針灸配合中藥治療輸卵管阻塞性不孕症病例報告

A Case Report of Tubal Factor Infertility Treated with Acupuncture, Moxibustion and Chinese Herbs Medicine

10.6516/TJTCM.2016.19(2)139

劉夢薇(Meng-Wei Liu)；楊素卿(Su-Qing Yang)

輸卵管阻塞性不孕症 ； 針刺 ； 艾灸 ； 中醫調理 ； Salpingemphraxis Infertility ； Acupuncture ； Moxibustion ； Traditional Chinese Medicine

中醫藥研究論叢

19卷2期（2016 / 09 / 30）

139 - 150

繁體中文

本病案描述一位32歲女性婚後近兩年無法懷孕，經西醫婦產科檢查發現有子宮後傾以及右側輸卵管阻塞扭曲，病患曾做過一次體外人工授孕但是沒有成功。經由中醫辨證論治發現患者屬腎陽虛體質合併肝鬱氣滯，進而導致基礎體溫高溫期過短（呈階梯式上升且無法維持一周）。治療採取方針並下，以溫補腎陽為主，疏肝理氣為輔；遂以左歸丸、右歸丸為主方，配上單味藥菟絲子、巴戟天、淫羊藿，滋腎陰，溫腎陽，兼以養血散寒，溫經通脈；針刺及艾灸還巢穴、婦科穴、中極穴、子宮穴、上三黃穴、腎關穴、陽陵泉穴、三陰交穴、太谿穴補腎調經、疏肝利膽、清瀉濕熱。患者在接受治療不到五個月即成功自然受孕，免去做第二次人工受精之苦。

Acupuncture, moxibustion, and traditional Chinese medicine (TCM) has positive effect on infertility, which has occurred more and more frequently in recent years. We report a 32-year-old female, trying to conceive for 2 years but fail after in vitro fertilization (IVF) once, with retrodeviation of the uterus and salpingemphraxis, got pregnant after taking 5-month TCM and received acupuncture and moxibustion treatments. She has shorter high temperature patterns of her basal body temperature (no longer than one week with stepwise increase), and we found her to have a constitution of kidney deficiency and liver depression qi stagnation. However, with the strategy to warm and invigorate the kidney-yang, in which we use mainly zuo gui wan and yo gui wan, acupuncture/ moxibustion in acupoints RN3, GB34, SP6, KI3, LR3, EX-CA1, Master Tung's Acupoints 11.06 Huanchao,11.24Fuke, 77.18Tien-huang Fu 88.12Ming-hunag, 88.13Tien-huang, and 88.14Chi-huang, she successfully conceived five months later and needs not to suffer IVF for the second time.

1. 王玉真、葉美玲(2009)。灸療法之療效與實證研究。醫護科技期刊，11(4)，211。
   連結：
2. de Lacey, Sheryl,Smith, Caroline A,Paterson, Charlotte(2009).Building resilience: A preliminary exploration of women's perceptions of the use of acupuncture as an adjunct to In Vitro Fertilisation.BMC Complementary and Alternative Medicine,9,50.
3. Madaschi, Camila,Almeida Ferreira Braga, Daniela Paes,de Cássia Savio Figueira, Rita,Iaconelli, Assumpto, Jr.,Borges, Edson, Jr.(2010).Effect of acupuncture on assisted reproduction treatment outcomes.Acupunct Med,28,180-184.
4. Smith, Caroline A.,Armour, Michael,Betts, Debra(2014).Treatment of women's reproductive health conditions by Australian and New Zealand acupuncturists.Complementary Therapies in Medicine,22,710-718.
5. Stener-Victorin, Elisabet,Humaidan, Peter(2006).Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer.ACUPUNCTURE IN MEDICINE,24(4),157-163.
6. 王麥絨、張鵬天(2005)。針刺與藥物貼敷治療輸卵管阻塞性不孕症96例。遼寧中醫雜誌，32(12)，1283。
7. 成德水、張同君、王淑珍(2001)。婦科專病中醫臨床診治。北京:人民衛生出版社。
8. 余海瓊、田淑華(2002)。針藥合用治療輸卵管炎性粘連不孕症108例。江蘇中醫藥，23(3)，32。
9. 李世玲(1999)。中藥內服外用配合針刺治療輸卵管阻塞性不孕症。河南中醫，1999(4)，51。
10. 李艷梅、宋立中、姜豪傑(2005)。中藥溫灸合用治療輸卵管阻塞性不孕症50例。中國針灸，4(25)，6-8。
11. 林昭庚編(2010)。新編彩圖針灸學。台北:知音出版社。
12. 林昭庚編(2001)。中西醫病名對照大辭典。北京:人民衛生出版社。
13. 崔廣淵(1990)。針灸配合中藥治療輸卵管阻塞性不孕症100例。中國針灸，10(3)，20。
14. 陳立德編(2010)。中醫婦科學。台中:弘祥出版社。
15. 陳榮洲編(1998)。婦科心法新解。台中:弘祥出版社。
16. 陳潮祖(2013)。中醫治法與方劑。北京:人民衛生出版社。
17. 楊維傑編(2004)。針灸經緯。台中:志遠書局。
18. 楊維傑編(2010)。董氏奇穴講座治療穴。洛杉磯:美國中醫文化中心。
19. 楊維傑編(2010)。針灸寶典。洛杉磯:美國中醫文化中心。
20. 楊維傑編(1999)。董氏奇穴針灸學。台中:志遠書局。