從中醫角度談女性不孕症

Female Infertility from the Perspective of Chinese Medicine

不孕症是臨床上常見的問題，由於華人傳統上傳宗接代的觀念，故歷代以來對不孕都極為重視，早在三千年前《周易》就有不孕的記載，在戰國時代的《黃帝內經素問》曾簡要地提出了不孕的病機，之後歷代對不孕症的認識與治療都有更進一步的發展；在中醫大致上認為女性不孕症的病因與先天生理缺陷、月經不調、臟腑功能失調、氣血失調、衝任失調、情緒影響與癥瘕引起胞脈閉阻等較有關係，臨床上大致可根據其症狀與病機分為先天生理缺陷、腎虛、肝鬱、痰濕與血瘀等證型，而在治療的方法上也可分為中藥辨證治療、中藥人工週期療法、中藥單驗方治療、中西醫結合治療、針灸療法與其他療法等；多樣的治療方式是中醫的特點，但卻也凸顯出療效不確定的缺點，因此積極的找出療效最佳的治療方式是現今臨床研究的重點所在。

Infertility is a common condition. Because of traditional Chinese concepts that emphasize the importance of consanguinity, infertility has been a problem long recognized in Chinese history. The subject of infertility was addressed in the I-Jing, written some 3,000 years ago. The Nei-Jing, written during China's Warring States Period, described the mechanisms of infertility. Afterward, the library of knowledge on infertility steadily grew and became more sophisticated. The causes of female infertility in Chinese medicine include congenital deformity, menstruation abnormalities, organ dysfunctions, disturbances in the Qi or blood, malfunctions in the Chong or Ren meridians, emotional effects and the compression of concretions or conglomerations. Based on symptoms and mechanisms, female infertility can be classified into five patterns, including congenital deformity, kidney vacuity, liver depression, phlegm-damp and blood stasis. Chinese medicinal therapies for female infertility include Chinese herb drugs with pattern identification, artificial menstruation cycle therapy, single formula therapy, combined Chinese and Western medicine therapy, acupuncture and moxibustion. The relatively large range of therapies, while a hallmark of Chinese medicine, also points up instabilities in treatment outcomes. Thus, determining the most effective therapy is the most important point of clinical studies.