Abstract:

Pelvic inflammatory disease (PID) is an infectious disease of the upper reproductive tract caused by the synergistic action of multiple pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, and anaerobic bacteria. Its pathological features include chronic inflammatory response and fallopian tube fibrosis, which can lead to serious complications such as infertility and ectopic pregnancy. In terms of pathogenesis, sexually transmitted pathogens mediate the initial infection through immune escape, and anaerobic bacteria exacerbate secondary infection through biofilm formation and toxins secretion. The excessive inflammatory response of the host and the activation of the transforming growth factor-β1 (TGF-β1)/Smad signaling pathway are the key driving factors for tissue fibrosis. In terms of therapeutic strategies, the combination of antibiotics can significantly improve the cure rate compared with single-drug therapy. The combination of Chinese patent medicines and antibiotics can reduce the recurrence rate and the levels of inflammatory factors. Physical therapy and the multi-disciplinary treatment model can improve the pain score and quality of life of patients with chronic pelvic pain. Many studies have confirmed that combination therapy achieves synergistic effects by covering multiple pathogens, inhibiting the inflammatory cascade reaction, and promoting tissue repair. However, the etiological diagnostic techniques in the acute phase and the anaerobic bacteria detection system need to be further optimized. In the future, whole-genome sequencing and genetic testing technologies should be combined to construct individualized stratified treatment strategies. The long-term efficacy of the triple combination of antibiotics, traditional Chinese medicine, and physical therapy for chronic PID should be explored, with the aim of providing more precise diagnosis and treatment paths for clinical practice.

Key words: Pelvic inflammatory disease, Drug therapy, combination, Combined application of Chinese medicine and western medicine, Bacteria, anaerobic, Pathogenesis