中藥治療不孕症之醫案報告

The Intervention of Traditional Chinese Medicine in Female Infertility: A Case Report

不孕症是婦科臨床的重要疾病之一，常見的病因包括男性精蟲問題(25%)、女性卵巢排卵障礙(27%)包括多囊性卵巢、巧克力囊腫或高泌乳激素、輸卵管和子宮問題(22%)包括輸卵管阻塞、骨盆腔沾黏和子宮內膜過薄（限制正常輸卵管活動、卵提取和傳送受精卵至子宮困難等）和不明因素(17%)，治療方式以促進排卵、改善結構和人工授精或試管嬰兒為主；而中醫根據症狀分出證型分別為腎虛、肝鬱、氣滯血瘀和氣血虛弱，再依各證不同進行治療。本病案以中藥治療一名35歲的女性，已經做過試管嬰兒並未成功，中醫診斷為腎虛證，治以溫腎養血益氣和滋陰益精；經過七次共3個月的治療，在103年11月底順利懷孕，超音波追蹤在6週測得心跳，CRL亦在正常發育範圍內；提供不孕治療或是人工試管失敗之後病人的另一項選擇。

Infertility is one of the most important diseases of gynecology and common etiologies are male factors(25%), ovulatory disorders including polycystic ovary syndrome (PCOS), endometriosis and hyperprolactinemia(27%), tubal disorders(22%) including obstruction of fallopian tubes, pelvic adhesion and endometrial thinning lining, and unexplained factors(17%). Treatments for these problems are ovulation induction, structural modification and artificial reproductive technique. According to the symptoms and signs of patients, we can divided them into kidney deficiency, liver depression, qi stagnation and blood stasis, qi and blood deficiency. These five patterns and then prescribe proper medication in accordance with corresponding patterns. This case report described a 35-year-old female diagnosed of kidney deficiency pattern and treated by Chinese medicine for 3 months. She received IVF in year 2013 but in vain. After 3 months course of treatment, pregnancy was checked in the late November, 2014. In the regular obstetrics checkup, fetal heart beats was detected and CRL (crown rump length) was in the normal development range. This successfully natural pregnant case provides another option for those who are infertility or ART failed.