abstracted & translated by
Bob Flaws, L.Ac.
On pages 29030 of issue #5, 2010 of Shan Xi Zhong Yi (Shanxi Chinese Medicine), Chen Yi-jun et al. published an article titled, “Clinical Observations on the Treatment of Premature Ovarian Failure with Moxibustion Combined with Chinese Medicinals.” A summary of this article is presented below.
Cohort description:
Thirty-eight cases of POF were enrolled in this cohort study. All met the diagnostic criteria for POF found in Shi Yong Fu Ke Xue (Practical Gynecology, Beijing, 2001, p. 781). Besides key symptoms, such as amenorrhea or scanty menstruation, these women’s estradiol (E2) was low, while their follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were high. In addition, their basal body temperature (BBT) graphs were monophasic. These women were all 28-38 years of age, with an average age of 32.3 years. Their disease course had lasted from six months to 2.5 years, with an average duration of 2.2 years.
Treatment method:
Moxibustion consisted of Artemisia moxa applied once every other day at Shen Shu (Bl 23), Pi Shu (Bl 20), Qi Hai (CV 6), and Zu San Li (St 36). After every 10th treatment, a 2-3 day rest was allowed.
The Chinese medicinal formula used consisted of:
Xian Ling Pi (Herba Epimedii)
Ba Ji Tian (Radix Morindae Officinalis)
Tu Si Zi (Semen Cuscutae)
Nu Zhen Zi (Fructus Ligustri Lucidi)
uncooked Huang Qi (Radix Astragali)
Shu Di Huang (cooked Radix Rehmanniae)
Shan Yao (Radix Dioscoreae Oppositae)
Dang Shen (Radix Codonopsis), 15g each
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Bai Shao (Radix Alba Paeoniae)
Dang Gui (Radix Angelicae Sinensis), 12g each
Zi He Che (Placenta Hominis), swallowed with the decoction
Xian Mao (Rhizoma Curculiginis)
Bu Gu Zhi (Fructus Psoraleae), 10g each
Mu Dan Pi (Cortex Moutan)
Ze Xie (Rhizoma Alismatis), 6g each
If there was more severe yang vacuity, processed Fu Zi (Radix Lateralis Praeparata Aconiti) and Rou Gui (Cortex Cinnamomi) were added.
If there was more severe yin vacuity, Huang Jing (Rhizoma Polygonati) was added.
If there was torpid intake, scorched San Xian (Three Immortals, i.e., Shan Zha [Fructus Crataegi], Shen Qu [Massa Medica Fermentata], and Mai Ya [Fructus Germinatus Hordei]) and Ji Nei Jin (Endothelium Corneum Gigeriae Galli) were added.
If sleep was poor, stir-fried Suan Zao Ren (Semen Zizyphi Spinosae), Bai Zi Ren (Semen Platycladi), and He Huan Pi (Cortex Albiziae) were added.
If sweating was profuse, Fu Xiao Mai (Fructus Levis Tritici Aestivi) was added.
One packet of these medicinals was decocted in water two time and administered in two divided doses, morning and evening, with three months equaling one course of treatment.
Study outcomes:
Cure meant that menstruation came and continued to come normally for three months, clinical symptoms disappeared, the BBT returned to a normal bi-phasic graph, and serum sex hormones returned to within normal parameters. Improvement meant that menstruation came but did not return to its normal periodicity, clinical symptoms decreased, the BBT became bi-phasic, and serum sex hormone levels markedly improved. No effect meant that the menstruation did not return, symptoms did not disappear, and serum sex hormones did not markedly change. Based on these criteria, 14 cases were judged cured, 20 case improved, and four cases got no effect, for a total effectiveness rate of 89.5%.
Discussion:
According to the authors of this study, this disease is located in the three viscera of the kidneys, liver, and spleen, but most importantly is related to the kidneys. Its disease mechanisms are kidney depletion, liver depression, spleen vacuity, and loss of regulation of the qi and blood of the chong and ren. Therefore, its treatment principles should be to enrich the kidneys and fortify the spleen, course the liver, resolve depression, harmonize, regulate, and rectify the chong and ren, supplement the kidneys to secure the former heaven, fortify the spleen to enrich the source of transformation and engenderment of the qi and blood and supplement and bank latter heaven.
Within the above formula, Xian Ling Pi and Xian Mao supplement the kidneys and invigorate yang. They also warm yang but do not damage yin. Tu Si Zi is an essential medicinal for warming and supplementing kidney yang. It also boosts the kidney qi and fills essence and marrow. Zi He Che is “a bloody, meaty natured ingredient that can greatly supplement the original qi.” Shu Di Huang nourishes the blood and regulates menstruation. Ba Ji Tian is an essential kidney-supplementing medicinal. Huang Qi, Dang Shen, and Bai Zhu boost the qi and fortify the spleen. Shan Yao fortifies the spleen and assists movement. It also prevents the other supplementing medicinals’ enriching sliminess from blocking the stomach. Ze Xie and Dan Pi likewise prevent the enriching sliminess of yin-supplementing medicinals, such as Shu Di Huang.
Moxibustion on Shen Shu, Pi Shu, Qi Hai, and Zu San Li regulates and rectifies the spleen and kidneys, supplements and boosts the kidney qi in order to strengthen and assist the body’s righteous qi, regulate and supplement the qi and blood, warm and free the flow of the blood vessels.
The authors close their article by saying that patients with POF should eat a clear, bland diet and should avoid acrid, peppery, stimulating foods. They should also regulate their lifestyle to avoid over-taxation while getting adequate physical exercise. In particular, they should guard their mind and emotions, trying to stay as happy and positive as possible. When these kinds of dietary and lifestyle modifications are combined with the above medical and physical therapies, the chances of success are significantly better.
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