The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
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A Scoping Review of Clinical Study in Pelvic Congestion Syndrome Focused on Blood Stasis

어혈을 중심으로 본 골반울혈증후군의 임상연구에 관한 주제범위 문헌고찰

  • Hye-Won An (Department of Obstetrics and Gynecology of Korean Medicine, College of Korean Medicine, Daejeon University) ;
  • Miso Park (Clinical Trial Center, Daejeon Korean Medicine Hospital of Daejeon University) ;
  • Ji-Yeon Lee (Department of Obstetrics and Gynecology of Korean Medicine, College of Korean Medicine, Daejeon University)
  • 안혜원 (대전대학교 한의학과 부인과학교실) ;
  • 박미소 (대전대학교 대전한방병원 임상시험센터) ;
  • 이지연 (대전대학교 한의학과 부인과학교실)
  • Received : 2024.07.03
  • Accepted : 2024.08.19
  • Published : 2024.09.01
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Abstract

Objectives: The purpose of this study is to summarize the etiology, diagnosis and treatment of pelvic congestion syndrome(PCS) in traditional East-Asian medicine(TEM) and Western medicine(WM) from the point of blood stasis. Methods: We followed the methodology of 5 steps of scoping review by Arksey and O'Malley and Levac et al. Studies from 2010 to October 19, 2023 were searched through seven search engines. Two reviewers independently searched and screened the studies. When there was a disagreement, a third reviewer decided its eligibility. Results: A total of 78 studies were selected, and 40 were TEM studies and 38 were WM. The average age of the study subjects was in their 30s and most had more than one child. Most of TEM were intervention studies and WM were mostly observational studies. In the WM, the etiology of PCS was considered pelvic venous insufficiency, and in the TEM, pathological conditions caused blood stasis in the pelvis. In TEM, the diagnosis was made according to previous studies' criteria; in WM, it was made through imaging. To treat PCS, WM seeks to block extended veins with embolization, and TEM to improve the environment in which stagnant blood is created through various treatments such as herbal medicine, enema therapy, etc. Total efficient rate (TER) in TEM and imaging findings in WM were most often used as outcome measures. Conclusions: This study summarized and analyzed overall concepts of PCS in TEM and WM.

Keywords

Acknowledgement

이 성과는 정부(과학기술정보통신부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임(No.RS-2023-00209469).

References

  1. World Health Organization. (2022). WHO international standard terminologies on traditional Chinese medicine. Geneva: World Health Organization.
  2. Yoon, Y. J. (2013). A Fundamental Study to Make a Questionnaire of Blood Stasis Specially Designed for Korean Obstetrics & Gynecology. J Korean Obstet Gynecol, 26(1), 92-108. https://doi.org/10.15204/JKOBGY.2013.26.1.092
  3. Lee, Y. J. & Son, S. S. (2014). The Difference of Quality of Life on Blood Stasis Using SF-36. J Korean Obstet Gynecol, 27(4), 15-24. https://doi.org/10.15204/JKOBGY.2014.27.4.015
  4. Beard, R. W., Reginald, P. W. & Wadsworth, J. (1988). Clinical Features of Women With Chronic Lower Abdominal Pain and Pelvic Congestion. British Journal of Obstetrics and Gynecology, 95(2), 153-61. https://doi.org/10.1111/j.1471-0528.1988.tb06845.x
  5. Lass, A., Croucher, C., Lawrie, H., Margara, R. & Winston, R. M. (1997). Right or left ovary--which one is better?. Human Reproduction, 12(8), 1730-1. https://doi.org/10.1093/humrep/12.8.1730
  6. Bratila, E., Bratila, C. P., Coroleuca, C. & Ciprian-Andrei, C. (2015). Collateral Circulation in the Female Pelvis and the Extrauterine Anastomosis System. Romanian Journal of Functional & Clinical, Macro-& Microscopical Anatomy & of Anthropology, 14(2), 223-7.
  7. Sladkevicius, P., Valentin, L. & Marsal, K. (1993). Blood Flow Velocity in the Uterine and Ovarian Arteries during the Normal Menstrual Cycle. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 3(3), 199-208. https://doi.org/10.1046/j.1469-0705.1993.03030199.x
  8. Tan, S. L., Zaidi, J., Campbell, S., Doyle, P. & Collins, W. (1996). Blood flow changes in the ovarian and uterine arteries during the normal menstrual cycle. Am J Obstet Gynecol, 175(3 Pt 1), 625-31. https://doi.org/10.1053/ob.1996.v175.a73865
  9. Ahangari, A. (2014). Prevalence of chronic pelvic pain among women: an updated review. Pain Physician, 17(2), E141-7. https://doi.org/10.36076/ppj.2014/17/E141
  10. Murata, T. (1994). Oriental Medicine and Pain in Obstetrics and Gynecology. In: Pain and Kampo: The Use of Japanese Herbal Medicine in Management of Pain, edited by T. Oyama and G. Smith. London:Springer-Velag, 119-28.
  11. Kim, D. I., Lee, D. K. & Lee, T. G. (2002). A Study of Pelvic Congestion Syndrome(PCS) causing Chronic Pelvic Pain. J Korean Obstet Gynecol, 15(2), 114-25.
  12. Arksey, H. & O'Malley, L. (2005). Scoping studies: towards a methodological framework. Int J Soc Res Methodol, 8, 19-32. https://doi.org/10.1080/1364557032000119616
  13. Levac, D., Colquhoun, H. & O'Brien, K. K. (2010). Scoping studies: advancing the methodology. Implement Sci, 5, 69.
  14. Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., et al. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med, 169(7), 467-73. https://doi.org/10.7326/M18-0850
  15. Aromataris, E. (2020). JBI Manual for Evidence Synthesis. Adelaide. JBI.
  16. McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochem Med (Zagreb), 22(3), 276-82. https://doi.org/10.11613/BM.2012.031
  17. Landis, J. R. & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159-74. https://doi.org/10.2307/2529310
  18. Zhang, X. Practical Obstetrics and Gynecology. 2nd Edition. Beijing: People's Medical Publishing House. 2003:603-8.
  19. Hiromura, T., Nishioka, T., Nishioka, S., Ikeda, H. & Tomita, K. (2004). Reflux in the left ovarian vein: Analysis of MDCT findings in asymptomatic women. AJR Am J Roentgenol, 183, 1411-5. https://doi.org/10.2214/ajr.183.5.1831411
  20. Jurga-Karwacka, A., Karwacki, G. M., Schoetzau, A., Zech, C. J., Heinzelmann-Schwarz, V. & Schwab, F. D. (2019). A forgotten disease: Pelvic congestion syndrome as a cause of chronic lower abdominal pain. PLoS One, 14(4), e0213834.
  21. Garcia-Jimenez, R., Valero, I., Borrero, C., Garcia-Mejido, J. A., Gonzalez-Herraez, J. V., Munoz-Chimbo, A. V., et al. (2023). Transvaginal ultrasonography predictive model for the detection of pelvic congestion syndrome. Quant Imaging Med Surg, 13(6), 3735-46.
  22. Williams, M. R., Westerman, R. A., Kingwell, B. A., Paige, J., Blombery, P. A., Sudhir, K., et al. (2001). Variations in endothelial function and arterial compliance during the menstrual cycle. J Clin Endocrinol Metab, 86(11), 5389-95. https://doi.org/10.1210/jcem.86.11.8013
  23. Valero, I., Garcia-Jimenez, R., Valdevieso, P., Garcia-Mejido, J. A., Gonzalez-Herraez, J. V., Pelayo-Delgado, I., et al. (2022). Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool. Tomography, 8(1), 89-99.
  24. Xia, C. & Zheng, Z. (2011). Clinical observation of ultrashort wave combined with muscle strength training in the treatment of pelvic congestion syndrome. Jilin Medicine, 32(31), 6589-90.
  25. Szaflarski, D., Sosner, E., French, T. D., Sayegh, S., Lamba, R., Katz, D. S., et al. (2019). Evaluating the frequency and severity of ovarian venous congestion on adult computed tomography. Abdom Radiol (NY), 44(1), 259-63. https://doi.org/10.1007/s00261-018-1707-9
  26. Dick, E. A., Burnett, C., Anstee, A., Hamady, M., Black, D. & Gedroyc, W. M. (2010). Time-resolved imaging of contrast kinetics three-dimensional (3D) magnetic resonance venography in patients with pelvic congestion syndrome. Br J Radiol, 83(994), 882-7. https://doi.org/10.1259/bjr/82417499
  27. Hocquelet, A., Le, B. Y., Balian, E., Bouzgarrou, M., Meyer, M., Rigou, G., et al. (2014). Evaluation of the efficacy of endovascular treatment of pelvic congestion syndrome. Diagn Interv Imaging, 95(3), 301-6. https://doi.org/10.1016/j.diii.2013.09.011
  28. Meneses, L. Q., Uribe, S., Tejos, C., Andia, M. E., Fava, M. & Irarrazaval, P. (2011). Using magnetic resonance phase-contrast velocity mapping for diagnosing pelvic congestion syndrome. Phlebology, 26(4), 157-61. https://doi.org/10.1258/phleb.2010.010049
  29. Meneses, L., Fava, M., Diaz, P., Andia, M., Tejos, C., Irarrazaval, P., et al. (2013). Embolization of incompetent pelvic veins for the treatment of recurrent varicose veins in lower limbs and pelvic congestion syndrome. Cardiovasc Intervent Radiol, 36(1), 128-32. https://doi.org/10.1007/s00270-012-0389-x
  30. van der Vleuten, C. J., van Kempen, J. A., & Schultze-Kool, L. J. (2012). Embolization to treat pelvic congestion syndrome and vulval varicose veins. Int J Gynaecol Obstet, 118(3), 227-30. https://doi.org/10.1016/j.ijgo.2012.04.021
  31. Siqueira, F. M., Monsignore, L. M., Rosa-E-Silva, J. C., Poli-Neto, O. B., Castro-Afonso, L. H., Nakiri, G. S., et al. (2016). Evaluation of embolization for periuterine varices involving chronic pelvic pain secondary to pelvic congestion syndrome. Clinics (Sao Paulo), 71(12), 703-8. https://doi.org/10.6061/clinics/2016(12)05
  32. Chen, H., Jin, H. & Huang, K. (2013). Observation on the efficacy of self-prepared Huayu Decoction in the treatment of 44 cases of pelvic congestion syndrome. Journal of Chengdu University of Traditional Chinese Medicine, 36(01), 88-90.
  33. Park, Y. C., Lee, J. S., Kim, M. H., Kim, D.Y. & Lee, S. D. (2011). Pharmacological action and Toxicity of Angelica sinensis. The Korean J of Oriental Medical Prescription, 19(2), 93-108.
  34. Gao, R., Yang, D. & Ma, X. (2017). Observation on the clinical efficacy of traditional Chinese medicine enema combined with moxibustion in the treatment of pelvic congestion syndrome. Chongqing Medicine, 46(23), 3283-6.
  35. Liu, H., Chen, D. & Wan, Z. (2019). Effect of traditional Chinese medicine enema combined with Xiaoyu patch on related indicators of pelvic congestion syndrome. Chinese J of Traditional Chinese Medicine Emergencies, 28(08), 1395-7.