Treatment for pregnancy failure after abortion without contraception for 4 years

Guo, female, 32 years old, married. Date of first diagnosis: March 23, 2004.

[Main complaint] Failure to conceive in 4 years without any contraceptive measures.

[Medical history and current situation] The patient used to have menstruation every 26-27 days, 7-8 days to stop, with moderate flow and occasional dysmenorrhea. After marriage, she became pregnant twice in 1995 and 1998, both of which were terminated by artificial abortion. After the operation, the menstrual flow gradually decreased and the cycle was regular. In 2000, the fetus stopped growing at 8 weeks of pregnancy, and a curettage was performed again. Since then, she has not taken any contraceptive measures and has not become pregnant. There is no abdominal pain or other discomfort. The last menstrual period was on March 15, 2004. Now it is the 8th day of the menstrual cycle, with a lot of vaginal discharge and a smell. Appetite is good, sleep is not good, and bowel movements are regular. The tongue is dark red, and the pulse is deep, fine and smooth.

【Syndrome differentiation】Damage to Chong and Ren meridians, deficiency of Yin and blood.

[Legislation] Nourishes yin blood, and replenishes the liver and kidneys.

[Disease analysis] The patient had a history of three pregnancies and had not gotten pregnant for four years after cohabiting without taking any contraceptive measures. This syndrome falls into the category of "secondary infertility".

Artificial termination of pregnancy causes the body's established organs, meridians, qi and blood functions that adapt to the physiological needs of pregnancy to suddenly become unbalanced. In addition, multiple surgeries damage Chong and Ren, which consumes Yin blood, so there is scanty menstruation, difficulty in retaining the fetus, and even infertility: the patient has not been pregnant for 4 years after the fetus stopped growing, and her emotions are not fulfilled. There must be liver qi stagnation, liver depression and qi stagnation. Qi stagnation for a long time will cause blood stasis, and blood stasis in the uterus will also prevent fertilization and pregnancy. Yin blood is deficient, and the mind is not nourished, so there is poor sleep: the tongue is dark red, and the pulse is deep and smooth, which is also a sign of Yin blood deficiency. The syndrome is that Chong and Ren are damaged and Yin blood is insufficient.

Prescription: Wolfberry 15g, Mulberry 10g, Ligustrum lucidum 15g, Rehmannia root 10g, Polygala tenuifolia 6g, Paeonia suffruticosa 10g, Bupleurum 3g, Citrus aurantium 10g, Albizzia julibrissin bark 10g, Lilium 15g, Honeysuckle 15g, Poria 20g, 7 packs.

The patient's first visit was on the 8th day of the menstrual cycle. According to syndrome differentiation, the method of nourishing Yin and blood was temporarily used as the main method, supplemented by soothing the liver. The prescription used Lycium barbarum, Morus altissima, Ligustrum lucidum, and Rehmannia root to nourish Yin and blood, and Bupleurum chinense, Citrus aurantium, Albizzia julibrissin, and Lilium to soothe the liver, regulate Qi, relieve depression, and calm the mind. After multiple artificial abortions and curettage of fetal arrest, the patient's heat toxins easily took advantage of the opportunity to invade the uterine vessels and belt vessels. Although there was no abdominal pain, the amount of urine was large and the symptoms were odor, so the first prescription was supplemented with honeysuckle. Honeysuckle is sweet and cold in nature. It enters the liver, stomach, and Tao meridians. It is good at treating the symptoms of stagnation of toxic heat in the blood. The teacher likes to use it to clear the latent heat in the blood.

Second visit: March 30, 2004. The last menstrual period was March 15, 2004. The basal body temperature was low, and the insomnia improved. The tongue was fat and dark, and the pulse was thin and smooth.

Prescription: 12g of wolfberry, 10g of Chinese angelica, 8g of Chuanxiong, 10g of Cyperus, 10g of Leonurus, 12g of Rubia, 10g of Zelan, 6g of Amomum, 12g of Dipsacus, 10g of Eucommia, 10g of Plantago, 3g of Aucklandia, 7 packs. Now that the ovulation period is approaching, the second visit should reduce the nourishing and greasy Yin-nourishing drugs to avoid affecting the Qi transformation function of kidney Yang. Dipsacus, Eucommia, Plantago, Chuanxiong, Leonurus, Rubia, Zelan are used to warm the liver and kidney and promote blood circulation. Add wolfberry and angelica to supplement the effect of nourishing the kidney and nourishing blood.

Third visit: April 6, 2004.

Basal body temperature rises for 6 days.

The tongue is fat and red, and the pulse is thin and smooth.

Prescription: Bupleurum 8g, Ligustrum lucidum 20g, Amomum villosum 6g, Ecliptae 12g, Albizzia julibrissin 10g, Dipsacus asper 20g, Ejiao 12g, Lotus seed heart 3g, Toona bark 15g, Rubus idaeus 12g, Viscum album 10g, 10 packs. After the second consultation, ovulation occurred as expected. The third consultation was based on the method of expanding Chong and Ren meridians. Avoid or use less blood-activating and downward-moving products to avoid premature bleeding.

Fourth diagnosis: April 16, 2004.

The last menstrual period was on April 8, 2004. The menstrual flow was slightly increased compared with the previous period. The basal body temperature before menstruation had an atypical biphasic pattern, with the high temperature phase lasting only 7 days.

The tongue is tender and dark, and the pulse is fine and smooth.

Prescription: Cuscuta 20g, Epimedium 12g, Polygala 6g, Cnidium 8g, Polygonum multiflorum 10g, donkey-hide gelatin 12g, Cinnamon 3g, Morinda officinalis 8g, Eucommia 10g, Artemisia capillaris 12g, Poria 12g, Viscum album 20g, Peach kernel 10g, 14 packs.

The patient has been treated for one menstrual cycle. The menstrual flow has increased and insomnia has improved, indicating that the deficiency of yin and blood has eased. The tongue is now tender and dark, the high temperature phase of basal body temperature only lasts for 7 days, and the luteal phase is short, indicating that the problem of kidney yang deficiency has become prominent. Therefore, the four-diagnosis prescription uses Cuscuta australis, Epimedium, Cnidium monnieri, Cinnamon bark, Morinda officinalis, Eucommia ulmoides, etc. to replenish kidney yang, supplemented by Polygonum multiflorum, donkey-hide gelatin, and Viscum album to nourish yin and blood.

Fifth visit: June 18, 2004 ET.

The last menstrual period was on June 2, 2004. The premenstrual basal body temperature had an atypical biphasic pattern, with the high temperature phase lasting for 10 days and the low temperature phase now present.

The tongue is tender and dark, and the pulse is fine and smooth.

Prescription: 8g Bupleurum, 15g Dipsacus asper, 15g Ligustrum lucidum, 10g Linderae, 3g Aucklandia lappa, 8g Ligusticum chuanxiong, 10g Epimedium, 10g Rehmannia root, 10g Chicken gizzard lining, 10g Citrus aurantium, 14 packs.

Sixth visit: September 21, 2004.

The last menstrual period was on September 17, 2004. The menstrual flow was moderate and the premenstrual basal body temperature was typically biphasic, with the high temperature phase lasting for 13 days.

The tongue is tender and dark red, and the pulse is thin, smooth and strong.

Prescription: 5g of Bupleurum, 20g of Wax Gourd Peel, 8g of Chuanxiong, 10g of Eucommia, 10g of Cyperus, 0g of Citrus aurantium, 10g of Chicken Gizzard Stone, 15g of Lycium Barbarum, 20g of Cuscuta, 20g of Viscum Alpinia, 20g of Dipsacus Asper, 12g of Poria, 【4 packs】.

After 5 months of treatment with the method of warming the kidney as the main method, nourishing yin as the auxiliary method, and assisting in soothing the liver, the patient's basal body temperature is gradually approaching normal, the corpus luteum function is significantly improved, and the pulse is smoother and stronger than before, indicating that the kidney qi is abundant, which has laid a good foundation for future pregnancy.

Seventh visit: October 12, 2004.

The last menstrual period was at 17h on September 2004. The basal body temperature rose for 14 days and dropped today.

The tongue is pale with yellow coating, and the pulse is deep and slippery.

Prescription: 15g of Polygonum multiflorum, 10g of Angelica sinensis, 10g of Citrus aurantium, 6g of Amomum villosum, 10g of Eucommia ulmoides, 8g of Ligusticum chuanxiong, 12g of Prunella vulgaris, 10g of Sappan wood, 10g of Radish Seed, 12g of Poria cocos, 6g of Curcuma aromatica, 10g of Cyperus rotundus, 10 packs. Take on the 5th day of menstruation.

After treatment, the basal body temperature has returned to normal, and it has dropped today. Menstruation is about to come. The yellow tongue coating appears again, indicating that there is heat in the body. The seven-diagnosis prescription reduces the use of warm kidney products for treatment, and the focus is shifted to clearing turbidity, promoting qi and clearing heat. Medicinal herbs such as Citrus aurantium, Amomum villosum, Prunella vulgaris, Radish seed, Curcuma aromatica, and Cyperus rotundus are used. Although the patient's basal body temperature has been high for 14 days and has dropped today, because menstruation has not yet come, it is unknown what the body temperature will be tomorrow. If the body temperature continues to rise after tomorrow, there may be a possibility of pregnancy. This prescription has used blood-related drugs such as Angelica sinensis, Sappan wood, and Curcuma aromatica, so for the sake of caution, the patient's body temperature continues to drop and the medicine is taken on the 5th day of menstruation.

/＼Diagnosis: October 26, 2004.

Last menstruation was on October 12, 2004. The premenstrual basal body temperature was atypically biphasic. The tongue was dark red and the pulse was deep and slippery. Prescription: 8g of Bupleurum, 12g of Lotus Leaf, 12g of Ejiao, 12g of Toona Bark, 1Cg of Dioscorea Opposita, 10g of Atractylodes, 3g of Rose, 20g of Raw Oyster, 15g of Eclipta Prostrata, 20g of Thistle, 3g of Lotus Seed Heart, 14 packs. Ninth diagnosis: November 16, 2004. Last menstruation was on October 12, 2004. The basal body temperature rose for 18 days. Today, the urine enzyme (HCG) was positive, confirming pregnancy. Recently, I have a cold and cough, with a small amount of vaginal bleeding and no abdominal pain.