Acupoint Catgut Embedding for Treatment of Chronic Pelvic Pain Due to the Sequelae of Pelvic Inflammatory Disease

Summary

This article outlines acupoint catgut embedding therapy for chronic pelvic pain caused by the sequelae of pelvic inflammatory diseases.

Abstract

Chronic pelvic pain caused by the sequelae of inflammatory pelvic disease is a common clinical condition of pelvic pain in women. At present, the main challenges in its treatment are the limited effectiveness of pain relief and the frequent recurrence of symptoms, which significantly impact patients’ quality of life and impose a considerable psychological burden on them. It is a clinically challenging disease. After summarizing years of treatment experience, the author’s team discovered that acupoint catgut embedding demonstrated notable clinical efficacy in managing chronic pelvic pain stemming from pelvic inflammatory disease sequelae. Compared to existing Western medicine treatment methods, acupoint catgut embedding offers advantages such as a good analgesic effect, lower recurrence rate, economic benefits, and a relatively straightforward procedure. This article provides a comprehensive guide on embedding absorbable catgut into patients’ acupoints for the treatment of chronic pelvic pain in females resulting from the sequelae of pelvic inflammatory disease.

Introduction

Chronic pelvic pain (CPP) refers to pelvic pain that persists for over 6 months, is non-periodic, and is unresponsive to non-opioid drugs. The latest research shows that the global incidence rate of CPP is ~5%-26%¹. Sequential pelvic inflammatory disease (SPID) is one of the main conditions causing CPP, accounting for 23%-30% of all cases of chronic pelvic pain in females². Due to the limited efficacy of existing analgesics in alleviating this pain, over 50% of CPP patients may seek non-pharmacological treatment³. Currently, the main non-pharmacological treatments include pelvic floor physical therapy, psychological therapy, neuroregulation, and dietotherapy. However, they also have limitations, such as suboptimal pain relief and difficulties in achieving long-term control. Most SPID women with CPP experience anxiety, depression, and decreased quality of life due to recurrent pain⁴. Therefore, finding an effective treatment method that can alleviate patients’ pain symptoms has become a pressing clinical concern.

Acupuncture and moxibustion, two of the main external therapeutic methods in traditional Chinese medicine, have shown good efficacy in treating pain-related conditions and have been widely used in clinical practice, especially in the relief of chronic pain, where their effectiveness surpasses other non-pharmacological treatments for CPP^5,6. In a cross-sectional study on the treatment of CPP with traditional Chinese medicine, 7.63% of chronic pain patients were chosen to receive acupuncture and moxibustion treatment, resulting in excellent therapeutic outcomes⁷. The acupoint catgut embedding introduced in this article is an extension and development of acupuncture and moxibustion. It refers to a traditional Chinese medicine external treatment technique that uses specially designed disposable medical devices to implant absorbable catgut into corresponding acupoints, providing prolonged and continuous acupoint stimulation to achieve analgesic effect. The author’s team has employed this technology to treat recurrent and incurable pelvic pain in women caused by SPID, yielding positive outcomes. It can be utilized either as a standalone treatment or as an important component of a comprehensive traditional Chinese medicine treatment plan or a combination of traditional Chinese and Western medicine. This article takes the most common traditional Chinese medicine syndrome (dampness heat stasis type) patients with SPID as an example to provide a detailed demonstration of the procedures for acupoint catgut embedding.

Protocol

All procedures of this study were conducted in accordance with clinical trial registration and have been approved by the Ethics Committee of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Filing No. 2021KL-004). All patients in this study provided informed consent to the investigators' use of data, images, and related video filming during the trial. 1. Preparation before operation Set the inclusion criteria as follows: include pa…

Representative Results

In this clinical study, a total of 88 participants were initially enrolled, with 8 cases dropping out (4 from the treatment group and 4 from the other one). The remaining 80 participants were divided using a random number table into the treatment and control groups, with 40 participants in each group. The course of treatment included catgut embedding once every 10 days, avoiding menstrual periods, for a continuous duration of 3 months. The patients in the treatment group also took a dose of Traditional Chinese Medicine d…

Discussion

There is no record of chronic pelvic pain in ancient Chinese medicine books, and according to its symptom characteristics, it can be mutually referenced with diseases such as "abdominal pain," "women's abdominal pain," and "menstrual abdominal pain." According to traditional Chinese medicine theory, when the blood vessels are open, improper care may lead to the invasion of pathogenic factors, such as dampness and evil heat, which can stagnate in the uterus and its channels, leading to a strugg…

Materials

disposable catgut embedding needles	Yangzhou Junbang Technology Development Co., Ltd	20212200112
disposable thread embedding kit	Shangdong Weigao Ruixin Medical Technology Co.,Ltd.	20182140148
SPSS26.0			statistical analysis software
sterile gloves	Fitone Latex Products Co.,Ltd Guangdong.	20172140158