不孕症 / Infertility 女性生殖功能，内分泌失调是 导致不孕症常见的原因。在其中 , 不乏许多器质性病变; 而功能 障碍也是产生病状，导致不孕症 常见的因素。近十余年，在英临 症的经历中，应用中医针灸，中 药治愈不孕症；治愈或改善导致 不孕的器质性，功能性病变的案 例越来越多. 我体会到对不孕症，生殖， 内分泌系统紊乱所产生的病状， 在中西医结合理论指导下，应用 针灸，中药，是产生最佳疗效的 正确方法。 1 Disorders of the reproductive and endocrinal systems are common causes of female infertility. These disorders can be either structural or dysfunctional. In my practice over the last decade, I have helped more and more women with infertility conceived their babies by using acupuncture and Chinese medicine to improve their functional disorders, or even cure their organic diseases. So I realized that it is a right treatment method to use acupuncture and Chinese herbal medicine based on integrated theories from traditional Chinese medicine and modern medicine for treating female infertility caused by reproductive and endocrine disorders.
一 用中医药进行人 周期治疗的背景： 1. Background understanding: 妇女的生理周期与西方不孕症多 发的社会背景： 现代医学生理学认为，女性自 10 一12 岁开始，由于性激素，生殖功 能日趋成熟，逐渐建立了正常的生 理周期。即在下丘脑，脑垂体有关 激素的作用下，卵泡开始逐渐长大， 成熟后游离， 卵子经由散端输卵管 摄取后，经由输卵管进入子宫，如 遇精子结合为受精卵，而置入子宫 内膜进入妊娠的生理过程; 如未遇 精子，则未受精卵，随子宫内膜脱 落排出，而形成月经。 2 A female starts a normal menstrual circle when her sexual harmony and reproductive function have been matured around twelve years old. Under the effects of relevant hormones, such as Luteotropic hormone (LH), Folliclestimulating hormone (FSH), gonadotropic hormone that are produced by the pituitary and Hypothalamus, a follicle develops mature and releases from her ovary every month, which moves to the uterus through a fallopian tube. If it is fertilized with a vital sperm to make a fertilized egg and implant into the endometrium of the uterus, a normal pregnancy will result. If it hasn’t met a vital sperm, it will flow out with some pieces of endometrial tissue as menstruation.
近年西方日益增多的不孕症，及妇科生殖，内分泌病变的产生常见于 ： In the West, there are increased incidences of infertility, which are caused by various reproductive and endocrine disorders. The common reasons include: 1 常年的心理压力，使卵巢功能抑制，而导 致卵巢不发育，甚至早衰。例如：一些攻 读PHD的女孩出现闭经。 1. 2 幼年过渡劳累，使卵巢，子宫的发育均可 能受影响。例如：一些运动员，舞蹈演员 的月经失调。 2. 3 过服避孕药，造成一些雌 / 孕激素比例失 调，活力下降。西方的女青年常会口服避 孕药长达 10年以上。 3. 4 晚婚晚孕。 5 酗酒，吸毒均会影响雌激素的正常代谢 3 4. 5. Long-term stress/depression affecting the ovarian function to cause ovarian mal-development, or early failure. Some young females suffer from amenorrhea when they undergo PHD study, or high degree courses, or after a severe accident. Excessive physical work or training during puberty causes maldevelopment in the ovaries or uterus resulting in menoxenia, often seen in some athletes and dancers. Excessive use of the contraceptive pill causes imbalance of Oestrogen & Progesterone causing their ovarian activity decreased. Some women in western countries take contraceptive therapies for over 10 years. Marriage or pregnancy in later ages. Taking drugs, or excessive alcohol intake.
二 应用中医针药进行人 周期的治疗： 2. Methods of inducing artificial ovarian cycle by acupuncture & herbal medicines. （ 一）中医治疗的理论基础： 根据生理学月经周期变化的规律，结合传 统中医理论，使治疗的方向更加明确，治疗 的力度大大增加。 1 补肾，脾 — 先, 后天之本，而促进卵子 的生长： 中医认为肾为先天之本， 生殖元气之本 源；脾为后天之本 ，是气 血不断得以补充 的渊源，因而在促生殖功能的第一阶段，先 补肾脾。 2 补阴养精，活血化瘀，而促进卵子的成熟 与排出；肾以阴精为本，故补阴生精以促卵 之成熟；活血化瘀以促成熟卵子的游离排出。 4 2。1 The foundational theory: In the first week: strengthen kidney and spleen, which are pre-heaven and postheaven organs to promote follicle growth. TCM recognizes that the kidney is an initial source to produce the original and reproductive Qi. The spleen is an important organ to continuously supply Qi & blood. Therefore, treatment should be focused on strengthening kidney and spleen in the first stage of the menstrual cycle. In the second week: nourish Yin and culture essence, move stagnated Qi & blood stasis. Nourish kidney Yin to produce essence for strengthening maturing follicles; move stagnant blood to detach the matured egg from the ovary.
3 温阳育阴，以促黄体生成： “欲补阳者， 则于阴中求阳”，是传统中医补 肾之关键，故在养阴的基础上助以温阳．温则使 气行，温则使血运，故可渐解气血之久郁。 4 疏肝活血以调经，或健脾补肾以固胎： 1）疏肝活血以调经： 逢经前则肝气易郁，而经血易瘀．故疏 肝气则瘀血得散; 经血得散，则痛经得解。 2）健脾补肾以固胎： 如已受孕，受精卵虽已植入。但气血不 足，脾肾两虚以致阴阳失衡，又是导致 流产的常见病机；当有虚象显露，或有 流产病史的女士，都应当继续补治，以 护妊娠正常发展。 5 In the third week: warm Yang and nourish Yin to promote progesterone growth: “If you plan to strengthen Yang, you must nourish Yin to treat Yang. ” This quotation explains a treating experience, which is a key technique on kidney’s tonification. It means you should use herbs to nourish kidney Yin, before warm kidney Yang, or use both of above herbs together. Strengthening Yang in the kidney meridian warms Qi & blood to remove their stagnations in ovaries and uterus, which agitates progesterone. In the fourth week: Spread liver Qi and blood to regulate menstruation; or strengthen spleen and kidney to protect foetus when pregnant. a) When the woman is in the last week before her menstruation, she easily presents with liver Qi stagnation leading to blood stasis, which can cause dysmenorrhoea. Therefore, it is a necessary treating principle to move stagnated Qi and stasis of blood to release dysmenorrhoea. b) If fertilized, the woman becomes pregnant. However, if she still possesses a deficiency of Qi and blood, she could easily present a miscarriage. Therefore, if a woman who has a miscarriage history, or has some symptoms and signs of Qi and Blood deficiency, continuing tonification in this stage to prevent miscarriage.
（二）针灸治疗的机理与方法： 2. 2 Fundamental theory and technique of Acupuncture: 1 加强人体自身调节的能力： 如长期应用口服避孕药的妇女所产生 的无因性不孕，就是由于常年应用人 雌 激素，而可能抑制孕激素，或使雌／孕激 素的活力比重失调，因而针灸可能 刺激 人体内部的自身的调整能力。 2 确切的促排作用： 经试验研究补肾俞穴，有确切的促排 卵的作用。 3 促进人体的自愈能力： 对一些器官有病变，或损伤的病患， 针灸可以促进自愈的过程。 如子宫内膜 异位症，每次月经造成了子宫内膜过多脱 落，而产生内膜损伤，失于光滑，瘢痕都 可能使孕卵不易着床。针灸则促进内膜的 自愈。 6 2. 2. 1 Stimulate and strengthen the self-regulating functions: For example, some women present with unexplained infertility, which may be caused by taking contraceptive pills for a long time. Due to excessive intake of artificial Oestrogen, the vitality of progesterone in their body has been decreased, or the proportion of these hormones is out of balance. Therefore, they present with infertility, but no any structural abnormality can be detected, so unexplained infertility is diagnosed. Acupuncture is good at stimulating the self-regulating function inside of the body to balance the hormonal disorder. 2. 2. 2 Promote ovulation: this has been proven by some research. 2. 2. 3 Strengthen self-healing function: For example, women with endometriosis may have some damages to their endometrium of uterus from excessive endometrial tissues displacement. Endometria become unsmooth, so it is hard for the fertilized egg to implant. Acupuncture will strengthen the self-healing function of endometria to improve the condition of the uterus.
取穴方法： Acu – points: 主穴：关元 (Ren 4), / 中极（Ren 3）, 气海（Ren 6） 归来（St 29）, / 子宫（Ext） 艾灸神阙 （Ren 8） 辅穴：百会（Du 20）, 1. 列缺（Lu 7）, 照海（Ki 6）; 外关（Sj 5）, / 合谷 （Li 4） 足临泣（Gb 41), / 太冲（Liv 3） 2. 足三里（St 36）, /阴陵泉（Sp 9） 血海（Sp 10）三阴交（Sp 6）, 公孙（St 4）, 太白（Sp 3），大都 （Sp 2） 3. 阴谷（Ki 10), 复留（Ki 7）, 太溪 （Ki 3）, 然谷（Ki 2）等。 7 Main points: Guanyuan (Ren 3), Zhongji (Ren 2), Guilai (St 29), Shenqu (Ren 8) Moxui Supporting points: Baihui (Du 20), Lieque (Lu 7), Zhaohai (Ki 6) Waiguan (Sj 5), Zulinqi (Gb 41), or Hegu (Li 4) Taichong (Liv 3) Zusanli (St 36), Fuliu (Ki 7), Taixi (Ki 3) Rangu (Ki 3), Sanyinjiao (Sp 6) etc. These points are selected according to the pattern/syndrome differentiation.
（三）中药治疗的机理与方法： 2. 3 Fundamental theory and prescription of herbal medicines: 中药与针灸的合用，相辅相 成，使治疗的力度大增，加上适 当中药剂型的选择，使治疗的力 度达到治疗原则所规定的目标， 因而这也是不孕症治效的重要方 法。临床可见，只应用针灸治疗 的妇女，常可规律地扎一年以上， 临床症状好转，却不能达到受孕 的疗效。可见治疗的方法是正确 的，但失于治疗力度不当 。 8 Chinese herbal medicine is used to support acupuncture. Integrating both will make the treatment fulfill the purpose expected for the individual patients. Some patient can be done acupuncture for over a year who feels better, but can’t been conceived, because she has been this treatment which is right, but not stronger enough
经辨证论治，根据不同的生理阶段，选用中药: According to TCM syndrome differentiation, herbs selected for the different menstrual stages are shown in the table. 以肾阴虚为主 中成药 中药颗粒/ 中草药 以肾阳虚为主 中成药 中药颗粒 /中草药 周期 治则 第一周 补肾，脾 — 先, 后天 之本，而促进卵 子的 生长 人参归脾丸 / 知柏地黄丸 女贞子 旱莲草 何首乌 枸杞子 等 八珍丸 / 乌鸡白凤丸 仙茅 淫羊藿 续断 菟丝子等 第二周 补阴养精，活血 化 淤，而促进卵子 的成 熟与排出 知柏地黄丸 / 桃红四物丸 丹参 香附 桃仁 红花等 乌鸡白凤丸 / 八珍益母丸 当归 香附 桃仁 红花等 Period Treating principle Predominance in kidney yin def Patent Powder/dry herbs Predominance in kidney yang def Patent Powder/dry herbs The first week* Tonify of kidney and spleen to promote follicles growth Guipi Wan, Zhibaidihuang Wan Nuzhenzi, Hanliancao, Heshouwu, Gouqizi etc. Bazhen Wan, Wujibaifeng Wan Xianmao, Yinyanghuo, Xuduan Tusizi, etc. The second week Nourish Yin essence, and move blood stasis to support maturing egg and ovulation Zhibaidihuang Wan, Taohongsiwu Wan Danshen, Xiangfu, Taoren, Honghua, etc. Wujibaifeng Wan, Bazhenyimu Wan Danggui, Xiangfu, Taoren, Honghua, etc. * The first day of menstruation is the start of the first week.
以肾阴虚为主 中成药 中药颗粒/ 中草药 周期 治则 第三周 温阳育阴，以促黄 体生成 八珍丸 / 金匮肾气丸 熟地黄 肉苁蓉 菟丝子 制首乌等 暖宫孕子丸 / 补中益气丸 巴戟天 菟丝子 桑寄生 艾叶等 第四周 疏肝活血以调经， 或健 脾补肾以固胎： 柴胡疏肝丸 /加味逍遥丸 / 归脾丸 丹参 香附 赤芍 泽兰等 逍遥丸 / 痛经丸 当归 香附 川芎 泽兰等 Period Treating principle Predominance in kidney yin def Patent Powder/dry herbs 以肾阳虚为主 中成药 中药颗粒 /中草药 Predominance in kidney yang def Patent Powder/dry herbs The Third Week Warm Yang and nourish Yin to Promote progesterone’s rowth Bazhen. Wan, Jinkuishenqi Wan Shudihuang, Roucongrong, Tusizi, Heshouwu, etc. Nuangongyunzi Wan, Buzhongyiqi Wan Baqitian, Tusizi, Sangjisheng, Aiye, ect. The Fourth Week Spread stagnated Qi and move blood stasis to regulate menstruation; or tonify kidney and spleen to protect foetus. Chaihushugan Wan, Jiaweixiaoyan Wan, Guipi Wan Danshen, Xiangfu, Chishao, Zelan, ect. Xiaoyao Wan, Tongjing Wan Danggui, Xiangfu, Chuanxiong, Zelan, ect.
三 周期疗法的适应病症: 3, The application on the promoting menstrual circle 1，无因性不孕：功能性原因导致的不孕，没有很重的病症，甚至没有明显 的临床症状；或是西医未能够诊断的不孕； Unexplanation infertility which can not be conceived, but no severe disease, even no symptoms, but also no clear diagnosis 2, 卵巢早衰；the early failure of ovary 3, 多囊卵巢，或多囊卵巢综合症，以及各种卵巢病症引起的月经后期，或 闭经. Polycystic Ovary, or PSCO, and Amenorrhea, or longer menstrual circle which is caused by an ovary's problem. 4, 患者希望促孕，如年龄偏大，或因为其它原因期盼尽快受孕。 Ladies expect to be quickly conceived. Such as ages, or other. 11
三 中医针药调治月经周期治效验案： 3. Case studies （一）经中医针灸治疗而自然受孕的成功案例 3. 1. Natural pregnancy supported by acupuncture and herbal medicine 例一：无因性不孕： Ms C Andrew 27岁， 理疗师，婚后五年未孕。经妇科 专家进行各项检察未见异常，故诊断为无因性不孕。 妇科专家建议中医治疗。就诊时明显焦虑，经前紧张 症， 轻度痛经，便秘。经五个月：针灸 一次 / 每 2周， 中成药调促月经周期，自然受孕, 足月顺产一子。 12 Case 1: Unexplained infertility Ms C A, 27 years old, who is a physiotherapist. No pregnancy for five years after her marriage. Gynaecological consultant has done all sorts of the examinations which are all negative. Therefore, unexplained infertility was diagnosed and she was referred to me for TCM treatment. Present symptoms: stress, restlessness, feeling weepy and nervous, worse in the week prior to her period, minor dysmenorrhoea, and constipation. Following five months of regular menstrual cycle supported by acupuncture and patent herbal medicine, she was naturally conceived and delivered a healthy boy in a full term.
病例一的中医治疗：TCM treatment on Case 1 中医辨证：肝肾阴虚，气滞胞宫。Differentiation of Syndrome: Liv & Ki Yin Def and Qi stagnation in the uterus 中医治法：舒肝理气，补益肝肾之阴。Treating Principle: to disperse Liv Qi stagnation, and to nourish Liv & Ki Yin 针灸：百会, 灸神阙，关元，气海，子宫，阴陵泉，三阴交， 足三里，太溪，照海，外关，足临泣。每 2周针灸 1次。 Acupuncture: Du 20, Mox at Ren 8, Ren 4, 6, Zigong, Sp 9, 6, St 36, Ki 3, 6, Sj 5, GB 41 中药：知柏地黄丸和逍遥丸----月经至排卵期； 人参归脾丸和柴胡疏肝丸----排卵期至月经期。 Patent herbs: Zhibaidihuang Wan & Xiaoyao Wan from the period to ovulation; Renshenguipi Wan & Chaihushugan Wan from ovulation to period. 每诊视病人状况，针灸穴位，与中成药稍有加减。 To make variation on acu-points and herbal medicine according to current condition of patient. 13
三 中医针药人 周期治效验案： 3. Case studies 例二：卵巢早衰导致不孕： Mrs J Woodward 32岁，科研人员。终身月经不调，一直用避孕药调治月经。 用药则月经至，停药则月经停。婚后希受孕，而停用避孕药，随致闭经。就 诊时已闭经两年余，确诊为卵巢早衰。就诊时焦虑，失眠， 紧张。激素血检 报告：雌激素水平低于５０。因其为医务研究人员，初诊时对中医尚有余顾， 故仅希一试，并先接受针灸与中成药，每周一诊。经治三月后，雌激素水平 升至 65 ，故认为有效，而愿意接受 针灸及中草药治疗。故根据月经周期，辩 证应用中草药与针灸，每周一诊。三月后雌激素升至 165，且月经隔月一次。 共经 11 个月治疗，使月经规律，受孕，顺产一子，健康；哺乳八个月。停哺 后，月经规律；产后18个月复孕。 14 Case 2: Infertility caused by the early failure of ovaries Mrs. J W, 29 years old, who is a researcher in PHD degree, has irregular menstruation for all of her life. She has to take oestrogen pills to give her regular periods. After her marriage, she wanted to become pregnant, but she has not had her period for more than two years after she stops her oestrogen pill. Her oestrogen level: < 50. So she was diagnosed as an early failure of ovaries. Present symptoms: depression, insomnia, nervous, restlessness etc. As a medical researcher, she initially did not have much confidence in TCM. After trying acupuncture weekly at first, then patent herbs being added for three months, she found that her oestrogen level increased to 65. Therefore, she wanted to continue TCM treatment. I changed her treatment from patent herbal form to dry herbal prescription and continued her weekly acupuncture. Her oestrogen level had increased to 165 after three months and she had her period every other month. Until being pregnant, she had been using TCM for eleven months. She delivered a health baby boy on term and gave eight months of breast-feeding. She started her regular period, and then she had another pregnancy the natural way 18 months after her first child.
病例二的中医治疗（大略）： TCM treatment on case 2: 中医辨证：肾阳早衰，气滞血瘀。Differentiation syndrome: Ki Yang collapse, Qi stagnation and blood stasis， 治疗原则：温补肾阳，行气化瘀 Treating Principle: to warm strengthen Ki Yang, to remove stagnated Qi and stasis blood 针灸：灸神阙，百会， 关元，气海，归来，阴陵泉，三阴交，阴谷，太溪， 然谷，外关，足临泣。 Acupuncture: Mox at Ren 8, Du 20, Ren 4, 6, St 28, Sp 9, 6, Ki 3, 2, Sj 5, Gb 41 中药：艾叶 10 g、仙茅10 g、淫阳霍15~30 g、熟地黄15 -30， 何首乌10 g、 当归 10 g、赤芍10 g、菟丝子 10 g, 紫石英 10 g、 川芎10 g、香附10。 经间期加桃仁10 g、红花 10；经前期加柴胡 10 g、乌药 10 g。 Herbal prescription: Aiye 10, Xianmao 10, Yinyanghuo 15 -30, Shudihuang 15 -30, Danggui 10, Chishao 10, Tusizi 10, Zishiying 10, Chuanxiong 10, Xiangfu 10. Plus Taoren and Honghua in the secondary week; Chaihu and Wuyao before period. 15
三 中医针药人 周期治效验案： 3. Case studies 例三：多囊卵巢综合症导致不孕： Mrs H Webb 34岁，医务人员。月经不调5 -6 年，时常停经，多则 2 -3 个月无月经，已诊为 多囊卵巢综合征．经针灸与中成药人 周期治 疗，致月经规律，而受孕。顺产一男婴；两年 后，希再孕未果，经针灸与中成药少助而复孕。 16 Case 3: Infertility caused by Polycystic Ovary: Ms H W, 32 years old, who is a medical researcher, had an irregular menstruation for five to six years. Amenorrhea occurred sometimes, which always lasts 2 – 3 months. She was diagnosed with polycystic ovary syndrome. She was given regular acupuncture and patent herbs until her period became regular. Then she conceived and delivered a health baby boy. After two years, she had another pregnancy with similar TCM support.
病例三的中医治疗：TCM Treatment on case 3: 中医辨证：脾肾气阳两虚，血瘀胞宫。Differentiation Syndrome: Both Qi & Yang Dif. on Sp & Ki, blood stasis in the uterus. 中医治法：健脾补肾，温宫化瘀。Treating Principle: to strengthen Sp & Ki; to warm and to melt the stasis in the uterus. 针灸：灸神阙，百会，风池，肝俞，脾俞，肾俞，命门，八寥，三阴交， 照海，然谷，外关，足临泣。 Acupuncture: Mox at Ren 8, Du 20, Gb 20, Bi 18, 20, 23, 31 -35, Du 4, Ki 6, 2, Sj 5 and Gb 41 中药：乌鸡白凤丸和逍遥丸于前两周；金匮肾气丸和柴胡疏肝丸于后两周。 Patent herbs: Wujibaifeng Wan and Xiaoyao Wan in the first two weeks; Jinguishenqi Wan and Chaihushugan Wan in the secondary two weeks. 17
三 中医针药人 周期治效验案： 3. Case studies 例四： 子宫内膜异位症导致不孕，且IVF失败： Mrs C Wardle 29岁， 银行职员。因子宫内膜 异位症而致痛经，经IVF治疗两次，均未成功 而求诊。应用针灸／周，加中成药人 周期， 先促身体恢复，改善痛经，继尔自然受孕，足 月顺产一女。 18 Case 4: Infertility caused by endometriosis, with IVF failed. Mrs. C W, 29 years old, who is a clerk, suffered from endometriosis, which caused dysmenorrhoea. After failing IVF twice, she was seeking the help from TCM. Regular acupuncture and patent herbal medicines were given to help her completely recover from IVF and release her dysmenorrhoea. Then she successfully conceived and delivered a baby girl.
病例四的中医治疗：TCM treatment on case 4 中医辨证：肝郁气滞，血瘀胞宫。Differentiation Syndrome: Liv Qi Stagnation and blood stasis in the uterus 中医治法：疏肝理气，化瘀通滞。Treating Principle: to disperse stagnated Liv Qi and to inspire blood circulation 针灸：百会，关元，气海，水道，外关，足临泣，阴陵泉，三阴交，阳陵泉，太溪， 然谷。每周 1次。 Acupuncture: Du 20, Ren 4, 6, St 29, Sj 5, Gb 41, 34, Sp 9, 6, Ki 3, 2 once weekly. 中药：前两周服逍遥丸和桃红四物丸；后两周服柴胡疏肝丸和八珍益母丸；于经期 服痛经宝颗粒。 Patent herbs: Xiaoyao Wan and Taohongsiwu Wan in the first two weeks; Chaihushugan Wan and Bazhenyimu Wan in the secondary two weeks. 说明：此例虽被诊为子宫内膜异位症，但是经过西医妇科腹腔镜治疗，两次IVF仍未取效。经中 医针药活血化瘀，以及促孕周期治疗，而获效。 19
三 中医针药人 周期治效验案： 3. Case studies 例五：泌乳素过高导致习惯性流产： Mrs C Franks 35 岁，秘书．三年内三次流产，被发 现泌乳素（Prolactin）过高．西医生认为：仅泌乳素 过高，一般与过于焦虑有关，不宜激素调整治疗。故 由妇产科专科医生转诊于余。 就诊时刚刚流产后，忧虑，抑郁，委屈，腹痛， 失眠； 西医复诊出，双侧卵巢囊肿，且腹腔镜取出卵巢囊肿。 经针灸，中药促进机体恢复后，进行促孕治疗。半年 后自然受孕，且继续保胎治疗，预防流产，足月而顺 产一女。 20 Case 5: Habitual miscarriages caused by excessive prolactin. Mrs. C F, 35 years old, who is a secretary, has had three miscarriages during last three years. She had a high prolactin level. The gynaecological consultant believed that the excessive prolactin may be related to stress. She was not fit to accept hormonal treatment, so she was referred to try alternative and complementary treatment. Present symptoms: During the first two to three days after her last miscarriage, she felt stressed, depressed, weepy, had insomnia and abdominal pain. Another ultrasound examination found multiple cysts on both of her ovaries, which were removed with a laparoscope. I used acupuncture and herbal medicine to help her recover and support pregnancy. She has conceived in a half year and continues to accept treatment for foetal protection. She had a baby girl when she arrived full term.
病例五的中医治疗: TCＭ Treatment on Case 5 中医辨证：肝郁气滞，气虚血瘀。Differentiation Syndrome: Liv Qi stagnation, Qi difficiency with blood stasis. 中医治则：舒肝理气，活血养血。Treating Principle: to inspire Liv Qi and blood, and to nourish blood 针灸：灸神阙，百会，神庭，关元，气海，子宫，阳陵泉，血海，阴陵泉，三阴交， 内关，合谷，太溪，太冲。 Acupuncture: Mox at Ren 8, Du 20, 24, Ren 4, 6, Zigong, Gb 34, Sp 9, 6, P 6, Li 4, Ki 3, and Liv 3 中药：初用加味逍遥丸和人参归脾丸；情绪稳定后进行中药加强周期的治疗，前两 周给以加味逍遥丸和知柏地黄丸，后两周给以加味逍遥丸和六味地黄丸，每晚（ 四周）加服调经促孕丸 1袋。 Patent herbs: Using Jiaweixiaoyao Wan and Renshenguipi Wan until her emotion calming down; then menstrual promoting with Jianweixiaoyao Wan and Zhibaidihuang Wan in the first two weeks; Jianweixiaoyao Wan and Liuweidihuang Wan in the secondary two weeks. Tiaojingcuyun will be added in every evening. 21
三 中医针药人 周期治效验案： 3. Case studies （二）中医针灸辅导IVF 成功案例： 3. 2. TCM supporting IVF: 例一：IVF 三次失败；经TCM成功相助，IVF成功，使一次妊 产二女，一子。 Mrs T Flatcher 27岁， 训练员．婚后五年试孕不效．西医 诊出左侧卵巢囊肿及输卵管堵塞，其丈夫精子内带抗体．就 诊前接受IVF，取卵后，无法受精．腹腔镜手术取出囊肿， 但被告双侧输卵管堵塞，不能通释． 夫妻双双接受中医 治疗，妻子规律针灸，及中药浓缩粉促 周期治疗；丈夫仅用中成药调治精子异常．两年后，第四次 IVF ，成功受孕，并刨腹产二女一男，三个健康婴儿。 22 Case 1: After three times of failed IVF, a successful pregnancy with triplets with support by TCM. Mrs. T F, 27 years old, who is a trainer, had no result when she tried to become pregnant for more than five years. She was diagnosed with a blockage on her left fallopian tube and cysts on her left ovary. Her husband was found having some antibodies in his sperm, which cannot fertilize his wife’s egg. A laparoscopy has been done to take the cysts away, but she was told both of her fallopian tubes being blocked, . The couple both received TCM treatments. The husband took some patent herbs for improving his sperm condition; the wife used regular acupuncture and concentrated herbal powders for making a regular menstrual cycle. After two years of treatment, she had her fourth IVF with a successful multiple pregnancies and had a caesarean to have two girls and one boy, all in healthy conditions.
病例六的中医治疗：TCM treatment on Case 6: 中医辨证: 肝郁血瘀 Differentiation Syndrome: Liv Qi stagnation with blood stasis 中医治则：舒肝理气，活血化瘀。Treating Principle: to inspire Liv Qi and blood, to disperse the stasis 针灸：灸神阙，百会，气海，关元，子宫，外关，合谷，足三里，三阴交，太溪，照海， 太冲。 Acupuncture: Mox at Ren 8, Du 20, Ren 4, 6, Zigong, Sj 5, Li 4, St 36, Sp 6, Ki 3, 6, Liv 3 中药浓缩粉：柴胡 10 g、香附10 g、枳壳 10 g、赤芍10 g、川芎10 g、当归 10 g、益母草10 g、 莪术 10 g、王不流行10 g、桃仁10 g、红花 10 g；经后加女贞子 10 g、何首乌10 g；排卵 期加用 3天痛经宝颗粒；排卵后加白芍10 g、阿胶 10 g。 Herbal powders: Chaihu 10, Xiangfu 10, Zhiqiao 10, Chishao 10, Chuanxiong 10, Danggui 10, Yimucao 10, Ezhu 10, wangbulixing 10, Taoren 10, Honghua 10. Heshouwo 10 and Nvzhenzi are added after period, Tongjingbao is added around of ovulation, Baishao and Ejiao 10 are added after ovulation. 丈夫用中成药柴胡疏肝丸与五子衍宗丸调治精子异常。 Chaihushugan Wan and Wuziyanzong Wan are given to her husband to strengthen his sperm. 23
三 中医针药人 周期治效验案： 3. Case studies 例二：近更年，而经中医成功相助IVF而妊产一子： Mrs S Moghul 49岁，教师．23 岁时曾妊娠，40 天而难免 流产，其后一直未孕。40岁之后，甚期有子，而遍查遍治 ．被发现双侧输卵管堵塞，已经两次IVF未效，故希中医以 助．届时已近 49 岁。疲惫，焦虑，耳鸣，并开始有潮热， 闭经等症（曾闭经 2 个月，经治复来)． 给予针灸及中药 调整内分泌，健脾补肾半年余，再次IVF 而成功，年底顺 产一子。 24 Case 2: A woman who is near menopause has been supported by TCM to have a boy through IVF. Mrs. S M, 49 years old, is a teacher. She was pregnant when she was 23 years old, but had a miscarriage in 40 days. She had never been conceived again since then. After she was 40 years old, she started to worry about her reproductive function and sought diagnosis and treatment. She had blockage on both of her fallopian tubes and failed two times with IVF. She visited me when she was 49 years old after missing her menstruation for two months. She also had exhaustion, hot flashes, depression, tinnitus, insomnia, and other symptoms. After a half year of TCM treatment, with tonification of kidney and spleen to regulate her hormones, she restarted her period and all the symptoms disappeared. Then she had a healthy son with a successful IVF.
病例七的中医治疗：TCM Treatment on Case 7: 中医辨证：肾阴不足，肝郁脾虚。Differentiation Syndrome: Ki Yin Def, Liv Qi Stagnation and Sp Qi def. 中医治则：健脾补肾，疏肝养阴。Treating Principle: to strengthen Sp and Ki, to disperse Liv Qi and to nourish Yin 针灸：灸神阙，百会，神庭，关元，气海，归来，合谷，太冲，阴谷，太 溪，然谷，三阴交，足三里。 Acupuncture: Mox at Ren 8, Du 20, 24, Ren 4, 6, St 29, Li 4, Liv 3, Ki 10, 3, 2, Sp 6 and St 36 中药：知柏地黄丸和加味逍遥丸； 月经复至后，用周期法治疗, 调整与稳定雌激素水平，健脾补肾以促孕。 Patent herbs: using Zhibaidihuang Wan and Jiaweixiaoyao Wan until the period coming back; a menstrual promoting treatment for maintaining and consolidate her hormonal level. 25
结论: Conclusion: 规律针灸及中药调整月经周期是治疗异常月经，促孕的有效方法 ， 不仅可以协助妇女正常受孕，同时可以通过改善机体的功能状态，调治 妇女的激素水平，而大大提高IVF 的成功率。 Supporting the menstrual cycle and inducing ovarian cycle with regular acupuncture and herbal medicine is an effective therapy for female infertility. Not only is it able to support females conceiving, by improving their reproductive function; raising hormonal levels and harmonizing the whole system; it also raises the success rate of IVF. By a way of analogy: acupuncture and herbal treatment function like ploughing which makes the seeds easier to implant. If a patient is in a good general and local condition, she will also easily conceive in a natural way, or with the help of IVF etc. 26
![参考文献：Reference: [1] C Kingsland. Infertility[M]. Cambridge UK: Organon Laboratories, 2000: 1 -9. [2] 夏桂成.](https://present5.com/presentation/49a28239b2b82a0a6f959f7fa2356e8d/image-27.jpg "参考文献：Reference: [1] C Kingsland. Infertility[M]. Cambridge UK: Organon Laboratories, 2000: 1 -9. [2] 夏桂成.")
参考文献：Reference: [1] C Kingsland. Infertility[M]. Cambridge UK: Organon Laboratories, 2000: 1 -9. [2] 夏桂成. 不孕不育与月经周期调理[M]. 北京: 人民卫生出版社, G Xia Infertility and Menstrual regulation, People Health Publishing House. 2001: 115 -133, 161 -210. [3] 董自强. 不育症验方精粹[M]. 北京: 北京科学技术出版社, Z Dong Experienced formula on Infertility Beijing Publishing House on Science and Technology 1990: 85 -135. [4] Adam Balen. Ovulation Induction[M]. Cambridge UK : Organon Laboratories, 2000: 7 -11. [5] 任长征, 李广文. 性腺轴激素含量变化与肾虚不孕症发病关系的研究[J]. 山东中医药大学学 报，C Ren and G Li Research on the relationship between the Hormonal Containing in the sexual Axis and infertility caused by Ki. def. Journal of Shandong Univ of TCM 1993 , 17 （3）: 33 -35. [6] 汤淑兰 中医调周法治疗原发性不孕，注册中草药学会会刊; S Tang The menstrual regulation of TCM treats Primary Infertility <Newsletter> RCHM, 1999， 12; [7] 江丹. 多囊卵巢及多囊卵巢综合征的中医辨证与治疗. 英国中医药学会会刊，TCM treatment on Polycystic Ovary and PCOS, Vol 17 No 1, P 11 -16 [8] 毛美蓉，张海峰. 活血消痰、软坚散结法治疗子宫内膜异位症65例的临床试验与研究[J]. 天津 中医学院学报, M Mao and H Zhang Clinical and tested study on 65 Cases of Endometriosis treated with the Method of Inspiring blood and removing phlegm, Journal of Tianjing Univ of TCM 1993, 12（1）： 8 -10. 27
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Some research which I am involved on Infertility recently--Acupuncture Improve the outcome of IVF European Journal of Integrative Medicine 4 (2012) e 234–e 244 Does acupuncture improve the outcome of in vitro fertilization? Guidance for future trials Universally Available Fan Qua, b, 1, Jue Zhouc, b, 1, Mark Boveyd, Giovanna Franconie, Kelvin Chanf, Caroline Smithf, Dan Jiang, Nicola Robinsoni, , Abstract Introduction The comprehensive review was to appraise the current evidence from both randomized and non-randomized trials by using both Chinese and western databases and to highlight the issues which could guide future trial design. Many infertile couples have chosen acupuncture as an adjunct when they undergo in vitro fertilization (IVF) or intra cytoplasm sperm injection (ICSI) treatment. More than forty trials have emerged since the first clinical research published in 1999 explored the effects of acupuncture on the outcomes of IVF. However, the current evidence makes it 29
与国内中医药科研团队的合作研究----知柏地黄丸纠正更年期综合症的临床 学研究Co-operated research with research team in China----Clinical Trail on ZBDIH Wan in Relieving Menopausal Symptoms. Journal of Complementary medicine in press Zhi-Bai-Di-Huang-Wan, a classic Chinese medicinal formula in relieving menopausal symptoms: a multi-centre, randomized and controlled trial from UK and China Dan Jiang 1* , Jian-Hong Zhou 2*, Jue Zhou 3 , Ying-Er Gu 2, Dong-Xia Yang 4, Qing Weng 5, Bing Wang 2 , Fang Yu 2 , Fan Qu 1** Abstract Objective: To explore the effects of Zhi-Bai-Di-Huang-Wan (ZBDHW), a classic formula of Chinese medicinal herbs in relieving menopausal symptoms in British and Chinese women. Methods: Between May 2011 and May 2013, 224 Chinese and British women were blinded to randomization into a ZBDHW group with 115 cases and a control group with 109 cases. The Clinical menopausal symptoms were assessed by the modified Kupperman Index Scale. 30
关于《中医在肿瘤康复治疗中作用的探讨与分析》论文即将发表 The Role of Chinese Medicine in Cancer Care—a critical review (Graphical Summary to Journal of Traditional and Complementary medicine in press) 31
谢谢 Thank You 32
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