Introduction.

At the end of the XX century, there is an immense improvement in the field of medicine. However, there are still diseases which cannot be healed effectively. The reports published in different countries provide information that the main problem at the end of the century are chronic diseases which do not exclude gynaecological ones. The classic example are pelvic inflammatory diseases of women. In the reports of epidemiologists an increase in the amount of hospitalized patients because of PID is really striking. This process was started in the sixties and includes part of Europe (Italy, Portugal, France, Germany, Poland), the USA and Canada. A new medical, economical and social problem appeared. The report made by National Center Health Statistic at the beginning of the fifties says that the ratio of severe PID to chronic ones is 1 to 9. There is more and more news that PID are connected with the decrease in immunity. Acupuncture, thanks to its analgesic, antiphlogistic effectiveness and possibility of increase in immunity, became daily PID treatment in our Institute. Effectiveness of acupuncture is emphasized especially in the cases where pharmotherapy did not show good results.

The Aims.

The aim of this work was appreciation of acupuncture treatment for PID

Materials and methods:

Researches were made on 164 women at the age 26 - 37, who had been treated earlier because of PID in Lodz Department of Obstetrics and Gynaecology in Polish institute Mother's Memorial Hospital. The main symptom was ache features of PlD. This disease had different force patients for many months. The disease appeared because of severe PID which changed into a chronic state, and was the reason of repeated relapse into disease. Gynaecologocal research indicates the features of PID (callosity and the growth of oviducts, postinflammatory adhesion, pain during examination, sensitivity of uterus). Sick women had been treated by antibiotics which broke analgesic effectiveness which did not yield good results and caused only short-term improvement. Before the detailed researches with all the ill people were made, amanuensis had been made in order to establish the essence of the disease, the time and the number of relapses of the disease. The idea of using acupuncture, its technical form and time of the treatment had also been explained.

The whole program of treatment included 148 women. Out of this group a subgroup of 40 women was made, who had an additional set of examination before and after the treatment. This set included indications of immunoglobulin's concentration of IgG, IgA, IgM class, concentration of C3 and C4 fraction complement of immunological groups of IgG, IgM class. Additionally the indication of OB parameter was made. Every patient had 10 applications during 3 weeks. Each application lasted 20 minutes. 10-12 needles were used which had different lengths from 2 to 6 cm. The following points were used: Hegu (Li 4), Quchi (Li 1l), Quichong (St 30), Zusanli (St 36), Sanyinjiao (Sp 6), Xuehai (Sp 10), Feishu (Ub 13), Shangliao (Ub 13), Dazhui (Gv 14), Qogu (Cv 2), Xingjian (Liv 2).

Auricular points: The evaluation of effectiveness of acupuncture treatment was made on the ground of the following results:

subjective patient's opinion about the pain before and after the treatment (a) analogical scale of pain (VAS), (b) a scale of pain in points from 0 to 10, (c) a descriptive scale of pain.

gynaecological examination

laboratory tests of chosen immunological parameters (made in Diagnostic Department of Institute Polish Mother's Memorial Hospital).

The results of the researches were subjected to statistic analysis, using Shapiro-Wolf test which stated whether the frequency of feature is normal. In case of normal frequency, a parametrical T-student test was used with the level of trust p. = 0,01. If there was no normal frequency of a feature a Wilcoxon test was used.

Results:

Using analogical, point and descriptive scale of pain it was stated that among the examined group of women 83% of them were completely cured, at 11% of them there was improvement, and there was no improvement at 6%. In gynaecological research at women who regarded the results as good and very good the cease of PID was observed.

In the researches of immunological parameters statistic increase in concentration of immunological fractions was observed: IgG (at 89%), IgA (at 93%) and IgM (at 89%). The statistic decrease in the concentration of goup immunological fractions IgG and IgM, the increase of the fraction C3 (at 93%) and C4 (at 91%) was observed.

OB parameter decreased in 88% of cases. The decrease was stated to be statistically significant.

Conclusions:

l. Acupuncture is the method which can be used with very good results in treatment of pelvic inflammatory diseases.

2. Acupuncture has an influence on changes of immunological parameters in pelvic inflammatory diseases at women.