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運用左歸丸、右歸丸治療繼發性不孕症病例報告

A Clinical Case Study of Application of Zuo-Gui-Wan and You-Gui-Wan for Secondary Infertility Treatment on A Patient with Polycystic Ovary Syndrome for Second Conception

摘要


不孕症的定義為女性在超過一年規律性生活且無避孕措施情況下未能受孕。目前排卵紊亂是導致不孕最常見的一種原因,而其中多囊性卵巢症候群(Polycystic ovarian syndrome, PCOS)是最可能的原因。儘管婦產科醫師多年來臨床上對多囊性卵巢症候群患者治療是根據不同目的給予不同的藥物治療,但是多囊性卵巢症候群的病因與機轉目前仍未確立。本篇論文為已產過一子的32歲女性被診斷罹患多囊性卵巢,且左側卵巢水瘤約2公分大小及子宮肌瘤3公分。該患者曾使用排卵藥治療無效後,在2020年10月5日求診中醫治療。依照體質辨證和中醫人工週期療法,我們在患者不同經期階段,給予滋補腎陰、活血化瘀、健脾利濕、養血調肝及溫補腎陽處方,服用中藥調理6個月後,患者自然懷孕,並成功剖腹產下足月健康嬰兒。

並列摘要


Infertility for women is defined by regular sex without contraception measures for over a year. Polycystic ovary syndrome (PCOS) is a highly likely cause of irregular ovulation, one of the most common infertility problems for women in their reproductive years. Although gynecologists have had clinical practices in customized prescriptions targeting various causes for patients with PCOS, specific causes and mechanisms of PCOS are not confirmed. In the paper, we provide detailed accounts for the PCOS treatments by making a case of a 32-year-old woman diagnosed with infertility in having a second child. With PCOS, a 2 cm left ovarian cyst, and a 3 cm uterine myoma, she has taken ovulation pills before seeking treatment in Chinese medicine at the traditional Chinese Medicine (TCM) clinic on October 5, 2020. Based on the TCM cycle therapy, we prescribed herbal medicines to cultivate kidney yin, activate blood, resolve stasis, nourish the spleen, disinhibit dampness, replenish blood, nourish the liver, and tonify the Kidney Yang and Qi across various stages of the patient's menstrual phases. After taking herbal medicine for six months, the patient conceived naturally and successfully delivered a healthy full-term baby by Caesarean section.

參考文獻


劉露、崔曉萍:左右歸丸對於不孕患者性激素水平與妊娠結局的影響。DOI:10.13463/j.cnki.cczyy.2020.01.027
衛生福利部國民健康署。衛生福利部國民健康署 108 年台灣地區人工生殖施行結果報告。https://www.hpa.gov.tw/File/Attach/14136/File_16505.pdf
Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertility and Sterility90: S60, 2008.
張尹人、蘇珊玉:運用中醫月經周期療法治療不孕症之病例報告。中醫婦科醫學雜誌 2015; 19: 24-36
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan; 81(1): 19-25.)

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