| Object iveOn the basis of systematic review on the recent20years'clinical research literature about aciesis treatment with TCM Cycle Therapy, this thesis discusses the syndrome differentiation laws, the medication regulations for each syndrome type and phase and the curative efficacy from the holistic angle of syndrome, therapy, prescription and medicine.MethodsCollect the literature about aciesis treatment with TCM Cycle Therapy from CNKI, CBM disc, VIP database, WANFANG Data, Pubmed, Hong Kong University Library and Hong Kong Central Library dated from January1990to December2010. Classify the literature according to the aciesis types. Conduct the quality analysis about the literature and classify them into three groups:good quality group, medium quality group and poor quality group. Standardize the data about treatment principle and method, representative prescription and medicine, etc. and establish a database to summarize and compare the treatment principles and methods, representative prescriptions, medicine and curative efficacy of TCM Cycle Therapy for aciesis of different types at different phases of menstruation cycle.Results:1. Treatment Principle and Method for Different Types of Aciesis at Different Phases(1) For aciesis due to ovulation difficulties:the postmenstrual treatment is mainly to nourish yin and blood, reinforce the kidney and vital essence and nourish the kidney and sooth the liver; the intermenstruum treatment is mainly to warm yang and nourish yin, reinforce the kidney and qi as well as invigorate blood circulation and the collaterals so as to promote the ovulation; the premenstrual treatment is mainly to reinforce the kidney and warm yang, nourish yin and the vital essence as well as replenish qi and blood. In this phase, for aciesis due to luteal phase defect, soothing the liver and relieving the qi stagnation are required besides reinforcing kidney and warming yang; for aciesis due to polycystic ovarian syndrome, eliminating dampness, reducing phlegm and removing blood stasis is further required besides warming collaterals and invigorating blood circulation.(2) For aciesis due to pelvic cavity factors, invigorating blood circulation and removing blood stasis is the major therapy which is the focus for four phases. Reinforcing kidney qi is added during the postmenstruation phase; regulating qi and activating channels for intermenstruum phase; reinforcing kidney and warming yang for the premenstruation phase; relieving depression by soothing liver and reinforcing the kidney qi to regulate menstruation for the menstruation phase.(3) For immune aciesis, reinforcing spleen and kidney and replenishing qi and blood are required for the postmenstruation phase; balancing yin and yang for intermenstruum phase; replenishing kidney yang and nourishing kidney and spleen for premenstruation phase; warming collaterals, nourishing and invigorating blood and regulating menstruation for menstruation phase.2. Representative Formulae for Different Phases of Different Types of Aciesis(1) Aciesis due to Ovulation DifficultiesThe representative prescriptions for the postmenstrual type of kidney deficiency are Kidney-yin Reinforcing Pill, Decoction of Glossy Privet Fruit, I'clipta and Rehmannia, Five Seeds Combo Pills, Ten-ingredient Reinforcing Yin Decoction, Kidney-yin Reinforcing Pill of Chinese Angelica and Red Peony, Eight-gem Decoction, Pill of Six Ingredients with Rehmannia, Golden-chamber Kidney-qi Pill, Decoction for Warming Channels, etc; the representative prescription for phlegmatic dampness is Atractylodes and Cyperus Phlegm-abducting Pill; the representative prescription for liver-qi stagnation is Conceptive Decoction by Soothing the Liver; the representative prescription for qi and blood deficiency is Six-five-four-two Composition.The representative prescriptions for the intermenstruum type of kidney deficiency are Kidney-yang Reinforcing Decoction, Kidney-yin Reinforcing Pill of Chinese Angelica and Red Peony plus Glossy Privet Fruit and Eclipta Pill; the representative prescription for phlegmatic dampness is Conceptive Decoction by Removing Phlegm; the representative prescriptions for liver stagnation are Decoction for Nourishing the Liver and Kidney plus Decoction for Eliminating Pathogenic Heat from Liver; the representative prescriptions for qi and blood deficiency are Decoction for Reinforcing Middle-warmer and Replenishing Qi and Spleen-invigorating Decoction.The representative prescriptions for the premenstruation type of kidney deficiency are Decoction for Warming Channels with Curculigo and Epimedium, Conceptive Pill, Decoction for Soothing the Belt Channel, Bing Ti Decoction for Replenishing Kidney Qi, Spleen and Stomach (Fu Qing-Zhu's Obstetrics and Gynecology), Pill of Anemarrhena, Phellodendron and Rehmannia plus Powerfully Tonifying Pill, Miscarriage Prevention Bolus, Pill of Argyi Leaf and Cyperus for Nourishing Yin (Synopsis of Treating Women's Diseases); the representative prescription for phlegmatic dampness is Decoction with Two Old Drugs for Relieving Stagnancy; the representative prescription for liver stagnation is Ease Powder Added with Moutan Bark and Cape jasmine Fruit; the representative prescription for qi and blood deficiency is modified Conceptive Pill.The representative prescriptions for the type of kidney deficiency during menstruation are Motherwort Decoction, Decoction for Dissipating Blood Stasis in Lower Abdomen and Peach Kernel and Safflower Decoction of Four Ingredients; the representative prescriptions for the type of phlegmatic dampness are Pill for Relieving Stagnancy, Pill for Opening the Uterus and Five-flavor Powder for Regulating Menstruation; the representative prescriptions for the type of liver stagnation is Ease Powder; the representative prescriptions for the type of qi and blood deficiency are Peach Kernel and Safflower Decoction of Four Ingredients, Wonderful Powder for Relieving Blood Stagnation, Decoction for Reinforcing Middle-warmer and Replenishing Qi, Decoction with Six Ingredients Including Costus and Amomum and Spleen-invigorating Decoction.(2) Aciesis due to Pelvic FactorsThe representative prescription for the postmenstrual type of kidney deficiency and blood stagnation is Kidney-qi Pill plus Peach Kernel and Safflower Decoction of Four Ingredients; the representative prescription for the qi and blood stagnation is Decoction for Removing Blood Stasis; the representative prescription for the qi deficiency and blood stagnation is Decoction for Regulating the Function of the Middle-Warmer plus Eight-gem Decoction; the representative prescription for the phlegm and blood stagnation is Cinnamon Twig and Poria Pill plus Spleen-invigorating Decoction; the representative prescriptions for the blood stagnation due to cold accumulation are Decoction for Warming Channels and Wonderful Powder for Relieving Blood Stagnation.The representative prescription for the intermenstruum type of kidney deficiency and blood stagnation is Decoction of Curculigo and Epimedium; the representative prescription for the qi and blood stagnation is Blood-mansion Stasis-dispelling Decoction; the representative prescription for the qi deficiency and blood stagnation is Blood-mansion Stasis-dispelling Decoction plus Decoction for Reinforcing Middle-warmer and Replenishing Qi; the representative prescription for the phlegm and blood stagnation is Cinnamon Twig and Poria Pill plus Tangerine Seed Pill; the representative prescription for the blood stagnation due to cold accumulation is Decoction for Dissipating Blood Stasis in Lower Abdomen. The representative prescriptions for the premenstruation type of kidney deficiency and blood stagnation are Spleen-invigorating Decoction and Kidney-qi Pill; the representative prescription for the qi and blood stagnation is Conceptive Decoction by Soothing the Liver; the representative prescription for the qi deficiency and blood stagnation is Decoction for Reinforcing Middle-warmer and Replenishing Qi; the representative prescription for the phlegm and blood stagnation is Decoction with Two Old Drugs for Relieving Stagnancy; the representative prescription for the blood stagnation due to cold accumulation is Argyi Leaf Decoction for Warming Uterus plus Kidney-qi Pill.Decoction for Dissipating Blood Stasis in Lower Abdomen or Peach Kernel and Safflower Decoction of Four Ingredients is adopted for each type during menstruation, except that for phlegm and blood stagnation, Atractylodes and Cyperus Phlegm-abducting Pill can be added.(3) Immune Aciesis3. The TCM Cycle Therapy for aciesis involves152varieties of herbal medicine, belonging to16categories. The most frequently used are tonifying-deficiency medicine (46varieties) used3286times; the second are medicine for invigorating blood circulation and removing blood stasis (29varieties) used1205times; the third are medicine for eliminating fever (15varieties) used330times. The common medicine for aciesis are mainly to replenish kidney and blood, invigorate blood circulation and relieve blood stasis, eliminate fever and cool blood, warm the internal to dissipate coldness and regulate qi and menstruation. They are mainly bitter, sweet, and pungent in flavor and warm or mild warm in nature. Medicines of bitter and sweet flavor are of the largest number, accounting for32.52%respectively. Medicines with bitter flavor are mainly for invigorating blood circulation and removing blood stasis, eliminating the fever and regulating qi. Medicines with sweet flavor are mainly for tonifying deficiency. Medicine of pungent flavor takes the second place, accounting for19.90%, including mainly the medicine for invigorating blood circulation and removing blood stasis, regulating qi and warming the internal. Medicine of salty flavor takes the third place, accounting for8.74%, including mainly the medicine for invigorating blood circulation, removing blood stasis and tonifying deficiency. About the attributive channels, medicine acting on the liver channel takes the largest percentage, accounting for29.81%of the total which is mainly for invigorating blood circulation, removing blood stasis and reinforcing yang. Medicine acting on the kidney channel takes the second place, accounting for23.40%which is mainly for reinforcing yang and nourishing yin. Medicine acting on spleen channel takes the third place, accounting for18.11%which is mainly for regulating qi, invigorating blood circulation, removing blood stasis and reinforcing qi.4. Summarizing the herbal medicine in the original prescriptions for aciesis of different types, the author ranks the first21according to the frequency of usage:angelica, cuscuta seed, prepared rhizome of rehmannia, nutgrass galingale rhizome, white peony root, Chinese yam, herba epimedii, barbary wolfberry fruit, szechwan lovage rhizome, radix salviae miltiorrhizae, glossy privet fruit, paeoniae radix, radix dipsaci, red osier, hoelen, morinda root, flos carthami, eupatorium, rhizoma curculiginis, Motherwort, radix achyranthis, etc. According to the usage frequency in different cycles, the author ranks these21frequently used herbal medicines as follows:(1) Postmenstrual phase:angelica, prepared rhizome of rehmannia, cuscuta seed, Chinese yam, glossy privet fruit, white peony root, barbary wolfberry fruit, red osier, herba epimedii, nutgrass galingale rhizome.(2) Interstruum phase:angelica, cuscuta seed, radix salviae miltiorrhizae, prepared rhizome of rehmannia, nutgrass galingale rhizome, flos carthami, herba epimedi, paeoniae radix, szechwan lovage rhizome, eupatorium.(3) Premenstruation phase:cuscuta seed, angelica, prepared rhizome of rehmannia, herba epimedii, radix dispaci from Sichuan of China, Chinese yam, white peony root, barbary wolfberry fruit, rhizome curculiginis, morinda root.(4) Menstruation phase:angelica, nutgrass galingale rhizome, szechwan lovage rhizome, Motherwort, paeoniae radix, radix salviae miltiorrhizae, eupatorium, prepared rhizome of rehmannia, cuscuta seed.4. It is observed that the pregnancy rates are62.16%,61.14%,58.08%and55.51%respectively for aciesis due to luteal phase defect, aciesis due to ovulation difficulties, aciesis due to premature ovarian failure/hypovaria, aciesis due to polycystic ovary, etc. The pregnancy rates are51.71%,39.39%and43.64%respectively for aciesis due to adenomyosis, aciesis due to salpingemphraxis, and aciesis due to immune factors. The pregnancy rates of different types of aciesis are superior to those of the Control Group and there's significant difference (P<0.05). The efficacy of TCM Cycle Therapy in the treatment of aciesis due to ovulation difficulties is superior to those due to pelvic or immune factors. Among all types of aciesis, TCM Cycle Therapy has better curative effect for aciesis due to luteal phase defect and ovulation difficulties, while it has poor effect for aciesis due to salpingemphraxis.Conclusion1. TCM Cycle Therapy has good curative effect for all types of aciesis. It is observed that the pregnancy rates are62.16%,61.14%,58.08%and55.51%respectively for aciesis due to ovulation factors, including luteal phase defect, ovulation difficulties, premature ovarian failure/hypovaria, and polycystic ovarian syndrome, etc. The pregnancy rates are51.71%and39.39%for aciesis due to pelvic factors including adenomyosis and salpingemphraxis. The pregnancy rate is43.64%for aciesis due to immune factors. The pregnancy rates of different types of aciesis are superior to those of the Control Group and there's significant difference (P<0.05).2. The most frequently used herbal medicines in the postmenstrual, intermenstruum, premenstrual and menstruation phases with TCM Cycle Therapy are listed as follows: Postmenstrual phase:angelica, prepared rhizome of rehmannia, cuscuta seed, Chinese yam, glossy privet fruit, white peony root, barbary wolfberry fruit, red osier Intermenstruum phase:angelica, cuscuta seed, radix salviae miltiorrhizae, prepared rhizome of rehmannia, nutgrass galingale rhizome, flos carthami, herba epimedi, paeoniae radix Premenstrual phase:cuscuta seed, angelica, prepared rhizome of rehmannia, herba epimedii, radix dispaci from Sichuan of China, Chinese yam, white peony root, barbary wolfberry fruit Menstruation phase:angelica, nutgrass galingale rhizome, szechwan lovage rhizome, Motherwort, paeoniae radix, radix salviae miltiorrhizae, eupatorium, prepared rhizome of rehmannia3. Unique features are demonstrated in the treatment of various types of aciesis at postmenstrual, intermenstruum, premenstrual and menstruation phases.Ovulation difficulties:nourishing yin and blood and replenishing kidney and vital essence are prescribed for postmenstrual phase; replenishing kidney and yang and invigorating qi and blood circulation for intermenstruum phase; nourishing kidney and yang and warming the uterus for the premenstrual phase; invigorating blood circulation, dissipating blood stasis and regulating qi and menstruation for menstruation phase.Luteal phase defect:nourishing kidney and blood and replenishing yang and vital essence are prescribed for postmenstrual phase; replenishing kidney, warming yang and invigorating blood circulation and collaterals for intermenstruum phase; nourishing kidney, soothing liver and warming the uterus for the premenstrual phase; soothing liver, invigorating blood circulation and regulating menstruation for menstruation phase.Polycystic ovarian syndrome:replenishing kidney and vital essence and nourishing yin and blood are prescribed for postmenstrual phase; invigorating qi and blood circulation, warming kidney and activating collaterals for intermenstruum phase; nourishing kidney and yang and warming the uterus for the premenstrual phase; eliminating dampness, dissipating blood stasis, invigorating blood circulation, and promoting menstruation for menstruation phase.Premature ovarian failure/hypovaria:warming kidney and vital essence and nourishing yin and blood are prescribed for postmenstrual phase; nourishing blood, invigorating blood circulation, and regulating Chong and Ren Collaterals for intermenstruum phase; warming kidney, reinforcing yang and replenishing kidney for the premenstrual phase; soothing liver, regulating qi, invigorating blood circulation and promoting menstruation for menstruation phase.Endometriosis:replenishing kidney and qi, invigorating blood circulation, eliminating blood stasis, soothing liver and activating collaterals are prescribed for postmenstrual phase; invigorating blood circulation, activating collaterals, soothing liver, regulating qi and eliminating blood stasis for intermenstruum phase; warming kidney, reinforcing yang and replenishing blood and invigorating blood circulation for the premenstrual phase; replenishing kidney, invigorating blood circulation, soothing liver, dispersing the depressed qi, removing blood stasis and eliminating tumor for menstruation phase.Salpingemphraxis:Invigorating blood circulation and dissipating blood stasis are the major therapy which is applied at the three phases except the postmenstrual phase. Nourishing yin and blood, reinforcing kidney and regulating menstruation are prescribed for the postmenstrual phase; invigorating blood circulation, dissipating blood stasis and activating collaterals for intermenstruum phase; invigorating blood circulation, dissipating blood stasis, replenishing kidney and yang, reinforcing qi and nourishing blood for premenstrual phase; soothing liver, regulating qi, dissipating blood stasis, activating collaterals, invigorating blood circulation and regulating menstruation for menstruation phase.Immune aciesis:replenishing spleen and kidney, invigorating blood circulation, nourishing blood and regulating Chong collateral to improve the immunity are prescribed for postmenstrual phase; replenishing kidney, nourishing blood and invigorating blood circulation to improve ovulation for intermenstruum phase; reinforcing kidney and yang, nourishing kidney and spleen, replenishing qi and blood and regulating qi for the premenstrual phase; warming collaterals, nourishing blood, invigorating blood circulation and regulating menstruation for menstruation phase. |
PDF Full Text Request