Cai's gynecology chronic pelvic formula with acupuncture alleviates chronic pelvic pain and reduces recurrence in patients with pelvic inflammatory disease sequelae.

Objective: To assess the efficacy of Cai's Gynecology Chronic Pelvic Formula combined with acupuncture in managing chronic pelvic pain (CPP) secondary to pelvic inflammatory disease (PID) sequelae, and its effect on recurrence.

Methods: A retrospective study assessed medical records from 240 CPP patients undergoing treatment between February 2019 and February 2024. Patients were divided into a control group (standard treatment, n = 120) and an observation group (standard treatment plus Cai's Chronic Pelvic Formula combined with acupuncture, n = 120), with treatment lasted for 28 days and follow-up for 6 months. The symptom scores (Visual Analog Scale, Self-rating Anxiety Scale and Self-rating Depression Scale), inflammatory markers [C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and cancer antigen 125 (CA125)], efficacy rates, and recurrence rates were all employed to measure treatment outcomes. Cox regression was leveraged to identify recurrence risk factors, while a nomogram model was developed and validated by Receiver Operating Characteristic (ROC), calibration curves, and decision curve analysis (DCA).

Results: The observation group had significantly lower post-treatment Traditional Chinese Medicine symptom scores, inflammatory markers (CRP: P < 0.001; TNF-α: P = 0.003; IL-6: P = 0.004), and CA125 (P < 0.001) versus the control group. The observation group also demonstrated shorter symptom resolution time (P < 0.05), with higher total treatment efficacy in comparison to the control group (93.46% vs. 79.70%; P = 0.002). In addition, the observation group showed lower recurrence rates (14.2% vs. 28.3%; P = 0.008) as well as postponed recurrence time when compared to the control group. Cox regression analysis identified treatment protocol (HR = 0.41, 95% CI: 0.24-0.71), disease duration (HR = 1.32, 95% CI: 1.08-1.62), and pre-treatment CRP level (HR = 1.18, 95% CI: 1.02-1.36) as independent recurrence predictors. In addition, the nomogram demonstrated high accuracy in predicting disease recurrence (C-index = 0.852), with both ROC (AUC = 0.837) and calibration curves confirming its reliability. DCA indicated high clinical net benefit of the studying treatment protocol.

Conclusion: Cai's Gynecology Chronic Pelvic Formula combined with acupuncture could significantly alleviate CPP and inflammation, and decrease recurrence rates. The nomogram may be used as a validated tool for predicting the disease recurrence, with benefits when integrated into clinical practice as a novel therapeutic strategy.