蔡小荪教授治疗子宫内膜异位症验案一则
One Proved Case of Professor CAI xiaosun's Experience in Treating Endometriosis
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1.上海市中医文献馆,上海 200020
2.上海交通大学附属第一人民医院,上海 200080
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黄素英, 蔡小荪. 蔡小荪教授治疗子宫内膜异位症验案一则[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41908540&Fpath=home&index=0
HUANG Suying, CAI Xiaosun. One Proved Case of Professor CAI xiaosun's Experience in Treating Endometriosis[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41908540&Fpath=home&index=0
黄素英, 蔡小荪. 蔡小荪教授治疗子宫内膜异位症验案一则[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41908540&Fpath=home&index=0 DOI:
HUANG Suying, CAI Xiaosun. One Proved Case of Professor CAI xiaosun's Experience in Treating Endometriosis[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41908540&Fpath=home&index=0 DOI:
子宫内膜异位症病机为宿瘀内结,积而成癥,蔡小荪教授临床上多采用通法,活血化瘀消癥。对于兼不孕,认为亦为肾气不足,络脉不通,根据月经周期采用蔡氏中药调周法,痛经消失,受孕妊娠,顽疾告愈。,病史摘要,2,经行腹痛剧烈,伴不孕4年。17岁月经初潮,周期25~27天,经期5天,痛经剧烈,夹血块,已婚未育,0-0-0-0。有原发性痛经史,每次发作腹痛剧烈,呈阵发性纹痛,持续半天,伴恶心呕吐,经前畏冷,腰酸伴胃部不适,行经第一天需卧床休息,经期腹部冷感喜热敷,痛作后自觉虚弱,极度疲惫,需休息3~4天,影响生活与工作。曾服复方阿司匹林片、安乃近、颠茄片及中药乌鸡白凤丸、艾附暖宫丸、益母草等,均疗效不显。后服消炎痛,止痛有效而坚持服用3~4年。1992年结婚,婚后1993年赴美定居,停服止痛药,痛经依旧。1994年10~12月先后三次人工授精均未成功。婚后二年未孕而始作检查,1995年12月腹腔镜检示:“子宫内膜异位症”严重,建议做腹腔镜手术治疗。1996年4月手术,术后医生告知用镭射已清除异位在卵巢和输卵管的大部分粘连疤痕组织。1996年7月,痛经复作,同年9月急诊超声波示“左侧卵巢囊肿”约3 cm,医生解释因病变严重导致手术失败。1997年4月作试管婴儿失败,1997年5月行卵巢囊肿引流术。1997年7月底请蔡师远程诊治(电话传真)。刻下:基础体温单相,痛经剧烈,左腰部酸痛。舌红,苔薄白,脉象缺。中医诊断 痛经、不孕,宿瘀内结,肾气不足西医诊断 子宫内膜异位症、女性不孕症干预措施 治则:活血化瘀消癥,参育肾促孕。采用蔡氏周期疗法,即经净后治以活血化瘀消癥,育肾通络,以“内异Ⅲ号”方为基础,药用:云茯苓12 g,桂枝3 g,赤芍10 g,丹皮10 g,桃仁10 g,夏枯草20 g,皂角刺30 g,炙甲片9 g,路路通10 g,仙灵脾12 g,巴戟肉10 g,炒杜仲12 g,服7剂。正值排卵期,再服“孕Ⅱ方”育肾培元,药用:云茯苓12 g,丹参12 g,生熟地各12 g,仙茅10 g,仙灵脾12 g,鹿角霜10 g,从蓉10 g,巴戟肉10 g,制黄精12 g,紫石英12 g,女贞子10 g,服8剂,加服河车大造丸2瓶。上方服完后,停药2~3天,再服四物调冲汤加减,经前三天开始服用,药用:炒当归10 g,大生地10 g,川芎6 g,赤芍10 g,败酱草20 g,五灵脂10 g,制香附10 g,怀牛膝10 g,延胡索12 g,制乳没各6 g,生蒲黄12 g,艾叶3 g,服10剂。疗效转归 5月份月事值期未行,基础体温居上不降,尿HCG(+),诊断为早孕。随访母胎正常。
The pathogenesis of endometriosis is the accumulation of accumulated blood stasis. Professor Cai xiaosun usually adopts the method of clearing blood to promote blood circulation and remove blood stasis. As for concurrent infertility,Professor Cai xiaosun thinks it is also due to insufficient kidney qi and blocked collaterals. According to the menstrual cycle, Cai's traditional Chinese medicine is used to regulate the cycle. Dysmenorrhea disappears, pregnancy occurs, and the stubborn disease is cured.,Summary of case history, Severe menstrual pain accompanied by infertility for 4 years. 17 years old menarche, cycle 25-27 days, menstruation 5 days, severe dysmenorrhea, blood clots, married without children, 0-0-0-0. She has a history of primary dysmenorrhea, and every attack has severe abdominal pain, paroxysmal tattoo pain, lasting for half a day, accompanied by nausea and vomiting, fear of cold before menstruation, backache and stomach discomfort. He needs to rest in bed on the first day of menstruation. She likes hot compress when she feels cold in the abdomen during menstruation. She feels weak and extremely tired after pain, and needs to rest for 3-4 days, which affects his life and work. Once taking APC, metamizole, belladonna tablets, and traditional Chinese medicine Wuji Baifeng pill, Aifu warm palace pill, motherwort and so on, the efficacy was not significant. After taking indomethacin, it is effective in relieving pain and can be used for 3-4 years. They got married in 1992 and settled in the United States in 1993. They stopped taking painkillers and still suffered from menstrual pain. From October to December 1994, three times of artificial insemination were unsuccessful. After two years of marriage, she was not pregnant and was examined. In December 1995, laparoscopy showed that "endometriosis" was serious. It was recommended to perform laparoscopic surgery. The operation was performed in April 1996. After the operation, the doctor informed that most of the adhesion scar tissue ectopic in the ovary and fallopian tube had been removed by laser. However, In July 1996, habitual abortion recurred. In September of the same year, the emergency ultrasound showed that the "left ovarian cyst" was about 3cmThe doctor explained that the operation failed because of the serious lesion. In April 1997, IVF failed and ovarian cyst drainage was performed in May 1997. At the end of July 1997, Mr. Cai was invited for remote diagnosis and treatment (telephone and fax). Engraved: the basic temperature is monophasic, the menstrual pain is intense, and the left waist is sore.The tongue is red, the moss is thin and white, and the pulse is absent.,TCM diagnosis, Dysmenorrhea, Infertility, accumulation of blood stasis, deficiency of kidney qi.,Western medicine diagnosis, endometriosis, female infertility.,Therapeutic methods, Treatment principle: promoting blood circulation, removing blood stasis and eliminating symptoms, participating in kidney cultivation and promoting pregnancy. Cai's cycle therapy is used, that is, after purification, the treatment is based on the formula of "Neiyi No. III", which is used for invigorating blood circulation, removing blood stasis and eliminating symptoms, nourishing kidney and unblocking collaterals. The medicines contain: Poria cocos 12 g, Cinnamomum cassia 3 g, Red peony 10 g, Paeonia moutan 10 g, Peach kernel 10 g, Prunella vulgaris 20 g, Saponins corniculatum 30 g, Pangolin 9 g, Beartiful Sweetgum Fruit 10 g, Epimedium 12 g, Morinda officinalis 10 g, fried Eucommia ulmoides 12 g, 7 doses.During the ovulation period, take the "pregnancy Ⅱ formula" to nourish the kidney and Peiyuan again. The medicines contain : Poria cocos 12 g, Salvia miltiorrhiza 12 g, Rehmannia glutinosa Libosch 12 g, and Chinese Foxglove 12 g, Curculigo orchioides Gaertn 10 g, Epimedium 12 g, antler cream 10 g, Cistanche 10 g, Morinda officinalis 10 g, refined polygonatum 12 g, amethyst 12 g, Ligustrum lucidum 10 g, 8 doses, and 2 bottles of Heche Dazhao pills. After taking above Chinese medicine, stop taking it for 2-3 days, and then take Siwu Tiaochong Decoction for addition and subtraction. Take it three days before menstruation. The medicines contain: fried Angelica sinensis 10 g, Rehmannia glutinosa Libosch 10 g, Ligusticum wallichii 6 g, red peony 10 g, Patrinia villosa 20 g, Trogopterus Dung 10 g, Cyperus rotundus 10 g, Achyranthes bidentata 10 g, Rhizoma Corydalis 12 g, frankincense 6 g and myrrh 6 g, raw Typhae 12 g, mugwort leaves 3 g. Take 10 doses.,Clinical outcomes, In May, the menstruation was not performed, the basal body temperature was not falling, and the urine HCG (+) was diagnosed as early pregnancy. The follow-up showed that the mother and fetus were normal.
痛经不孕子宫内膜异位症
habitual abortionCai's GynecologyCai xiaosun
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