CN118453812A - Traditional Chinese medicine enema for treating chronic pelvic inflammatory disease and preparation method thereof - Google Patents

Abstract

The present invention relates to a Chinese medicine enema medicament for treating chronic pelvic inflammatory disease, which is a preparation made of the following Chinese medicine raw materials in weight-to-gram ratio: 25-30g of Rabdosia rubescens, 25-30g of Patrinia patriniae, 10-15g of Tripterygium wilfordii, 10-15g of Curcuma zedoariae, 25-30g of Paeonia suffruticosa, 12-15g of Cyperus rotundus, 15-18g of Gleditsia sinensis, 20-30g of Fritillaria thunbergii, 20-30g of Corydalis yanhusuo, 20-30g of Paeonia lactiflora, 10-20g of Poria, 5-10g of Aconite sutsugamushi, 10-15g of Cinnamomum cassiae, 20-30g of Fructus liquidambaridis, and 20-30g of Millettia spatholobi. The preparation method is as follows: take the above Chinese medicine, add appropriate amount of water and soak for 25-35 minutes, decoct twice, 1h for the first time and 0.3h for the second time, combine the decoction, let stand for 1h, filter, take the supernatant, concentrate to 100ml, boil and pack. The invention has obvious therapeutic effect on various symptoms of chronic pelvic inflammation and infertility caused by fallopian tube obstruction. The unified prescription does not require dialectical analysis and has almost no toxic and side effects.

Description

Traditional Chinese medicine enema for treating chronic pelvic inflammatory disease and preparation method thereof

Technical Field

The invention relates to a traditional Chinese medicine enema for treating chronic pelvic inflammatory disease and a preparation method thereof.

Background

Chronic pelvic inflammatory disease is a common and frequently encountered disease in gynecology, has the characteristics of long disease course, repeated attack and difficult recovery, seriously influences the life quality of patients, and even causes oviduct adhesion and blockage to cause infertility. Western antibiotics are effective for short periods of time, but have a high recurrence rate. The traditional Chinese medicine adopts the treatment methods of clearing heat and detoxicating, activating blood and removing stasis and regulating qi to relieve pain to carry out the drug treatment, but the specific dialectical treatment is needed in most cases, and the effect is poor; and the single Chinese medicine type has lower effective rate for treating chronic pelvic inflammatory disease, and is not beneficial to clinical popularization.

Disclosure of Invention

The invention aims to provide a traditional Chinese medicine enema for treating chronic pelvic inflammatory disease and a preparation method thereof, aiming at overcoming the defects of the prior art, and the traditional Chinese medicine enema has obvious treatment effect on various symptoms of the chronic pelvic inflammatory disease and the caused tubal obstructive infertility.

The technical scheme of the invention is as follows:

the invention relates to a traditional Chinese medicine enema for treating chronic pelvic inflammatory disease, which is a preparation prepared from the following traditional Chinese medicine raw materials in parts by weight:

monarch drug: 25-30g of oridonum, 25-30g of herba patriniae, 10-15g of rhizoma sparganii and 10-15g of rhizoma curcumae;

Ministerial drugs: 25-30g of moutan bark, 12-15g of nutgrass galingale rhizome, 15-18g of spina gleditsiae, 20-30g of fritillaria thunbergii, 20-30g of rhizoma corydalis and 20-30g of white paeony root;

adjuvant drug: 10-20g of poria cocos wolf, 5-10g of prepared aconite root, 10-15g of cassia twig,

The preparation method comprises the following steps: 20-30g of fructus liquidambaris and 20-30g of caulis spatholobi.

The preparation method of the traditional Chinese medicine enema for treating chronic pelvic inflammatory disease comprises the following steps:

Firstly, weighing the traditional Chinese medicine raw materials according to the prescription, respectively, adding a proper amount of water, and soaking for 25-35 minutes; then decocting for 2 times, 1 st time for 0.5h, and 2 nd time for 0.3h; then merging the decoctions, standing for 1h, filtering, and taking filtered clear liquid; then, boiling the obtained filtered clear liquid with strong fire, and concentrating with small fire to 100ml; finally, the concentrated liquid medicine is boiled and split charging is carried out.

The application method of the medicament provided by the invention comprises the following steps: :

the enema is kept for 1 time before sleeping every night in the non-menstrual period, 100ml of the enema is used for 1 course of treatment every 12 days, three courses of treatment are used continuously, and the menstrual period is stopped.

The prescription of the invention comprises the following raw material components:

rabdosia Rubescens (Hemsl.) Hara: bitter and sweet in flavor, slightly cold in nature. It enters lung, stomach and liver meridians. Has effects of clearing heat and detoxicating, promoting blood circulation and relieving pain. Has the main function of curing the abdominal mass.

Herba Patriniae: cool, pungent and bitter in flavor, enters liver, stomach and large intestine meridians, has the effects of clearing heat and detoxicating, resolving carbuncles and expelling pus, and removing stasis and relieving pain, and can be used for treating diseases such as acute abscess, carbuncles and sores, postpartum stasis and abdominal pain, and the like. Modern pharmacological researches have found that herba Patriniae has a certain antibacterial and immunity enhancing effects.

Triangular prism: pungent and bitter in flavor and neutral in nature. Enter liver and spleen meridians. Break blood, remove stasis, promote qi circulation and relieve pain. Is used for treating obstruction and amenorrhea and heart and abdomen stagnant pain caused by blood stasis or blood stasis and qi stagnation. It is often combined with Yu Zhu.

Zedoary turmeric: pungent and bitter in flavor and warm in nature. Enter liver and spleen meridians. Break blood, remove stasis, promote qi circulation and relieve pain. Is used for treating obstruction and amenorrhea and heart and abdomen stagnant pain caused by blood stasis or blood stasis and qi stagnation. It is often combined with san Leng.

Spina gleditsiae: warm nature, pungent taste, good therapeutic effect on liver and stomach meridians, and has the effects of relieving swelling, removing toxic substances, expelling pus, and killing parasites. Research proves that spina gleditsiae is beneficial to promoting metabolism of the body and blood circulation so as to promote toxin discharge in the body.

Thunberg fritillary bulb: bitter and cold, enter lung and heart meridians. Clearing heat, resolving phlegm, relieving cough, detoxicating, resolving hard mass and resolving carbuncle. It can be used for treating pulmonary abscess, acute mastitis, scrofula, and skin sore.

Cortex moutan: pungent and bitter in flavor, slightly cold in nature, entering heart, liver and kidney meridians. Has effects of clearing heat, cooling blood, promoting blood circulation, and removing blood stasis. Clinically, the Chinese medicinal composition is used for treating warm diseases, excessive heat of nutrient blood, high fever, bleeding due to blood heat, yin deficiency, fever and the like.

And (3) rhizoma cyperi: pungent, slightly bitter, slightly sweet and flat in nature, enter liver, spleen and triple energizer meridians. Contains a large amount of nutgrass galingale rhizome, has excellent heat clearing effect and anesthetic effect, and can be clinically used for treating the pain symptoms of the gastric cavity and the liver.

Rhizoma corydalis: pungent and bitter taste, warm nature, has the effects of activating blood, promoting qi circulation and relieving pain, and is mainly applied to chest and hypochondrium, epigastric pain, dysmenorrhea and other conditions.

White peony root: bitter and sour taste, cold nature, entering liver and spleen meridians, and has the effects of nourishing blood, softening liver, relieving pain. It is mainly used for treating chest pain, abdominal pain, hypochondrium pain, liver pain, and cholecystitis pain. The white paeony root is rich in components for promoting blood circulation and removing blood stasis, has the functions of relieving inflammation and promoting blood circulation, and can effectively improve salpingitis and restore the physiological function of the salpingemphraxis.

Poria cocos: sweet and light in taste and neutral in nature. It enters heart, lung, spleen and kidney meridians. Promoting diuresis, removing dampness, strengthening spleen and stomach, and tranquilizing mind. Can be used for treating edema, phlegm retention, palpitation, spleen deficiency, anorexia, loose stool, diarrhea, etc.

Preparing radix aconiti lateralis preparata: pungent, sweet, severe heat and toxic, it can restore yang to rescue adverse rise of qi, supplement fire to strengthen yang, dispel cold to alleviate pain, and restore heart, kidney and spleen meridians.

Ramulus Cinnamomi: pungent and sweet in flavor and warm in nature. It enters lung, heart, kidney and liver meridians. Warm and unblock the channels and collaterals and warm and promote yang qi. It is combined with Huang Qi to achieve the effects of invigorating qi, warming meridians and activating yang. It is good at dispersing cold accumulation in vessels and dispersing blood-activating herbs to strengthen the actions of activating blood and resolving stasis.

Road way: slightly cold in nature, enters spleen and stomach lung meridian, dispels wind, unblocks collaterals, promotes diuresis and removes dampness. It has bitter taste and can clear heat, remove dampness, and unblock collaterals to alleviate pain, and this herb has good effect of dredging oviduct.

Caulis Spatholobi: pungent, bitter and sweet in flavor, warm in nature. Enter liver meridian. Promoting blood circulation, replenishing blood, relaxing tendons, and activating collaterals. Can be used for treating dysmenorrhea, amenorrhea or puerperal abdominal pain due to blood stasis, and has effects in removing blood stasis in oviduct, and dredging oviduct.

Compared with the prior art, the traditional Chinese medicine enema for treating chronic pelvic inflammatory disease and the preparation method thereof have the following beneficial effects:

The traditional Chinese medicine enema for treating chronic pelvic inflammatory disease is based on the turbid toxin theory, takes detoxification and turbidity-eliminating principle, and takes four medicines of herba patriniae, rubescentis, rhizoma sparganii and rhizoma curcumae as monarch medicines to play the roles of detoxification and turbidity-eliminating. The Chinese medicinal composition takes thunberg fritillary bulb, chinese honeylocust spine, tree peony bark, nutgrass galingale rhizome, rhizoma corydalis and white paeony root as ministerial drugs, and is matched with monarch drugs to eliminate symptoms and dissipate stagnation, and release pelvic internal adhesion. Poria cocos, radix aconiti lateralis preparata, and ramulus cinnamomi are adjuvant drugs for warming middle-jiao and lower-jiao and helping absorption. The traditional Chinese medicine preparation is prepared by scientific compatibility, has the effects of detoxifying and resolving turbidity together, can remove stasis and smooth thoroughfare and conception vessels, and has self-healing and good curative effect.

Clinical observation and analysis show that the salpingitis infertility caused by chronic pelvic inflammatory disease is caused by abnormal functions of viscera, qi and blood circulation, and excessive physiological or pathological products in the body can not be discharged in time, and the excessive accumulation in the body is caused to be turbid toxin. The toxin is caused by turbid materials, the turbid materials are accompanied with toxin, the cell vessels are directly injured, the cell vessels are blocked and can not be stopped, and the essence can not be controlled to become pregnant, so the disease is caused. The key point of this disease is the accumulation of turbid toxin in the body, qi stagnation and blood stasis. The pharmacological effect of the formula of the invention is very effective for treating the disease, and the invention has obvious curative effect in fact.

The effects can be summarized as follows:

1) The invention is clinically applied for more than 30 years, has better treatment effect on lower abdominal pain, lumbosacral ache, pelvic effusion, adnexa thickening and thickening, pelvic peritonitis and periodic lower abdominal pain of pelvic congestion syndrome caused by chronic pelvic inflammatory disease, and has better treatment effect on the infertility caused by oviduct obstruction. The traditional Chinese medicine enema has the characteristics of scientific and reasonable compatibility, simple preparation process, convenient use and no adverse reaction of the medicine.

2) The invention uses the method of detoxification and turbidity elimination, the unified prescription does not need dialectical treatment, and can be used by patients who are diagnosed to accord with the disease characteristics.

3) By adopting enema administration, the medicine can directly reach the affected part, improve the pelvic blood supply, promote the absorption of inflammatory exudation and the loosening of adhesion tissues, and also can help to recover the physiological function of fallopian tubes.

4) The external medicine is used for treating and absorbing rectal mucosa, and can avoid irritation to stomach and duodenum caused by oral administration.

The following are data of clinical experiments performed on the traditional Chinese medicine enema preparation for treating chronic pelvic inflammatory disease:

The inventor carries out clinical observation on 80 cases of patients meeting the diagnosis standard of chronic pelvic inflammatory disease and infertility caused by oviduct obstruction. 40 patients with chronic pelvic inflammatory disease, 40 patients with oviduct obstructive infertility, and patients in groups with ages 22-50 years old, and disease course 2 months-3 years old. By using the medicine of the invention, the medicine is generally used for 3-4 treatment courses, wherein 36 patients with chronic pelvic inflammatory disease are cured, the cure rate reaches 90%,38 patients are effective, and the effective rate is 95%; 32 patients with oviduct obstructive infertility have the effective rate of 80 percent.

According to the clinical research guidelines of new traditional Chinese medicines, an integration method is adopted for diagnosing chronic pelvic inflammatory disease. Scoring criteria: uterine movement restricted tenderness for 5 minutes; the oviduct is in a strip rope shape and presses the pain for 5 minutes; thickening and tendering one or two sides of uterus for 5 minutes; the pain of the lower abdomen, the lumbosacral part falls down for 3 minutes; increasing the belt down by 1 minute; low fever and fatigue 1 minute, menstrual abdominal pain, 1 minute. Each year the disease course increases by 0.5 minutes. The integral is more than 15 minutes, the integral is less than 10 to 14 minutes, and the integral is less than 5 to 9 minutes.

Efficacy assessment criteria:

And (3) curing: symptoms, physical signs and gynecological examination are all recovered to be normal, and no recurrence occurs within half a year after stopping the medicine. The standard product is 0 minutes according to the diagnosis. The effect is shown: the symptoms disappear, the gynecological examination is obviously improved, and the integration after treatment is reduced by more than 60% compared with the integration before treatment. Improvement: symptoms, physical signs and gynecological examination are all reduced, and the integration after treatment is reduced by 30-60% compared with the integration before treatment. Invalidation: no significant improvement in post-treatment symptoms, signs and gynecological examination, and less than 30% decrease in post-treatment integral than pre-treatment integral.

With reference to the diagnosis and treatment standard revised by the third academy of the obstetrics and gynecology professional committee of the Chinese-western combination society, 40 cases of infertility patients with salpingemphraxis all meet the diagnosis standard of traditional Chinese medicine and western medicine, and are completely diagnosed by hysteroscopic radiography.

The effect is shown: the hydrotubation operation is smooth after 1 treatment course (3 menstrual cycles); the method is effective: the patient is unobstructed after 2 to 3 treatment courses; invalidation: examination is still not smooth for more than 3 treatment courses.

Modern medicine holds that salpingitis not only causes salpingemphraxis, but also causes salpingemphraxis to be stiff and adhered with surrounding tissues due to scar formation, and meanwhile, salpingemphraxis is affected by salpingemphraxis, cilia movement is affected by salpingemphraxis, sperm passing is prevented, and infertility is caused. The pathogenesis of the disease is mainly that turbid toxin is generated internally, blocks the venation, and blocks obstruction, so that two sperms cannot beat mutually. Therefore, the method of detoxifying and eliminating turbid is adopted. The traditional Chinese medicine herba patriniae, rabdosia rubescens, detoxifies and eliminates turbidity, has anti-inflammatory effect, and is beneficial to absorption of inflammatory infiltration and loosening of adhesion tissues; rhizoma sparganii, rhizoma curcumae, cortex moutan, rhizoma cyperi, rhizoma corydalis and radix paeoniae alba can promote blood circulation and remove blood stasis, can improve local blood circulation of oviducts through rectal administration, accelerate metabolism, and help to improve the normal function of oviduct scars, and enhance the peristaltic motion of oviducts, so that ova are smoothly discharged and easy to conception.

In case 1, a woman, 50 years old, shijia Yu Hua Ou, the doctor of China in the year 2020, the doctor of China in the day 5 and 12, and chronic pelvic inflammatory disease repeatedly attacks for 5 years, and the doctor of China in the North medical department and the Hebei province is treated by anti-inflammatory and traditional Chinese medicines, and the symptoms are still repeatedly attacks, aggravated gradually, and seriously influence daily life. The symptoms are lower abdomen pain, waist being like a fold, leucorrhea with multiple colors and yellow with peculiar smell, vulvar itching and incapacity of normal sexual life. Gynecological examination: cervical lifting pain, posterior cervical, limited movement and thickening of bilateral appendages. The symptoms disappear after 3 courses of treatment of the above-mentioned enema.

Case 2 blue is a certain, female, 27 years old, shijia Luancheng, 2021, 23 days later and my visit, the lower abdomen is intermittently stressed and painful for more than 20 days, waist soreness is accompanied, pelvic effusion is checked by B ultrasonic, the symptom disappears after 3 treatment courses of enema with the prescription are given, and the patient is healed by B ultrasonic detection.

Case 3 Chen Mou, female, 26 years old, shanxi. The patient can visit the place of the patient in 7 th year and 2 nd day of 2021, the effect of taking the traditional Chinese medicine is not obvious from the repeated attack of the dysmenorrhea, the patient takes the ibuprofen to relieve pain in the past menstrual period, the menstrual period is gradually aggravated with vomiting and diarrhea, the effect of taking the ibuprofen is not good, and the normal life is influenced by the menstrual period lying in bed every time. Giving the pelvic cavity color ultrasound examination to prompt 16mm of pelvic effusion, and gynecological examination to treat uterine tenderness. After the enema is used for 4 treatment courses, the dysmenorrhea is obviously improved, and then the enema is used for 1 treatment course, and the pelvic color ultrasonic pelvic effusion is checked to disappear, and the menstrual abdominal pain is slight.

Case 1 Zhang Mou, women, 35 years old, shijia deer spring, 16 days old from 2020, had a doctor visit, had no contraception and no conception since 3 years after the wedding, had no abnormality in six hormone studies, had a dominant follicle in ovulation monitoring, and had no abnormality in men's examination. The patient has pain due to flatulence and distention of lower abdomen, excessive leukorrhagia, soreness of waist, fatigue and aggravation after catching cold, and has 3.3X2.2 cm of right accessory cyst after B ultrasonic examination, and oviduct radiography prompts that two side oviducts are open and not smooth. After 4 treatment courses of the above prescribed enema treatment, the lower abdominal pain disappeared and the right accessory cyst was examined by B-ultrasonic examination for 0.3cm. The hospital stopped 5 months 2021 checked that HCG (+) had been pregnant.

Case 2 Liu Mou, female, 29 years old, south people, 2021, 3 months, 12 days old, medical visit in our hospital, secondary infertility 3 years. The right oviduct is resected by ectopic pregnancy before 3 years, and the left oviduct is suggested to ascend by checking oviduct radiography before 1 year, so that the contrast agent in the pelvic cavity is not dispersed. Gynecological examination: the vulva has married, the vagina is smooth, little yellow secretion is produced, the cervical is slightly eroded, the uterus is in a posterior position, the size is normal, the pain is pressed, and the accessory on the left side is thickened. After 5 courses of treatment of the prescription enema, oviduct radiography prompts normal left oviduct shape, and the contrast agent is dispersed in the pelvis. Stopping menstruation for 52 days at 10 months and 10 days of 2022, and performing B ultrasonic examination: intrauterine early pregnancy.

Case 3 Zhang Mou, female, 25 years old, shijia village. The patient is diagnosed in 10.3.2022 and the primary infertility is 2 years. The wedding is not contraception and is not pregnant 2 years ago, and the maximum of 6 months is after the plain menstruation is wrong. Six hormone and color Doppler ultrasound are once examined to diagnose polycystic ovary syndrome, the discharge is promoted for 2 periods of infertility, and then oviduct examination contrast diagnosis is carried out on two side oviducts to lead to obstruction. The semen convention and the prostate color Doppler ultrasound of men indicate no abnormality. After 3 courses of treatment following the prescribed enema treatment, salpingography prompts patency of the fallopian tubes on both sides. After two months of excretion promotion, 2023, 3, 10 and 37 days of menstruation stop, the urine HCG (+) is self-tested, and the pregnancy is already established.

Detailed Description

Example 1: a traditional Chinese medicine enema for treating chronic pelvic inflammatory disease is prepared from the following traditional Chinese medicine raw materials in parts by weight:

25g of oridonum, 25g of herba patriniae, 106g of rhizoma sparganii, 10g of rhizoma curcumae, 25g of cortex moutan, 12g of rhizoma cyperi, 15g of spina gleditsiae, 20g of fritillaria thunbergii, 20g of rhizoma corydalis, 20g of radix paeoniae alba, 10g of poria cocos, 5g of radix aconiti lateralis preparata, 10g of cassia twig, 20g of fructus liquidambaris and 20g of caulis spatholobi.

The preparation method of the traditional Chinese medicine enema for treating chronic pelvic inflammatory disease comprises the following steps:

firstly, weighing the traditional Chinese medicine raw materials according to the prescription, respectively, adding a proper amount of water, and soaking for 25-35 minutes;

Then decocting for 2 times, 1 st time for 0.5h, and 2 nd time for 0.3h;

then merging the decoctions, standing for 1h, filtering, and taking filtered clear liquid;

then boiling the obtained filtered clear liquid with strong fire, and concentrating with small fire to 100ml;

Finally, the concentrated liquid medicine is boiled and split charging is carried out.

Example 2: a traditional Chinese medicine enema for treating chronic pelvic inflammatory disease is prepared from the following traditional Chinese medicine raw materials in parts by weight:

27g of oridonum, 27g of herba patriniae, 13g of rhizoma sparganii, 12g of rhizoma curcumae, 26g of cortex moutan, 13g of rhizoma cyperi, 16g of spina gleditsiae, 26g of fritillaria thunbergii, 26g of rhizoma corydalis, 25g of radix paeoniae alba, 15g of poria cocos, 7g of radix aconiti lateralis preparata, 12g of cassia twig, 25g of fructus liquidambaris and 25g of caulis spatholobi.

The preparation method of the traditional Chinese medicine enema for treating chronic pelvic inflammatory disease comprises the following steps:

firstly, weighing the traditional Chinese medicine raw materials according to the prescription, respectively, adding a proper amount of water, and soaking for 25-35 minutes;

Then decocting for 2 times, 1 st time for 0.5h, and 2 nd time for 0.3h;

then merging the decoctions, standing for 1h, filtering, and taking filtered clear liquid;

then boiling the obtained filtered clear liquid with strong fire, and concentrating with small fire to 100ml;

Finally, the concentrated liquid medicine is boiled and split charging is carried out.

Example 3: a traditional Chinese medicine enema for treating chronic pelvic inflammatory disease is prepared from the following traditional Chinese medicine raw materials in parts by weight:

30g of oridonum, 30g of herba patriniae, 15g of rhizoma sparganii, 15g of rhizoma curcumae, 30g of cortex moutan, 15g of rhizoma cyperi, 18g of spina gleditsiae, 30g of fritillaria thunbergii, 30g of rhizoma corydalis, 30g of radix paeoniae alba, 20g of poria cocos, 10g of radix aconiti lateralis preparata, 15g of cassia twig, 30g of fructus liquidambaris and 30g of caulis spatholobi.

The preparation method of the traditional Chinese medicine enema for treating chronic pelvic inflammatory disease comprises the following steps:

firstly, weighing the traditional Chinese medicine raw materials according to the prescription, respectively, adding a proper amount of water, and soaking for 25-35 minutes;

Then decocting for 2 times, 1 st time for 0.5h, and 2 nd time for 0.3h;

then merging the decoctions, standing for 1h, filtering, and taking filtered clear liquid;

then boiling the obtained filtered clear liquid with strong fire, and concentrating with small fire to 100ml;

Finally, the concentrated liquid medicine is boiled and split charging is carried out.

Claims (2)

1. A traditional Chinese medicine enema for treating chronic pelvic inflammatory disease is characterized in that: the medicament is a preparation prepared from the following traditional Chinese medicine raw materials in parts by weight:

25-30g of oridonum, 25-30g of herba patriniae, 10-15g of rhizoma sparganii and 10-15g of rhizoma curcumae; 25-30g of moutan bark, 12-15g of nutgrass galingale rhizome, 15-18g of spina gleditsiae, 20-30g of fritillaria thunbergii, 20-30g of rhizoma corydalis and 20-30g of white paeony root; 10-20g of poria cocos, 5-10g of prepared aconite and 10-15g of cassia twig; 20-30g of fructus liquidambaris and 20-30g of caulis spatholobi.

2. The preparation method of the traditional Chinese medicine enema for treating chronic pelvic inflammatory disease according to claim 1, comprising the following steps of

Firstly, weighing the traditional Chinese medicine raw materials according to the prescription, respectively, adding a proper amount of water, and soaking for 25-35 minutes; then decocting for 2 times, 1 st time for 0.5h, and 2 nd time for 0.3h; then merging the decoctions, standing for 1h, filtering, and taking filtered clear liquid; then, boiling the obtained filtered clear liquid with strong fire, and concentrating with small fire to 100ml; finally, the concentrated liquid medicine is boiled and split charging is carried out.