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Clinical experience of Jinjiling to treat infertility complicated with
endometriosis
Written by Zhaoke, Translated by Hu Xiaohua
Endometriosis is a gynecologic common disease which incidence shows rising
trend gradually. This disease is onset commonly in child bearing period and is easy to cause infertility. According to the records, 30%-50%
of infertility cases are complicated with endometriosis, while 30%-50%
of endometriosis cases develop into infertility. It can be concluded that
endometriosis is closely related with infertility. There is not a unified
therapy for infertility complicated with endometriosis in modern medicine
until now, it is treated by expectant treatment usually. For the middle and
severe cases, drugs and operation are
used. Actually, the above therapies do not be accepted by the patients easily. Professor Jinjiling who has accomplishments in TCM gynecology,
and has learned
after Professor Xiaguicheng, a famous specialist of TCM gynecology.
Jinjiling concluds TCM therapy methods on infertility complicated with
endometriosis from her clinical experiences of more than 40 years, which has
strong clinical effect on this disease.
1. Reinforcing kidney and activating blood, dealing with both root cause and
symptoms. Professor Jin concluded that pathogenesis of this disease lies in
kidney deficiency and blood stasis. The onset of infertility is related with
kidney closely for kidney dominating reproduction. Kidney is the mother of qi and blood, kidney-yang deficiency induces failure of warming blood,
kidney qi deficiency induces failure of blood transportation, both of the
factors induce
blood stasis syndrome. Blood stasis is not only a pathogenic factor, but
also a pathological product. So kidney deficiency is the root and blood
stasis is the branch, it is characterized by root deficiency and
branch excess. So reinforcing kidney and activating blood are the best
therapy. Kidney-reinforcing with herbs for activating blood and removing
stasis is
used in non-menstrual period, and removing stasis is used in menstrual
period.
In non-menstrual period, basic prescription is Jiawei Guizhi Fuling Pill
(Cassia twig, Poria cocos, Peach kernel, Cortex moutan, Peony, Sparganium,
Zedoary turmeric, Chinaberry fruit, Rhizoma corydalis, Salvia, Prunella
vulgaris and Santsigu tuber.), added herbs of reinforcing kidney.
In menstrual period, basic prescription is Tongjingning (Trogopteroum feces,
Pu-huang, root of dahuriae angelica, Myrrh, Cyperus rotundus, Rhizoma
corydalis, Asarum, Radix auckladiae, Angelica sinensis,
Rhizomaligusticichuanxiong, Fructus Evodiae , etc. ).
2. Regulating menstrual cycle
In 1980s, Professor Jin put forward that both Waning-Waxing Change and
transformation of
kidney yin-yang are onset in
menstrual cycle . Regulating yin and yang can be helpful to recover
ovulation and luteal function, improve regulative mechanism to balance
yin-yang. In menstrual cycle, Activating blood and removing stasis,
reinforcing kidney and nourishing blood should be used, the
prescription is Guizhi Fuling Pill, modified with the herbs of warming the
kidney-yang, such as Barrenwort, Japanese teasel, Dodder, Fluoritum, Antler
glue ,etc. Modern medicine reports that ovarian dysfunction and dysimmunity
can cause infertility complicating with endometriosis, except mechanical
factors. So reinforcing kidney can improve immune, regulate the function of
ovary to be pregnant easily.
3. Internal and external treatment, regulating emotion.
Professor Jin developed many methods of internal and external treatment.
(1) Retention enema and electricion introduction ：Concentrated decoction
100ml, extracting medical solution with empty needle tube，36oC
to 40oC,
inserting catheter into anus with 10-15cm, injecting the solution into
intestine slowly. And then placing the positive and negative electrode of
the direct current electrizer on the abdomen and lumbosacral region within
the tolerance of threshold. 20min per time, once a day, stopping in
menstrual cycle, 10 days one session,
(2) Posterior fornix compress: for the cases of vaginal posterior fornix
nodules, Mixing Qili San with yellow rice wine into paste, putting on a
cotton ball and pasting on the nodule every other day, stopping in menstrual
cycle, one month one session.
(3) Hot medicated compress with herb charge: For the myometrial gland cases
and chocolate cyst, Xiaoyu San (Homalonemae rhizoma 20g, Pubescent angelica
20g, Acanthopanax Gracilistylus20g, Radix saposhinikoviae 20g, Blood resin
20g, Safflower 20g, Angelica sinensis 15g, Olibanum 15g, Myrrh15g, Red peony
root 15g, Root of Dahuriae Dngelica 15g, Zhuidifeng 30g, Herba Speranskiae
Tuberculatae 30g, by levigation ), encapsulating it with gauze and steaming
it 20 min, hot medicated compress on lower abdomen, 0.5h per time, once a day,
stopping in menstrual cycle, one month one session.
Rectum and colon can absorb the medical solution directly into pelvic tissue
through retention enema and electricion introduction, which can make local
focus maintains higher drug concentration, promoting local qi-blood
circulation, and improving microenvironment in pelvic cavity directly. The
actions of Qili San are activating blood and removing stasis, detumescence
analgesic. Compress Qili San on the lesion site, it has penetrating power,
fast effect and the efficacy of drug playing directly, which is benefit to
dissipate local nodules.
Local hot medicated compress by Xiaoyu San composed by herbs of activating
blood and removing stasis, which makes the herbs penetrating skin from
exterior to interior , transmitting into viscera and lesion site, dredging
meridians, warming middle-jiao to dispel cold, regulating qi movement,
relieving pain and swelling, , improving absorption of hematoma and
masses, external treatment can eliminate lesions and increasing pregnant
chances.
Dysmenorrhea caused by endometriosis(EMs) makes the patients sense fear for
severe pain. Mental pressure can aggravate pain to induce vicious circle.
Sterile Couples feel excessive anxiety to decrease pregnant chances, so
psychological guide should be combined with internal and external treatment,
encouraging the patients relaxing.
4. Case sample:
Tang, first visited on March, 2006, and had been diagnosed bilateral
chocolate cyst by B Supersonic Wave for 1 week.
Bilateral laparocystectomy has been done in 2004 for bilateral ovarian
chocolate cyst, and he has been diagnosed bilateral ovarian chocolate cyst again
before one week . 30 days for one menstrual cycle, 7 days for one menstrual
period. Menstrual amount was normal with dark red color, blood clots, lower
abdominal distensile pain, the ast menstruation was on Feb. 20, 2006,
2-year non-pregnancy without contraception.
Treatment:
Reinforcing kidney and activating blood.
Prescriptions:
Jiawei Guizhi Fuling Pill.
Modifying with the herbs of reinforcing kidney and nourishing blood to warm
kidney-yang, the herbs of activating blood and removing stasis were used in
menstrual period. And in non-menstruation, retention enema and electric ion
introduction were used.
After 4- menstrual-cycle treatment, the patient was pregnant. |
