慢性反覆不癒白帶合併子宮腺肌症及卵巢巧克力囊腫多致因不孕症之中醫療法病例報告

A Medical Case Report of Modified Gui Pi Tang Formula, Acupuncture and Steam Therapy in Infertile Women with Chronic, Recurrent Leucorrhea, Adenomyosis, and Ovarian Endometriosis

子宮內膜異位、子宮腺肌症、卵巢巧克力囊腫及反覆不癒的白帶等分別皆為導致繼發性不孕的主要原因之一，當上述病症皆同時發生在一位不孕婦女身上時，諸多的不適，不但困擾不孕婦女的日常生活品質，也降低各種人工生殖介入成功的機率。本案報告一位35歲反覆不癒的白帶多年合併子宮腺肌症及卵巢巧克力囊腫的不孕婦女，在接受試管嬰兒療程失敗後，求助於中醫藥療法，先於經後期以清心蓮子飲清心益氣、十味敗毒散清熱利濕、少腹逐瘀湯溫經活血、清燥救肺湯潤肺養陰治之，並於排卵期間健脾養心，兼調其脾不統血及帶下之證，期間搭配每週一次局部針刺：三陰交、氣海、關元及藥草薰蒸：氣海、關元及八穴，治療1個月，反覆不癒的白帶症痊癒且順利懷孕。

Endometriosis, adenomyosis, ovarian endometriomas and chronic recurrent leucorrhea are common pathologic findings significantly related to the menstrual and reproductive characteristics of women. Although noted during younger reproductive years, it usually presents in women over 35 years of age. For those with a strong desire to preserve fertility, there is presently no uniform agreement on the most appropriate therapeutic methods to manage the condition. Herein, we present a case of long-term secondary infertility with successful pregnancy after treatment of chronic recurrent leucorrhea with traditional Chinese herbs herbal steam and acupuncture therapies. For those who want to conceive, early combined traditional Chinese herbs herbal steam and acupuncture therapies to relieving the condition of chronic leucorrhea before attempting to fall pregnant is advisable. This is because chronic, recurrent leucorrhea tends to kill sperms in vagina and cervical os immediately. The combination of Qing-Xin-Lian-Zi-Yin (清心蓮子飲), Shi-Wei-Bai-Du-San(十味敗毒散), Shao-Fu-Zhu-Yu-Tang (少腹逐瘀湯) and Qing-Tsao-Fei-Tang (清燥救肺湯) were first prescribed for treating symptoms such as acne, breast tenderness, and chronic, recurrent cough which were frequently occurred the past few periods. Modified Gui-Pi-Tang (歸脾湯) was then prescribed for relieving the condition of leucorrhea prior and afterblood circulation and soothe the nerves. The patients' PSQI scores decreased from 20 to 6 and from 14 to 6, respectively. Their sleep condition was significantly improved, and the efficacy was good. Moreover, they did not experience side effects such as amnesia, fatigue, gastrointestinal discomfort, thirst, or changes in taste. The dosage was reduced until the patients no longer needed to take the medication, and the time required to fall asleep was reduced to 10-20 minutes.