus, yam, stir-fried atractylodes, ligusticum chuanxiong, earthworm, and schizonepeta. In order to enhance the curative effect, under the guidance of the formula ideas of clearing away heat and dampness, promoting blood circulation and removing blood stasis, invigorating qi and strengthening spleen, and dispersing nodules and unblocking collaterals, the medicinal flavors that play the corresponding functions in various aspects can be added, such as phellodendron, sophora flavescens, houttuynia, cyperus, codonopsis, tuckahoe, millettia, etc.

[0011] In the composition, red vine and patrinia are the main drugs, clearing away heat and detoxifying, removing blood stasis and eliminating carbuncle; white flower oldenlandia diffusa strengthens the function of clearing heat and removing dampness, dispersing stagnation and reducing swelling, angelica and salvia nourish blood and promote blood circulation, three-edged lancea, curcuma, corydalis, thorn of sapodilla, and rhizoma striata promote qi and blood circulation, remove blood stasis and dredge collaterals, and are all the ministerial drugs; astragalus, yam, stir-fried atractylodes macrocephala are used to invigorate qi and strengthen spleen, strengthen the body and expel evil, chuanxiong, earthworm, and nine fragrant insects regulate qi and remove blood stasis, remove blood stasis and promote new blood. All the drugs are used together, and the whole prescription plays the effects of clearing heat and removing dampness, promoting blood circulation and removing blood stasis, invigorating qi and strengthening spleen, and dispersing stagnation and dredging collaterals. This prescription is carefully selected, and a variety of medicinal flavors are selected, and one taste has multiple effects. For example, red vine and patrinia have the effects of promoting blood circulation, dispersing stagnation and relieving pain while clearing heat and detoxifying, and can treat sores, carbuncle, swelling and pain, and stasis and abdominal pain, and are the preferred drug pair for treating gynecological damp-heat stasis. In particular, red vine can reduce abdominal tissue adhesions and is the first choice for treating pelvic inflammatory disease with damp-heat stasis. Jiuxiangchong is pungent and warm, which can regulate qi and relieve pain, circulate blood, and warm the middle, treat liver and stomach qi stagnation, abdominal cold pain, and can assist in treating the disadvantages of heat-clearing and detoxifying drugs on the spleen and stomach. Gleditsia sinensis is pungent and warm, reduces swelling and pus, dispels wind and kills insects. "Compendium of Materia Medica" records that "for those who have not yet formed carbuncle, it can lead them to dissipate, those who are about to break, it can lead them to come out, and those who have already ulcerated can lead them to pus. It is the first important agent among ulcer poison drugs. It also drains blood and treats wind-heat poison in the middle of the body, so this medicine is also recommended as a pioneer in the treatment of leprosy." The four are combined with other medicinal flavors that nourish blood and activate blood circulation, promote qi and remove blood stasis, and invigorate qi and strengthen the spleen. The drugs are used accurately, take care of each other, and are integrated.

[0012] Compared with the prior art, the present composition can not only be used to treat pelvic inflammation in various parts, but also can treat infertility caused by it. The Chinese medicines of invigorating qi and strengthening spleen are added to the prescription to strengthen the whole prescription's function of strengthening the body and eliminating evil, greatly reducing the incidence of gastrointestinal discomfort; and two insect medicines of stir-fried earthworm and nine fragrant insect are added to search for blood stasis in the collaterals, regulate qi and dredge the collaterals, and promote the absorption of inflammatory substances. It helps to relieve salpingitis, endometritis, improve the patency of fallopian tubes, and improve infertility. When this medicine is used in the form of retention enema or sitz bath, the drug power can reach the diseased area directly, with quick power and great effect. If retention enema or sitz bath is used in conjunction with oral administration of this medicine, it can achieve the effect of both internal and external treatment, which is beneficial to treatment.

[0013] The preferred ratio of the medicinal raw materials of the composition is: 24-30g of red vine, 24-30g of Patrinia scabra, 24-30g of Hedyotis diffusa, 12-15g of Angelica sinensis, 12-15g of Salvia miltiorrhiza, 12-15g of Trillium, 12-15g of Curcuma, 12-15g of Corydalis, 9-12g of Gleditsia sinensis, 12-15g of Fructus Smilacis Glabrae, 12-15g of Astragalus, 9-15g of Dioscorea opposita, 6-12g of stir-fried Atractylodes macrocephala, 6-9g of Ligusticum chuanxiong, 6-9g of Eupolyphaga sinensis, and 3-5g of Chrysanthemum incisa.

[0014] Certain medicinal flavors can be added according to the patient's clinical symptoms, or the ratio of each raw material can be appropriately adjusted to better exert the therapeutic effect of the composition.

[0015] The composition can be decocted in water or made into oral preparations such as tablets, pills, powders, granules, capsules, oral liquids, or external preparations such as enemas, vaginal douches, sitz bath fumigations, vaginal suppositories, anal suppositories, and ironing compresses according to conventional processes.

[0016] As one of the more preferred embodiments of the present invention, the weight ratio of the raw materials of the composition is: 30g of red vine, 30g of Patrinia scabra, 30g of Hedyotis diffusa, 15g of Angelica sinensis, 15g of Salvia miltiorrhiza, 15g of Tripterygium wilfordii, 15g of Curcuma zedoaria, 15g of Corydalis yanhusuo, 9g of Gleditsia sinensis, 15g of Fructus liquidambaris, 12g of Astragalus, 15g of Dioscorea opposita, 6g of Rhizoma Atractylodis Macrocephalae, 6g of Rhizoma Chuanxiong, 9g of Eupolyphaga sinensis, and 3g of Rhizoma Cibotii. The weight composition of the medicament is a daily dose for oral administration. When it is made into an external medicament, the daily dosage is adjusted according to the routine.

[0017] This composition is preferably made into enema liquid for use, or cooperates with retention enema while taking this medicine orally. Traditional Chinese medicine retention enema therapy can make the liquid medicine fully absorb into the blood circulation through the abundant venous plexus under the rectal mucosa. As a kind of external treatment method with a long history and mature application, it has been applied to the treatment of hundreds of diseases in various sub-specialties such as internal, external, gynecology, children, anorectal, digestion, andrology, and has been recognized and favored by doctors and patients. The rectum is adjacent to the uterus and appendages, and the venous plexus is anastomosed with each other. The rectum absorbs fully, the total amount of drug absorption is higher than oral administration, and the bioavailability increases. After the drug is absorbed by the rectal mucosa, in addition to playing a systemic therapeutic effect, it is more important to play a local medication effect, so that the drug can directly penetrate into the lesion site, so that the effective drug concentration can be maintained for a long time, promote local blood circulation, be beneficial to the absorption of inflammatory lesions, and improve the conditions such as fibrosis and adhesion. At the same time, enema administration has a very small impact on liver and kidney function than oral administration. Liquid retention enema is a most effective method for treating gynecological pelvic inflammatory disease. Many documents show that retention enema of traditional Chinese medicine formulas for clearing away heat and dampness, promoting blood circulation and removing blood stasis can relieve clinical symptoms of patients with pelvic inflammatory disease and reduce inflammatory reactions. The combined use of antibiotics is more effective than the use of antibiotics alone. The enema of this combination can allow the liquid medicine to reach the local lesion directly, promote the absorption of inflammatory substances, effectively relieve pelvic and uterine adhesions, improve the function and patency of the fallopian tubes, and improve female fertility.

[0018] When making a retention enema solution for use, you can follow the following steps:

[0019] 1. Connect one end of the catheter to a disposable syringe, lubricate the other end with cooking oil and insert it into the anus 10-15cm. Use one pack of liquid medicine (100ml) at a time, heat the liquid medicine slightly higher than body temperature (39-41 degrees), and use a syringe to draw 80-100ml of liquid medicine. Slowly push the liquid medicine, and gently pull out the catheter after the liquid medicine is pushed.

[0020] 2. Body position: It is recommended to lie on your side (or squat), with a spacer under your buttocks and a small pillow to raise your buttocks 10cm. Expose your anus and keep warm.

[0021] Usage: 1 pack per day for enema, it is recommended to be done before going to bed, empty the stool before enema. Keep the enema for more than 4 hours, the liquid will not be discharged when you wake up the next morning. DETAILED DESCRIPTION

[0022] The composition of the present invention is clinically named Penning Recipe, and the raw material ratio can be appropriately adjusted according to the patient's physical signs, or the raw materials can be appropriately increased. When a specific dosage form is prepared, it is matched with a corresponding dosage form name, such as Penning decoction, Penning granules, etc. The technical scheme is described in detail below by way of examples, but the protection scope of the present invention is not limited to the following examples.

[0023] Example 1

[0024] The ratio of the medicinal raw materials of the composition is: 30g of red vine, 30g of Patrinia scabra, 30g of Hedyotis diffusa, 15g of Angelica sinensis, 15g of Salvia miltiorrhiza, 15g of Trillium, 15g of Curcuma, 15g of Corydalis, 9g of Gleditsia sinensis, 15g of Fructus Smilacis Glabrae, 12g of Astragalus, 15g of Dioscorea opposita, 6g of stir-fried Atractylodes macrocephala, 6g of Ligusticum chuanxiong, 9g of Scolopendra subspinipes, and 3g of Chrysanthemum incisa.

[0025] Example 2

[0026] The ratio of the medicinal raw materials of the composition is: 24g of red vine, 24g of Patrinia scabra, 30g of Hedyotis diffusa, 12g of Angelica sinensis, 12g of Salvia miltiorrhiza, 12g of Trillium, 12g of Curcuma zedoaria, 12g of Corydalis, 9g of Gleditsia sinensis, 12g of Fructus Smilacis Glabrae, 12g of Astragalus, 9g of Dioscorea opposita, 6g of stir-fried Atractylodes macrocephala, 6g of Ligusticum chuanxiong, 6g of Scolopendra subspinipes, and 3g of Polygonum multiflorum.

[0027] Example 3

[0028] The ratio of the medicinal raw materials of the composition is: 30g of red vine, 24g of Patrinia scabra, 30g of Hedyotis diffusa, 15g of Angelica sinensis, 15g of Salvia miltiorrhiza, 15g of Trillium, 15g of Curcuma, 15g of Corydalis, 12g of Gleditsia sinensis, 15g of Fructus Smilacis Glabrae, 15g of Astragalus, 15g of Dioscorea opposita, 12g of stir-fried Atractylodes macrocephala, 9g of Ligusticum chuanxiong, 9g of Scolopendra subspinipes, and 5g of Chrysanthemum incisa.

[0029] Example 4

[0030] The ratio of the medicinal raw materials of the composition is: 30g of red vine, 30g of Patrinia scabra, 24g of Hedyotis diffusa, 12g of Angelica sinensis, 15g of Salvia miltiorrhiza, 12g of Trillium, 12g of Curcuma, 15g of Corydalis yanhusuo, 128g of Gleditsia sinensis, 15g of Fructus Smilacis Glabrae, 15g of Astragalus, 12g of Dioscorea opposita, 9g of stir-fried Atractylodes macrocephala, 9g of Ligusticum chuanxiong, 6g of Scolopendra subspinipes, and 3g of Chrysanthemum incisa.

[0031] Clinical efficacy data

[0032] According to the raw material ratio of Example 1, a Penning decoction of 1 gram per milliliter of crude drug was prepared, and retained enema administration was performed for clinical efficacy observation. Taking the treatment of 100 patients diagnosed with chronic endometritis by hysteroscopy and pathology as an example, the efficacy of the composition in treating pelvic inflammatory disease of damp-heat stasis type, qi stagnation and blood stasis type, qi deficiency and blood stasis type, and infertility caused by the composition was demonstrated.

[0033] Diagnostic points: pain and distension in the lower abdomen, soreness and pain in the lumbosacral region; large amount of vaginal discharge, yellow or mixed red and white; may be accompanied by mild to moderate fever, abdominal distension, diarrhea, frequent urination, and urgency. Gynecological examination shows purulent vaginal discharge with a peculiar smell. Congestion and edema of the cervix or endometrium, with inflammatory exudates. Uterine tenderness or limited movement. A large number of white blood cell infiltration is seen under hysteroscopy. Examination of cervical secretions shows a large number of white blood cells and pathogens such as chlamydia and mycoplasma. At the same time, there are signs of damp heat, blood stasis, qi stagnation or qi deficiency, such as red or dark tongue, white or yellow tongue coating.

[0034] Efficacy judgment criteria: Cured - symptoms and signs return to normal. Effective - symptoms and signs are significantly improved, and most of the inflammation is absorbed. Ineffective - symptoms remain unchanged.

[0035] The patients were randomly divided into Penning decoction group (n=52) and control group (n=48). The control group was treated with conventional antibiotics, while the Penning decoction group was treated with Penning decoction enema. After one month of treatment, the hysteroscopy was repeated, and the lesion endometrium was taken for pathological and immunohistochemical examination. The results showed that 30 cases in the Penning decoction group were cured, 15 cases were effective, and 7 cases were ineffective, with a total effective rate of 86.54% (45 / 52); 13 cases in the control group were cured, 21 cases were effective, and 14 cases were ineffective, with a total effective rate of 70.83% (34 / 48). There was a statistically significant difference between the two groups (P<0.05). The pregnancy rates of the two groups were followed up for 6 months after treatment. The pregnancy rates of the Penning decoction group were 61.54% (32 / 52) and 35.42% (17 / 48) in the control group. The pregnancy rate in the Penning decoction group was higher than that in the control group, and there was a statistically significant difference between the two groups (P<0.05). Penning enema can effectively improve the endometrial inflammatory response in patients with chronic endometritis and increase the pregnancy rate.

[0036] Typical Cases

[0037] Case 1: Patient with salpingitis after intrauterine adhesion surgery

[0038] Du Zhu, female, 30 years old, outpatient number 91020519. On April 7, 2022, she was admitted for "1 adverse pregnancy history, pregnancy preparation". In 2020, she had an inevitable miscarriage in the second month of pregnancy and underwent curettage. The embryo chromosomes were not checked. After the operation, the menstrual volume was small, and a sanitary pad was enough, 1mp4.23. She did not get pregnant again for several months without contraception.

[0039] On June 7, 2022, my department performed hysteroscopic endometrial lesion resection + adhesion lysis + tubal insufflation. During the operation, the cervical canal was narrowed, there was resistance to the probe entering, the uterine cavity was abnormal in shape, the lower segment of the bilateral lateral walls was obviously narrowed, the right uterine angle was extremely deep, and the thickness of the anterior and posterior endometrium was normal. After cutting the bilateral lateral walls, the uterine cavity shape basically returned to normal, and the openings of both fallopian tubes were exposed. The intubation and insufflation showed that the resistance on both sides could not inject the drug solution (the possibility of spasm was not ruled out). Pathology: The endometrium showed secretory changes, immunohistochemistry CD38 (-), CD138 (-)

[0040] Postoperative diagnosis: 1. Mild to moderate fibrous uterine adhesions; 2. Fallopian tube obstruction.

[0041] After the operation, an artificial cycle was given, and the patient was treated with oral Penning prescription + Penning decoction enema for one month. The pregnancy was confirmed in July 2022.

[0042] Changes before and after: Improved inflammatory lesions of the fallopian tubes, controlled the recurrence of intrauterine adhesions, and achieved successful pregnancy the next month.

[0043] Case 2: Recurrent miscarriage, postoperative patient with intrauterine adhesions

[0044] Zhu*li, female, 37 years old. Clinic number 91117894. First visit: 2021.09.20. Chief complaint: history of adverse pregnancy, preparation for pregnancy.

[0045] She had an abortion in 2008, a biochemical pregnancy in March 2021, and an inevitable miscarriage and curettage in August 2021. The chromosomes of the embryo were not checked. Menstrual history: regular menstruation, 4 / 30, moderate volume, lmp8.21. Auxiliary examination: NK 22.5% in an external hospital in August 2021, BUS: endometrium 5mm, uneven echo; male semen PR22.5%. Diagnosed as recurrent miscarriage. After trying to conceive for 2 months with oral Chinese medicine + ultrasound follicle monitoring, she did not conceive. On December 1, 2021, ultrasound indicated the possibility of uterine adhesions. After trying to conceive for several months on her own, she still did not conceive.

[0046] On March 1, 2022, our department performed hysteroscopic endometrial adhesion lysis + fallopian tube hydrotubation. During the operation, the uterine cavity morphology was slightly abnormal, with multiple columnar adhesion bands visible, and only part of the uterine cavity could be seen. After adhesion separation with micro scissors, the uterine cavity morphology basically returned to normal, the double uterine horn structure appeared, and the intubation and hydrotubation showed that the resistance of both fallopian tubes was small. Postoperative endometrial pathology showed: the endometrium showed proliferative changes, immunohistochemistry CD38(-), CD138(-).

[0047] Postoperative revised diagnosis: 1. Moderate intrauterine adhesions; 2. Recurrent miscarriage.

[0048] After the operation, artificial cycle + oral Penning prescription of traditional Chinese medicine combined with Penning decoction retention enema treatment were given.

[0049] On April 8, 2022, I had a hysteroscopy. During the operation, I found that the uterine cavity was normal and the openings of both fallopian tubes were clear. I continued to take the Chinese medicine Penning prescription combined with Penning decoction for retention enema. On May 24, 2022, I had a follow-up visit, lmp4.21, 33 days of amenorrhea, and a successful pregnancy. On May 24, I had a blood test of HCG1398, E2 331.2pg, P 23.09nmol, and no difference in thyroid function.

[0050] Treatment: After intrauterine adhesion separation surgery, the recurrence of adhesions was suppressed, endometrial function was improved, and a successful pregnancy occurred the next month.

[0051] Case 3: Infertility, chronic endometritis patient

[0052] Wang * Ye, female, 27 years old, outpatient number 91593246. First visit: 2022.08.01. Chief complaint: Required hysteroscopy before FET.

[0053] Current medical history: married, not pregnant for 2 years without taking any contraceptive measures, egg retrieval 2 times, fresh embryo transplant 1 time but no implantation, currently 5 embryos remaining for transplantation, hysteroscopy is required before FET.

[0054] Past medical history: laparoscopic teratoma removal in 2019. Menstrual history: regular menstruation, 5 / 28-29, dysmenorrhea, lmp7.25

[0055] Diagnosis: Female infertility; chronic endometritis.

[0056] On August 2, 2022, a hysteroscopic endometrial lesion resection was performed in our department. During the operation, the uterine cavity was normal in shape, the posterior wall endometrium was uneven and obviously messy, polypoid hyperplasia was seen in the anterior wall endometrium, and the openings of both fallopian tubes were visible. After the entire endometrium was processed with micro-biopsy forceps, about 3g of tissue was removed for pathological examination. After the operation, the endometrium was basically evenly distributed, and the uterine cavity was filled with diluted levofloxacin injection.

[0057] Pathology: The endometrial tissue showed proliferative changes, and immunohistochemistry showed CD38 (1 focal positive cell / HPF) and CD138 (1 focal positive cell / HPF).

[0058] Supplementary diagnosis: 1. Female infertility; 2. Chronic endometritis.

[0059] After the operation, the Chinese medicine Penning Fang was taken orally and Penning Fang enema was used for treatment.

[0060] On September 14, 2022, an in vitro fertilization embryo transfer was performed and the pregnancy was successful.

[0061] Treatment effect: Improved chronic endometrial inflammation and the second transplant resulted in a successful pregnancy.

[0062] Case 4: Infertility, a patient with endometrial polyps after surgery

[0063] Zhou * Qing, female, 33 years old, clinic number 90809435. First visit: 2022.05.31. Chief complaint: married, not pregnant for 2 years without contraception, B-ultrasound repeatedly showed uterine polyps for 2 months.

[0064] Current medical history: sexual life 1-2 times a week, no contraception, no pregnancy for 2 years. Vaginal ultrasound at an external hospital on April 21, 2022 suggested: slightly strong echoes were detected in the uterine cavity, and polyps could not be ruled out. Vaginal ultrasound at an external hospital on May 28, 2022 suggested: endometrium 10mm, 0.5*0·3*0·4cm slightly strong echoes were found in the uterine cavity, the boundaries were unclear, and blood flow signals were seen, so polyps were considered.

[0065] Auxiliary examination: Hysterosalpingography performed by the Provincial Women's and Children's Health Care Center in November 2021 showed: double T is patent.

[0066] Menstrual history: menstrual regularity, pmp3.23, lmp5.10

[0067] Diagnosis: Female infertility; endometrial polyps.

[0068] On June 24, 2022, a hysteroscopic endometrial lesion resection was performed in our department. During the operation, the following findings were found: a large amount of purulent and bloody secretions on the surface of the cervix, multiple polyp-like hyperplastic tissues were visible on the posterior wall of the uterine cavity, the rest of the endometrium was basically evenly distributed, and the openings of both fallopian tubes were clear. The polyp pedicle was removed with a micro-biopsy forceps for pathological examination, and the cervix was packed with a piece of iodine gauze.

[0069] Pathological findings: endometrial polyps, endometrium showed proliferative changes, immunohistochemical staining results showed CD38 (+), CD138 (+, 1 hot spot / HPF).

[0070] Revised diagnosis: 1. Endometrial polyp; 2. Pericervicitis; 3. Chronic endometritis.

[0071] As prescribed by the doctor, the patient took the oral Penning prescription combined with Penning enema. One week later, he started taking dydrogesterone tablets twice a day, one tablet each time, for 10 consecutive days.

[0072] Follow-up visit on September 14, 2022, and the patient was advised to try to get pregnant this month.

[0073] Follow-up visit on September 26, 2022, amenorrhea for 38 days, blood HCG 111 on September 24, HCG 344 on September 26, successful pregnancy.

[0074] Treatment effect: After 2 years of infertility, the patient received enema treatment after endometrial polyp removal and successfully became pregnant in the second month after the operation.

[0075] Case 5: Patients with postoperative intrauterine adhesions, salpingitis, and chronic endometritis

[0076] Zhang*miao, female, 28 years old, outpatient number 91544060. First visit on July 6, 2022. Chief complaint: scanty menstruation, married without contraception and not pregnant for 7 months.

[0077] Current medical history: had one abortion in the past, and had scanty menstruation after surgery. In 2018-2019, she underwent hysteroscopic adhesion separation twice at Huzhou Women's and Children's Health Care Hospital and Run Run Shaw Hospital, and her menstrual volume increased slightly after surgery. Multiple ultrasounds showed that the endometrium was 5.7cm during ovulation, and she had not been pregnant for 7 months without contraception. Lmp6.27 (took Bujiale), and the volume was scanty.

[0078] Auxiliary examination: folate metabolism gene TT type, the male has mild asthenospermia.

[0079] Past medical history: diagnosed with generalized anxiety disorder in 2020, hysteroscopy in 2020, cervical incompetence diagnosed during surgery. Denied major organ disease and other surgical history

[0080] Menstrual history: Menstrual cycle 30 days, menstruation lasts 5-7 days, Lmp6.27 (take Bujiale), small amount.

[0081] Diagnosis: Intrauterine adhesions.

[0082] On August 2, 2022, the patient underwent hysteroscopic endometrial lesion resection + adhesion lysis + tubal insufflation in our department. During the operation, the uterine cavity was slightly abnormal in morphology, and a small amount of muscular adhesion tissue was seen on both sides, mainly on the left side. The left uterine cornu was deeper, the openings of both fallopian tubes were thinner, and some endometrium was obviously congested. Intubation and insufflation showed that the resistance on the right side was medium to small, and the resistance on the left side was medium, with no overflow. After adhesion separation with micro scissors, the morphology of the uterine cavity basically returned to normal. After the operation, the uterine cavity was filled with levofloxacin injection, Gong Ankang injection was given intrauterine to prevent adhesions, and 1ml water bag was given to support the uterine cavity. Pathology: The endometrium showed proliferative changes, CD38 (10 positive cells / HPF in the hotspot area), CDl38 (9 positive cells / HPF in the hotspot area)

[0083] Revised diagnosis: 1. Mild muscular uterine adhesions; 2. Salpingitis; 3. Chronic endometritis.

[0084] Postoperative oral administration of Penning prescription + enema of Penning decoction

[0085] On September 10, 2022, the patient underwent a hysteroscopy review in our department. During the operation, the uterine cavity was basically normal in shape, no obvious adhesion tissue was found on both sides, the endometrium on the right side was congested and thin, the openings of both fallopian tubes were clear, and part of the endometrium in the uterine cavity was obviously congested. After intubation, the resistance on the right side was medium to small, and the resistance on the left side was small, and there was no overflow. Pathology: The endometrium showed proliferative changes, CD38 (5 hot spots / HPF), CD138 (-)

[0086] Revised diagnosis: 1. Postoperative uterine adhesions; 2. Salpingitis; 3. Chronic endometritis.

[0087] After the operation, the Chinese medicine Penning prescription was taken orally and Penning decoction was enema for treatment.

[0088] Follow-up visit on October 24, 2022, self-tested urine pregnancy showed +, blood HCG on October 24 was 4403.42IU / L, successful pregnancy.

[0089] Treatment effect: The patient had undergone hysteroscopic adhesion separation surgery many times in the past. After the surgery, she received enema treatment with Penning Fang for one month. The hysteroscopy was repeated, and the patency of the fallopian tube and endometrial pathological immunohistochemistry showed that the salpingitis and chronic endometritis had improved significantly. The patient became pregnant successfully in the first month after the review.

Claims

1. A Chinese medicine composition for treating pelvic inflammatory disease and infertility caused thereby, characterized in that The invention is prepared from the following medicinal raw materials in weight proportion: 24-30g of red vine, 24-30g of Patrinia scabra, 24-30g of Hedyotis diffusa, 12-15g of Angelica sinensis, 12-15g of Salvia miltiorrhiza, 12-15g of Tripterygium wilfordii, 12-15g of Curcuma zedoaria, 12-15g of Corydalis yanhusuo, 9-12g of Gleditsia sinensis thorn, 12-15g of Fructus Smilacis Glabrae, 12-15g of Astragalus membranaceus, 9-15g of Dioscorea opposita, 6-12g of stir-fried Atractylodes macrocephala, 6-9g of Ligusticum chuanxiong, 6-9g of Eupolyphaga sinensis, and 3-5g of Cibotium barometz.

2. The composition according to claim 1, characterized in that The weight ratio of each medicinal raw material is: 30g of red vine, 30g of Patrinia scabra, 30g of Hedyotis diffusa, 15g of Angelica sinensis, 15g of Salvia miltiorrhiza, 15g of Trillium, 15g of Curcuma, 15g of Corydalis, 9g of Gleditsia sinensis, 15g of Fructus Smilacis Glabrae, 12g of Astragalus, 15g of Dioscorea opposita, 6g of stir-fried Atractylodes macrocephala, 6g of Ligusticum chuanxiong, 9g of Scolopendra subspinipes, and 3g of Chrysanthemum incisa.

3. The composition according to claim 1, characterized in that The weight ratio of each medicinal raw material is: 24g of red vine, 24g of Patrinia scabra, 30g of Hedyotis diffusa, 12g of Angelica sinensis, 12g of Salvia miltiorrhiza, 12g of Trillium, 12g of Curcuma, 12g of Corydalis, 9g of Gleditsia sinensis, 12g of Fructus Smilacis Glabrae, 12g of Astragalus, 9g of Dioscorea opposita, 6g of stir-fried Atractylodes macrocephala, 6g of Ligusticum chuanxiong, 6g of Scolopendra subspinipes, and 3g of Croton tiglium.

4. The composition according to claim 1, characterized in that The weight ratio of each medicinal raw material is: 30g of red vine, 24g of Patrinia herb, 30g of Hedyotis diffusa, 15g of Angelica sinensis, 15g of Salvia miltiorrhiza, 15g of Trillium, 15g of Curcuma, 15g of Corydalis, 12g of Gleditsia sinensis, 15g of Fructus Smilacis Glabrae, 15g of Astragalus, 15g of Dioscorea opposita, 12g of stir-fried Atractylodes macrocephala, 9g of Ligusticum chuanxiong, 9g of Scolopendra subspinipes, and 5g of Chrysanthemum incisa.

5. The composition according to claim 1, characterized in that The weight ratio of each medicinal raw material is: 30g of red vine, 30g of Patrinia scabra, 24g of Hedyotis diffusa, 12g of Angelica sinensis, 15g of Salvia miltiorrhiza, 12g of Trillium, 12g of Curcuma, 15g of Corydalis yanhusuo, 12g of Gleditsia sinensis, 15g of Fructus Smilacis Glabrae, 15g of Astragalus, 12g of Dioscorea opposita, 9g of stir-fried Atractylodes macrocephala, 9g of Ligusticum chuanxiong, 6g of Scolopendra subspinipes, and 3g of Chrysanthemum incisa.

6. The composition according to any one of claims 1 to 5, characterized in that It is made into an oral preparation or an external preparation; the oral preparation is a tablet, a pill, a powder, a granule, a capsule or an oral liquid, and the external preparation is an enema, a vaginal douche, a sitz bath fumigation, a vaginal suppository, an anal suppository or an ironing compress.

7. Use of the composition according to any one of claims 1 to 5 in the preparation of a medicament for treating pelvic inflammatory disease and infertility caused thereby.

8. Use of the composition according to claim 6 in the preparation of a medicament for treating pelvic inflammatory disease and infertility caused thereby.