Zhang Rui, Ai Bing-Wei
Affiliated Hospital of Nanjing University of CM, Nanjing 210029, Jiangsu Province, China.
Jiangsu Province Hospital of TCM.
Zhongguo Zhen Jiu. 2019 Mar 12;39(3):293-5. doi: 10.13703/j.0255-2930.2019.03.017.
The clinical experience of professor for anovulatory infertility is introduced from three perspectives of , syndromes and menstrual period in this article. Professor believes that ovulation disorders mainly involves the liver, spleen and kidney, and four syndromes, including spleen-kidney -deficiency syndrome, liver-depression and kidney-deficiency syndrome, phlegm-dampness obstruction syndrome, -stagnation and blood-stasis syndrome are common in clinic. The combination of syndrome differentiation and menstruation differentiation should be adopted in treatment. The syndrome differentiation should be mainly applied. The acupoints for excess syndrome include Quchi (LI 11), Hegu (LI 4), Tianshu (ST 25), Sanyinjiao (SP 6) and Neiting (ST 44); while the acupoints for deficiency syndrome include Zhongwan (CV 12), Taixi (KI 3), Ganshu (BL 18) and Qimen (LR 14). In auricular acupuncture, kou (CO), wei (CO), pi (CO), neifenmi (CO), sanjiao (CO), dachang (CO) and shenmen (TF) could be selected for excess syndrome, while wei (CO), pi (CO), neifenmi (CO), zigong (TF), pizhixia (AT), shen (CO) and luanchao could be selected for deficiency syndrome. Moxibustion can be added to treat the patients with deficiency syndrome or cold syndrome. The menstruation differentiation could be used as auxiliary method. In the later period of menstruation, strengthening-spleen and promoting-blood method is applied and Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Zigong (EX-CA 1), Sanyinjiao (SP 6) and Zusanli (ST 36) are selected; in the intermenstrual period, tonifying-kidney and nourishing-, warming- and nourishing- method is applied and Shenshu (BL 23), Yaoyangguan (GV 3), Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6) and Hegu (LI 4) are selected; in the earlier period of menstruation, soothing-liver and tonifying-kidney, promoting- and relieving-depression method is applied and Taichong (LR 3), Qimen (LR 14), Luanchao (Extra), Zigong (EX-CA 1) and Xuehai (SP 10) are selected; during menstruation, Taixi (KI 3), Xuehai (SP 10) and Sanyinjiao (SP 6) can be added to nourish kidney, nourish blood, promote blood circulation and regulate menstruation to promote oogenesis. In addition, B-ultrasonography can be used to monitor ovulation and guide intercourse to improve pregnancy rate.
本文从、证型和经期三个角度介绍了教授治疗无排卵性不孕症的临床经验。教授认为,排卵障碍主要涉及肝、脾、肾,临床常见脾肾两虚证、肝郁肾虚证、痰湿阻滞证、气滞血瘀证四种证型。治疗应采用辨证与辨经期相结合的方法,以辨证为主。实证取穴包括曲池(LI 11)、合谷(LI 4)、天枢(ST 25)、三阴交(SP 6)、内庭(ST 44);虚证取穴包括中脘(CV 12)、太溪(KI 3)、肝俞(BL 18)、期门(LR 14)。耳针方面,实证可选取口(CO)、胃(CO)、脾(CO)、内分泌(CO)、三焦(CO)、大肠(CO)、神门(TF);虚证可选取胃(CO)、脾(CO)、内分泌(CO)、子宫(TF)、脾下(AT)、肾(CO)、卵巢。虚寒证患者可加用艾灸。辨经期可作为辅助方法。经期后期,采用健脾养血法,选取中脘(CV 12)、关元(CV 4)、气海(CV 6)、子宫(EX-CA 1)、三阴交(SP 6)、足三里(ST 36);经间期,采用补肾养精、温养胞宫法,选取肾俞(BL 23)、腰阳关(GV 3)、气海(CV 6)、关元(CV 4)、中极(CV 3)、子宫(EX-CA 1)、足三里(ST 36)、三阴交(SP 6)、合谷(LI 4);经前期,采用疏肝补肾、理气解郁法,选取太冲(LR 3)、期门(LR 14)、卵巢(Extra)、子宫(EX-CA 1)、血海(SP 10);经期,加用太溪(KI 3)、血海(SP 10)、三阴交(SP 6),以滋肾养血、活血化瘀、调理月经,促进卵子生成。此外,可采用B超监测排卵并指导同房,以提高受孕率。