龍膽瀉肝湯合桂枝茯苓丸治療妊娠十週死胎不下醫案報告

Treating a Women Diagnosed with First-Trimester Miscarriage by Traditional Chinese Medicine

Miscarriage 是指胚胎在未發育到足以生存前就沒有心跳，或是懷孕滿20 週以前或出生體重小於500 公克的胎兒，由非人為因素脫離母體，導致懷孕失敗。一般常規治療多會使用子宮刮除術（dilatation and curettage, D&C），而中醫古籍也主張積極介入，然而目前此類之中醫治癒病例報告並不多。此病例是一位30 歲婦女，妊娠十週經西醫婦產科檢查發現胎兒無心跳， 藉中醫科學中藥龍膽瀉肝湯、桂枝茯苓丸及藥物薰蒸療法，順利排出死胎之報告，或許可提供不想手術的婦女一個替代的方案。Miscarriage, or spontaneous abortion, is the term used for a pregnancy that ends on its own, within the first twenty weeks of gestation. The death takes place in the early stage of the baby's development as the fetus prior to fetal viability (the stage of potential independent survival). The danger of a miscarriage is the most common complication of early human pregnancy. Surgical treatment (most commonly vacuum aspiration, sometimes referred to as a D&C or D&E) is the fastest way to complete the process. It also shortens the duration and heaviness of bleeding, and avoids the physical pain associated with the miscarriage. Despite clinical guidelines recommending this procedure which is performed in an operation room still leaves some complication to be desired such as infection, endometrial adhesion, and infertility. Not surprisingly, many women with miscarriage have turned to traditional Chinese medicine (TCM) in search of a non-invasion way to manage their demised fetus. A thirty-year-old female patient experienced a fetal demise at ten weeks of pregnancy which was confirmed by her gynecologist few days prior to seeking TCM advice. The demised fetus was completely expelled after taking Chinese herbal formula which contains a fixed ratio of two commercially available traditional Chinese medicines, Long-Dan-Xie-Gan-Tang and Gui-Zhi-Fu-Ling- Wan. In this case, we adopted their efficacies at clear the liver fire and quicken the blood and transform stasis and applied it as a short-term auxiliary treatment for demised fetus at the first trimester. This approach seems to offer a non-invasive alternative treatment to miscarriage.