A Academic Thought Study In The Treatment Of Endometriosis-associated Infertility By Professor Zhou Shiyuan

Endometriosis-associated infertility was first proposed by Buyalos in2000, it is generally believed that about25%-40%of infertility suffer from endometriosis, and about40%-60%of endometriosis suffer from infertility, the number of endometriosis with infertile is20times with infertility with non endometriosis. because of the high incidence rate and the undefined pathogenesis, there is still no satisfactory treatment. Professor Zhou Shiyuan has a wealth of clinical experience in treating infertility, as well as in endometriosis-associated infertility. She stressed that treatment of endometriosis-associated infertility should follow the general rule of infertility. Therefore, this study attempts to explore the general rule of Professor Zhou Shiyuan's treatment in infertility that is the special rule of endometriosis infertility, aim at inheriting experience of the traditional Chinese physician, improving the level of clinical evidence to improve clinical research.First, elaborate the general rule of Professor Zhou Shiyuan in the treatment of infertility. Professor Zhou Shiyuan's academic thoughts origin rooted in the" Inner Canon of Iiuangdi."" Nanjing" and other classics, Follow Zhang ZhongJing's dialectical treatment system, Branch from the jin, yuan, Ming and qing period and the modern home. A profound comprehension oi 《Plain Questions· to the larger theory》, the esssence of plain question of' menstruation comes to time, so is able to fertilize" is recuperate menstruation must before Fertilization, when menstruation become normal then male offspring. Women with menstrual physiology for the first, menstruation, pregnant, fetiferous, breastfeeding all from the blood. Blood originates from internal organs of the body, Organs as the fundamental. However, in these organs, The menstruation is more closely to kidney, liver, spleen. the Kidney Storing the Essence and Controlling the Reproductivity, The kidney essence produce the kidney qi, when the kidney qi is sufficient, the Tian gui will be accumulated and the Chong. Ren meridian is circulated so the menses will come regularly and the women can be pregnant. The kidney has the leading function in the menses generating. The liver controls dispersion and storing blood which is the inherent of the women. The liver is the yin nature and the function is for yang, so we use the pungent herbs to disperse and use the sore herbs to tonify the liver. The spleen's function is to promote the sport and to Facilitate the rise; Function of the stomach is to accommodate and to decrease, They are the source of blood. Filled with the breath of the five zang-organs, menstruation to come, menstrual on schedule to get birth. She is respected academic thought of Zhangjingyue and Fuqirigzhu,which "menstruation based on kidney" and "menstruationc comes from kidney" are profoundly affected the thoughts of Professor Zhou's academic. Theory and clinical practice through repeated demonstration, forming a " conditioning menstrual and help conceive," the academic system.Conditioning menstruation, Professor Zhou follow what 《nei jing》 said "complies with the pathogenesis,""observe where yin and yang are and then conditioning, just peace is just right," is Good at conditioning Chong and Ren, she pays attention on organs, caring at qi and blood, Conditioning menstruation and Fertilization, treatment follow the disease's period. By soothing the liver to invigorate the spleen solving kidney depression, invigorating spleen to nourish kidney essence, nourishing kidney essence to nutrition the liver blood, nourishing the liver blood to help kidney etc, The liver, the spleen and the kidney promote and use each other. Because the menstruation come from the kidney, nourishing kidney as the main of pregnancy and regulating menstruation; the liver is the congenital base of life of women liver for innate, Moderate to conceive, so stressed together cure liver and kidney; The spleen kown as the postnatal base of life, exuberant spleen can born fine and pregnancy is possible. Follow the different stages of menstruation, sent the different prescriptions and drugs;"stasis with weak"and"easy to deficieny and excess"are the characteristics of menstrual period, so during the menstrual period circulation and regulation is the first principle, regulating qi and activating blood as treatment; the characteristics of late period of menstruation which is yin exuberant and yang deficieny, compensate kidney essence and supplement qi and blood are treatment; The period between two menstruations the feature is superposed yin becoming yang. To improve the occasion, activate blood and resolve stasis to help ovulation as the key therapy. he characteristics of early period of menstruation which is yang exuberant and yin deficieny, in treatment, we should reinforce yang and regulate qi. Statistical analysis of the herb rule was performed with Excel2003and spssl1.5. Professor Zhou Shiyuan commonly used such drugs (the frequency of the top20) as:angelica, white peony, Rehmannia, glutinosa, Cuscuta, Dipsacus. Cortex Moutan, medlar, Dogwood, yam, Radix Rehmanniae, Chuanxiong, red peony, astragalus, human placenta, Morinda, Poria, Rcd-rooted Salvia, peach kernel, Achyranthes, Cyperus rotundus.Second, Introducing the special rule of the treatment in endometriosis-associated infertility of Professor Zhou. The essence of "stasis" have reached a consensus, which agree that stasis is final pathology results of endometriosis. Xia Guicheng consider that the remainder of the blood and the cloud liquid which produced by Menstrual and birth flowing in the vessels and collaterals of the uterus and overflowing out of the uterus, Resulting the loss of smooth in qi and blood, qi of kidney is weak, then the accumulation bring about blood stasis; CaiXiaoSun think that cyclic bleeding of the ectopic endometrium is "internal bleeding", which belongs to traditional Chinese medicine theory of abnormal flow of the blood; and this can not be excreted or absorption in time, therefore it forms blood stasis; Xiao Cheng Cong believe that the mass of the disease is formed by abnormal flow of the blood which view from the local lesion, clinical symptoms and laboratory parameters are blood stasis. Professor Zhou Shiyuan has different points between contemporary famous, which performance her new understanding of endometriosis-associated infertility's pathogenesis.Professor Zhou consider that the main cause of endometriosis-associated infertility is the deficiency of kidney or kidney-Yang deficiency, or with cold-evil, or with liver depression, caused to the non grabbing of chongqi, and blood reverse to disorder, hence stasis is developing the disease which blocked the collaterals. That is to say the incidence of endometriosis-associated infertility is kidney deficiency and the form of the disease is blood stasis.Professor Zhou proposed the rule which is followed by " dredge qi and blood in ordet to make it reconcile and moderate" in 《Plain Questions· to the larger theory》. The main treatment is tonicing the kidney to sooth chongqi, eliminating stasis to free the collateral vessels, on the specific use of infertility treatment should also follow the general rules that "conditioning menstrual and help conceive".Professor Zhou who conditioning menstrual and help conceive.emphasised on Conditioning tonic Viscera and Bowels. balancing of yin and yang. Paying attention to Liver, Spleen and Kidney, and Considering heart and lung,and the most important of pregnancy is tonicing the kidney. Professor Zhou consider clinical evidence to endometriosis, kidney yang deficiency is the more common in the kidney deficiency patients. When we choose drug to tonic the kidney,must be into thoroughfare vessel, which can make among conditioning menstrual, sooth chongqi and pregnancy to care of each other. Follow the phases of the menstrual to select prescription. And take into account the treatment of other associated disease. Endometriosis-associated infertility are often easy to merge hyperprolactinemia, luteal dysfunction, luteinized unruptured follicle syndrome, Professor Zhou is always according to the disease choose different treatment methods. For high levels of prolactin, Professor Zhou often increase the dose of peony, malt. Professor Zhou has a unique understanding of luteinized unruptured follicle syndrome, she Analysises that when follicular rupture is the fact that yin to reach the extreme point of the transformation, and the essence of follicle not rupture is yin below the extreme. Thus, stressed the need to enrich yin, and enrich essential qi, then use spina gleditsiae, Semen Leonuri and other medicinals to follow. For patients with luteal insufficiency, Zhou stressed that it is the cause of the "base" of follicular phase insufficient.Professor Zhou consider that treatment needed focusing on the"base", that in the follicular phase, focus on enriching yin and essense, use antlers frost. the donkey-hide gelatine, antlers glue, morinda officinalis, Faeries spleen, etc. which are the warm-tonifying medicine at the same time to reach the aim of "use yang-tonifying medicinals can achieve yin-tonifying ". When the luteal phase, we can Couple with medicinals to warm the kidney, Often choose Dodder, Morinda, antlers frost, cinnamon, Curculigo and other drugs. Professor Zhou like to use medicinals in Clinical treatment of endometriosis-associated infertility such as Morinda, amethyst, yam, Placenta, antlers frost, turtle shell, Wulingzhi, Puhuang, leeches. Eupolyphaga, Chuanxiong and so on.The author makes a preliminary study of diagnosis and treatment of endometriosis, which is endometriosis-associated infertility's basic disease. Further from the pathogenesis, treatment, prescriptions made on the person's viewpoint and method of transmission, Trying to achieve a combination of inheritance and innovation purposes.