The Study On The Diagnosis And Treatment Of Endometriosis Based On The Tri-jiao Membrane Theory

Endometriosis(EMs)is one of the most enigmatic common disorder in gynecology nowadays.But the knowledge about pathogenesis of EMs is still fragmentary.Although there is no such disease name has been known in TCM,but through the corresponding dialectical treatment of different stages of this disease,an unexpected curative results will always be achieved.As the essence of Tri-jiao was revealed,Professor Yao Meiling first proposed that EMs should be guided by the “Tri-jiao Membrane theory”,and clearly pointed out the site of disease,its pathogenesis and treatment ideas.In order to find out more sufficient theoretical basis,this article first reviewed the knowledge of endometriosis from Western medicine and Traditional Chinese Medicine(TCM).Firstly,it started with a basic understanding on the etiology,pathogenesis,clinical manifestations,diagnosis and treatment of Western medicine,and from that enumerate the related disease names,pathogenesis and treatment of the similar diseases that found in the ancient TCM classics.Based on the physio-pathological research of Tri-jiao which was summarized by Yao Hesheng,this article have concluded and clarifies the concept,morphological structure,physio-pathology and its characteristics,and treatment principles of Tri-jiao membrane.This revealed the membrane of Tri-jiao named Jiaomo,which is the main place for its physiological activities and pathological changes.From theperspective of the anatomical structure and physiological function of Jiaomo,it is considered that it is closely similar to the newly discovered interstitial organs and fascia tissues,and so it deserves a further exploration.Based on the relevant explanation of Yao's endometriosis Tri-jiao membrane pathogenesis was proposed,this article continued to analyzes the relevant basis of endometriosis and its Tri-jiao membrane pathogenesis with modern medical explanations.There are 3 points of view are proposed respectively:(1)Jiaomo is the site and pathway where the development of lesion and pathogenesis of EMs takes place,which is consistent with Sampson's retrograde menstruation theory;(2)The dysfunction of qi transformation of Tri-jiao and the pathological changes with obstructed by the dampness,blood stasis and phlegm in the internal environment of Jiaomo is the crucial factor to developing disease.Simultaneously,the “in situ endometrial determinism” theory also pointed out the similar viewpoint which is the specificity of endometrium to break through its defense line is the key of pathogenesis of EMs.Both theories have the same similarities on the viewpoints of lesion and pathogenesis of EMs;(3)The insufficient of qi,blood and body fluid in transportation caused by the dysfunction of qi transformation of Tri-jiao is related to the damage to the stability of neuro-endocrine-immune network,both are the prerequisite for the onset.This article also puts forward the other influence factors of the disease such as social factors,environmental factors and personal factors,which are actually causing the imbalance of the physiological function of Tri-jiao.The mechanism of TCM external treatment such as enema and hot ironing with Chinese herbs methods act on the Jiaomo have been discussed,which tend to proven the close relationship between endometriosis and its Tri-jiao membrane pathogenesis.In order to further demonstrate the endometriosis and its Tri-jiaomembrane pathogenesis,this article also summarized the TCM clinical research and medical case literature on endometriosis in the past 10 years.A total of 132 literature,with a total of 2,932 cases were collected,a total of 162 prescriptions,and 240 types of Chinese drugs through statistical analysis.Based on the above theoretical basis,were further explore the correlation between its syndrome differentiation and medication laws and the mechanism of Tri-jiao membrane pathogenesis,and the following conclusions are:(1)The lesion of endometriosis is located in Jiaomo,which normally occurs in the lower part of Tri-jiao membrane,more closely related to the kidney,liver,and spleen;(2)Endometriosis is the mixture of asthenia and sthenia,and blood stasis is the main pathological by-product.The pathogenesis is mainly due to the heat-up,water retention,blood stasis with heat on Tri-jiao,which also affects the kidneys,liver,and spleen function;(3)Regulate the Tri-jiao function is the main treatment purpose of EMs,while to improving blood circulation and removing blood stasis is the principle of treatment.Simultaneously,remember tonify the asthenia,always emphasis to the regulation of the liver,spleen,heart,and kidney function together with improve qi activity,remove coldness,remove dampness and phlegm;(4)Among the 33 high-frequency Chinese drugs,the drugs that have a direct effect on Tri-jiao include Xiangfu,Chaihu,Huangqi,Gancao,Fuling,Baizhu,Yiyiren,Rougui and Chuanxiong.Combining theoretical and literature research in this study,the innovative exploration was carried out from the following three aspects,and summarized:(1)Endometriosis and its Tri-jiao membrane pathogenesis has a very high agreement with the explanation of modern medical etiology and pathogenesis;(2)There are differences in the understanding of EMs from ancient TCM classics because there is no relevant discussion about the connection with Tri-jiao;(3)According to the Tri-jiao membrane theory toanalysis the mechanism of various syndromes and the characteristics of Chinese drugs used,it is found that the Tri-jiao and its membrane can be involved.It believed that the Tri-jiao membrane pathogenesis plays a key role in participating in the entire development of disease.Highly suggested to further study and discuss about this topic.Based on the understanding of endometriosis and Tri-jiao membrane theory,this article systematically analyzes the correlation between the Tri-jiao membrane pathogenesis of endometriosis and any other aspects,and clearly highlights the significance of in-depth research and discussion on this theory,in order to provide more scientific and convincing theoretical basis in clinical and research field as clinical guidance.