Late autumn has arrived, the cold wind is gradually rising, for some sisters who are difficult to implant embryos and worry about protecting the fetus, the upcoming "severe winter" seems to be impossible to pass... Their uterus has fallen into "hibernation" for various reasons, and various treatment methods such as Western medicine, surgery, uterine cavity perfusion, and test tube transplantation are difficult to "wake up". How can a womb that has fallen into "hibernation" usher in the "spring" of vitality and install a warm "bed" for the baby?
Recently, Professor You Zhaoling, chief professor of integrated traditional Chinese and Western medicine gynecology in Changsha Jiangwan Hospital and a national-level famous Chinese medicine doctor, said in an interview: "If the uterus is the first suite of life, then the endometrium is the first bed of life. Endometrial tolerance is an important starting point for women's pregnancy success or failure, only if the endometrial tolerance is normal, the uterus may be able to tolerate and nurture." It turned out that this was the "birth theory" from professor You Zhaoling's original reproductive theory of the four theories.
Professor You Zhaoling was in a visit at Changsha Jiangwan Hospital
Professor You Zhaoling's "Fetal Theory" is based on the main purpose of improving the implantation rate of embryos and the success rate of clinical pregnancy, and puts forward new ideas and new methods that are conducive to the formation of embryos and membranes, assisting embryo implantation, and absorbing embryos and fetal elements. Its core idea is to focus on the "coordination, tolerance and compatibility" between the endometrium and the embryo, and to achieve the purpose of "tolerance" through the "two steps of fetal safety". "Two steps of fetal safety": that is, before implantation after ovulation, the emphasis is on "building a nest and attracting phoenixes", so the spleen is mainly healthy, supplemented by supplementation of the kidney, in order to improve the quality of the inner membrane through the blood essence of the spleen, taking, taking, taking, supporting, raising embryos, and fetal elements; after implantation, the emphasis is on ensuring "Guotai Min'an", so the kidney is mainly supplemented, supplemented by healthy spleen, aimed at cultivating the essence of the kidney to tie, solid, nourish, nourish, nourish the embryo, and fetal yuan. That is what Professor You said: "The spleen is in front of the camp, and the kidney is in the back." For the two stages, she created the implantation party, the implanting pot and the fetal formula, the fetal formula, the fetal pot, and the fetal pot.
Case Sharing:
Ms. Wang, a 37-year-old patient, was introduced by you to the specialist clinic of Professor You Zhaoling of Changsha Jiangwan Hospital due to repeated test tube failures. Based on the medical history and auxiliary examination, Professor You analyzed the problems:1. DOR (small number of follicles); 2. uterine adhesions (postoperative re-adhesion); 3. PID (endometritis, pelvic inflammatory disease + pelvic adhesions). The patient had 4 residual frozen blastocysts in the test tube, and Professor You suggested the plan: 4D-TVCD (four-dimensional ultrasound) after passing the hysterical adhesion isolation, continuous FET after reaching the standard, and the whole process of Chinese medicine accompaniment. In October 2020, the hysteroscopic review passed and took the balloon, and the D20-day check 4D-TVCD prompted the thickness of the inner membrane, the condition of the uterine cavity, the binding belt, and the tolerance of the inner membrane basically met the standard, and the doctor ordered that the natural cycle transplantation should be carried out in December 2020, and Professor You gave: 1. IVF implantation party 10 pay, composition: astragalus 15g ginseng flower 10g baishu 12g white peony 15g lotus seed 10g lily seed 10g lily flower 5g mulberry parasitism 10g dogwood 10g silk seed 10g wumei 10g licorice 5g, 1 pay per day, fry 200ml * 2 times warm, take on the day of transplantation. 2. 2 implantation pots, one on the 2nd and 5th day of transplantation. On the 8th day of transplantation, the blood was measured with HCG 693.2mIU/mL, progesterone 29.3 ng/mL, and estradiol 281.9 pg/mL on day 12. Follow-up treatment: 1. IVF fetal formula 10 pay, composition: astragalus 10g ginseng 10g perilla stem 10g baishu 10g yam 15g lotus whisker 6g dogwood 10g mulberry parasitism 15g kudzu 10g fetal chrysanthemum 5g silk seed 10g tangerine peel 10g licorice 5g, 1 pay per day, frying method same as before. 2. 3 you's fetal pot, stew one every 5 days. After the follow-up of the fetus until 3 months, at the end of September 2021, the caesarean section delivered 1 female treasure, the mother and daughter are safe.
You's "Nathan theory" features
1 "Different categories step by step" content introduction
Professor You Zhaoling said: Due to the different ways of conception, the physiological characteristics of pregnant people are not the same, and they should be divided and treated, so Professor You summarized it into 4 words in the theory of fetal birth - "different categories and steps". The so-called "different categories" refers to the different fertilization methods of patients, which are divided into four categories: in vitro fertilization - embryo transfer (IVF-ET), artificial insemination (AI), chinese and Western combination of drug fertility and chinese medicine self-conception; the so-called "step-by-step" means that such patients should be implemented before implantation, after implantation "two steps" strategy to ensure the smooth implantation of embryos, improve pregnancy rate.
1.1 Before embryo implantation - classification and treatment
For those who receive IVF-ET, AI, and Chinese and Western medicines to help conceive, Professor You advocates starting fetal feeding before the embryo implants. Treatment at this stage emphasizes differential administration.
1.1.1 For IVF-ET fertilizers
For those who receive IVF-ET fertility, the purpose of TCM adjuvant treatment is to protect the egg and nourish the membrane and implant the fetus.
Features of the program: First, the prescription drugs used are mainly to strengthen the spleen, supplemented by kidney supplements, and purify the heart and nourish the spirit. It is often used to use ginseng, astragalus, white art, yam, lotus seed, psoralen, dogwood, mulberry parasitism, continuous interruption, gardenia, lily and other drug combinations. The second is the combination of decoction and medicinal food "implantation pot", medicine borrows food taste, food aids medicine. The third is to control the timing and synchronize the "drug embryo".
How to do this: Start taking the drug on the day of the embryo transfer. For those who transplant fresh embryos, take 12 Chinese medicine decoctions and 2 implantation pots on the 2nd and 7th day after transplantation. For blastocyst transplanters, take 10 chinese medicine decoctions and 2 implants on the 2nd and 5th day after transplantation.
1.1.2 For AI, Chinese and Western medicines to help conceive, or advanced age pregnancy preparation
For those who receive AI, Chinese and Western medicines to help conceive, and those who are preparing for pregnancy at an advanced age, the purpose of Chinese medicine adjuvant treatment is to absorb sperm into embryos and nourish the membrane "strong bed".
Program features: Because the combination of sperm and egg of this kind of fertility method is carried out in the body, its treatment method focuses on tonifying the kidney and sperm, opening the window to implant, and at the same time to improve the qi and strengthen the spleen, and strive to achieve the effect of fetal taking, supporting and raising the fetus on the basis of a strong bed base. Commonly used drugs are sand garden seeds, silk seeds, mulberry seeds, yellow essence, ginseng, astragalus, yam, white art, lily and so on.
Specific method: Start taking 14 doses of Chinese medicine on the day of the first infusion or on the day of the guidance of intercourse; implantation pot 1 is taken after the first infusion, or on the 6th day after the guidance of intercourse.
1.1.3 For patients with recurrent miscarriage or a history of adverse pregnancy
For patients with recurrent miscarriage or a history of adverse pregnancy, the purpose of TCM adjuvant treatment is to cultivate damage recovery and nourish embryos and long membranes.
Features of the programme: Because of its history of recurrent miscarriages or adverse pregnancies, fetal adoption should also begin before the embryo implants. Following the principle of "pre-cultivating its loss" in traditional Chinese medicine, the treatment is to tonify the kidney and spleen, benefit the qi and nourish the blood, and regulate the chong ren, and the commonly used drugs are: silkworm seed, continuous interruption, mulberry parasitism, ripe yellow, white peony, deer antler cream, bayantian, dang ginseng, baishu and so on.
Specific method: Start taking decoction before preparing for pregnancy, and cooperate with warm nest pot, nest pot, pregnancy pot, yang membrane pot, yang nest cake, yang membrane cake, etc. for treatment, usually adjusting and treating the 3 menstrual cycle.
1.2 After embryo implantation - dialectical medication
For those who receive IVF-ET, AI, Chinese and Western medicines for fertility, as well as recurrent miscarriages or have a history of adverse pregnancy, the second step of the fetal feeding program is implemented after a positive urine test. Treatment at this stage emphasizes dialectical application of medicinal diet, focusing on fetal care and fetal protection.
Features of the program: First, dialectics, generally take kidney deficiency, blood fever, deficiency of qi and blood, blood stasis, etc. as the main points of the disease, and the treatment focuses on supplementing the kidney and strengthening the spleen, and fixing the fetal element. The second is the combination of medicine, diet and nutrition, which is intended to absorb embryos and raise fetal elements. In medicine, "one root, two mountains and three leaves" is often used, namely ramie root, dogwood, yam, mulberry leaf, light bamboo leaf, and orange leaf. For those with bleeding, add lotus whiskers, lotus rooms, skullcap charcoal, wumei charcoal, etc.; those with abdominal pain add fried white peony, burning licorice and so on. This issue emphasizes not to use cold, hot, too dry, greasy, lightly infiltrated, and toxic products.
Specific methods: The time of taking meals and medicines begins after confirming implantation, and those who receive IVF-ET, AI, and Chinese and Western drugs to help conceive, take the drug until the ultrasound B ultrasound sees the fetal heart rate as appropriate. Traditional Chinese medicine decoctions are generally taken in 10 doses, and 2 are in-place pots, 1 every 5 days. In patients with recurrent miscarriage, the current stage of fetal treatment is generally maintained for more than two weeks of the previous abortion and small birth. All kinds of patients with fetal leakage and fetal restlessness will continue to dialectical fetal treatment. Patients are instructed not to do actions such as lifting their hands, bending down to carry, climbing up the stairs, etc., avoid emergency braking in the car, avoid sexual intercourse within three months; avoid eating dogs, sheep, beef, and fried, barbecued, spicy divergent things that hinder the fetus. Pay special attention not to stay up late, avoid colds, spring dreams, and keep your stools clear.
Professor You Zhaoling led the disciples
2 "Category step-by-step" innovation lies
2.1 The tire is moved forward, due to the "time" conditions
The simultaneous administration of medicine and diet before embryo implantation is a breakthrough in time for the traditional Chinese medicine method of fetal implantation. Traditional fetal care methods are mostly implemented after pregnancy is determined, or when there is a threatened miscarriage. Clinical practice has proved that the desired effect is often not achieved. Professor You proposed that on the day of embryo transfer, or after artificial insemination or drug ovulation induction and fertility, that is, before the embryo implantation, Chinese medicine decoctions and medicinal diets with spleen and qi as the main treatment method should be taken, and the embryo should be nourished with a long membrane to promote embryo implantation. Clinical trials have demonstrated that this method can reduce the incidence of biochemical pregnancy in IVF-ET patients, thereby improving embryo implantation rate and clinical pregnancy success rate.
Due to the "time" conditions, it is also reflected that Professor You's administration time and course of treatment are determined based on the time law of fertilized egg development, delivery and implantation, and truly achieve accurate treatment.
It is well known that in the natural state, human embryos are implanted in the mother in the form of blastocysts. The blastocyst is formed about the 5th to 6th day after fertilization, the blastocyst enters the uterine cavity after formation, and floats free for 1 to 2 days before it begins to implant, and on the 9th day after fertilization, that is, the 5th day after the blastocyst enters the uterine cavity, it is fully implanted into the uterine lining and completes the implantation of the fertilized egg.
For those receiving IVF-ET, each reproductive center will decide to transplant fresh embryos, frozen embryos, or blastocysts according to individual differences.
In general, blastocysts are the terminal stage of embryo in vitro culture, which takes longer than fresh embryo in vitro culture, and the implantation rate after transplantation is relatively high and two days earlier. Therefore, For those who transplant blastocysts, Professor You requires the decoction to start taking on the day of transplantation, generally 10 doses in a row; the implantation pot is taken one on the 2nd and 5th days of transplantation, that is, on the day when the blastocyst begins to implant and the day when the endometrium is fully implanted, to help the blastocyst penetrate the implantation process.
For those who transplant fresh embryos, because the time of in vitro culture of fresh embryos is slightly shorter than that of blastocysts, the time of implantation after transplantation is later than that of blastocysts, so while letting patients take 12 doses of decoction continuously, it is emphasized that the time of taking implantation pot should be selected on the 2nd and 7th day of transplantation, that is, the day when fresh embryos begin to implant and the day of complete implantation of the inner membrane.
For artificial inspirators, because fertilization is carried out in the body, the development of fertilized eggs takes time, Professor You advocates that the decoction medicine began to be taken after the first transsemination, generally taking 14 doses continuously; the implantation pot was taken on the 6th day of insination (that is, the day when the blastocyst began to implant the endometrium).
2.2 Re-strengthen the spleen before implantation, and re-replenish the kidneys after implantation
Before implantation, Professor You mainly uses the spleen and stomach, supplemented by kidney tonic. Modern medicine believes that the uterus has a very short window period allowing the fertilized egg to implant. Among them, the synchronous development and functional coordination of blastocyst surface trophoblasts and endometrial lining are important conditions for implantation of fertilized eggs. Because the transferred embryos enter the uterus 3 to 4 days earlier than the natural cycle of fertilized eggs, this jet lag causes the endometrial growth to be later than the embryo development, coupled with the effects of deregulation, ovulation induction, puncture egg retrieval, embryo transfer and other endocrine effects, so that the endometrial growth is slow. The thin inner membrane is not compatible and cannot start the window period in time. Therefore, at this time, it is urgent to promote the growth of the inner membrane and maintain the fetal element. However, the spleen is healthy to help transport, quickly replenish the spleen and stomach of the day after tomorrow, and the water valley is refined to refine the qi and blood to take the long membrane as the only way.
The Inner Classics say, "Those who have a pulse are tied to the kidneys." "When the kidney qi is full, it can tie the fetus; the kidney deficiency is damaged, and the fetus is bound to be not solid." Therefore, after the embryo implants, it is mainly to supplement the kidneys, supplemented by a healthy spleen.
2.3 Combined diet and medicine, equal emphasis on recuperation
Medicinal food is good at nourishing the body's qi and blood, and the addition and subtraction changes are flexible, suitable for a long period of time. Professor You combines decoction medicine with medicinal diet, focusing on the cause, the person, the time, and the place.
"Feeding according to evidence", that is, dialectical feeding. For example, those with spleen deficiency should choose more spleen and spleen-strengthening products such as dang ginseng and astragalus; those with kidney deficiency should choose more earring dendrobium, yellow essence and other yin and kidney tonic drugs; waist pain, vaginal secretion of coffee-like substances, and even bleeding, ramie root, or wormwood leaf, etc.; bloating, nausea, can be added Su stem, sand kernel, etc.
"Feeding according to the time" is mainly reflected in the corresponding medicinal diet given according to the different periods of embryonic development, and the taking time is refined to the first few days of embryo transfer. As mentioned earlier, before the embryo implants, the treatment focuses on strengthening the spleen and nourishing membrane, promoting embryo implantation, so patients are often allowed to take implantation pots. After the embryo implantation, the treatment focuses on tonifying the kidneys and nourishing the blood, improving the qi and the fetus, and generally letting the patient take the fetal pot and the fetal pot.
"Feeding according to people", manifested in the administration of medicinal food, but also combined with the age of the patient's physique varies from person to person: fat people have more phlegm and wet, less use of fat and thick; thin people are more false fire, less use of warm and dry. Young or active people, the amount of medicinal food can be appropriately increased; the elderly and quiet, as well as the body of the spleen deficiency, the dosage should be light, or eat less and more meals.
"Giving food according to the place" emphasizes that medicinal food is different according to the difference between the terroirs of the fang domain. For patients in the north who come from a cold, rainy and dry environment, more moisturizing products are given and appropriate warm supplements are given; and for patients in the south who are in hot, rainy and humid areas, they are always given light products, appropriate dry and wet.
2.4 Use Gui qian with caution and add anthers skillfully
In the traditional Formula, angelica and Sichuan Root are often matched with products that smooth qi and blood, such as Zhang Zhongjing Jiao Ai Siwu Soup, Angelica San, "Outer Terrace Secret Essentials" Angelica Soup, "Ancient and Modern Medical Unity" Taishan Panshi Scatter and other prescriptions, there are angelica and Sichuan Root; angelica is also included in the famous Fang Fetal Yuan Drink. Gui qian is a spicy and fragrant dry product, You Shi believes that it is not appropriate in the warm area of the south, especially modern people like to eat spicy fried, fat and thick products, often moist and hot, so Professor You lin testimony rarely use Gui Qian, afraid that its moving tire will hurt the fetus.
For those who are not well nourished by qi and blood, or pregnant women with high laboratory D-dimer, large blood flow resistance, and abnormal blood coagulation detection indicators, Professor You generally chooses flower drugs that are both unsmooth and safe without the disadvantages of moving fetuses to disperse the veins, such as ginseng flowers, plum blossoms, tortoiseshell flowers, lilies, placentas, etc.
In summary, Professor You's "fetal theory", which not only integrates Traditional Chinese and Western medical theories, but also embodies the preventive medicine idea of "treating diseases before they occur" in Traditional Chinese medicine, which can effectively improve the implantation rate of embryos and the success rate of clinical pregnancy, adapt to the needs of the times, and is the inheritance and development of traditional Chinese medicine fetal settlement methods.
Changsha Jiangwan Hospital is led by Professor You Zhaoling, a national-level famous Chinese medicine doctor, and Professor Zhu Fufan of the Second Xiangya Hospital, to create a joint diagnosis and treatment model of traditional Chinese and Western medicine and fetal protection, for patients with different symptoms, the combination of Chinese and Western, complementary advantages, personalized dialectical treatment, and scientific and accurate fetal preservation of the whole course of disease management, significantly improve the success rate of fetal preservation for patients with difficult pregnancy and reconception.
For infertility patients, the doctoral team of professors such as Professor You Zhaoling, a national-level famous Chinese medicine doctor, Professor Xu Dabao, Professor Wan Yajun, and professor Xiao Hongmei, an expert in reproductive medicine, has created a multidisciplinary joint diagnosis and treatment platform for GEST in Jiangwan, breaking the traditional mode of treatment, and innovating to carry out multidisciplinary joint diagnosis and treatment of gynecology, infertility, traditional Chinese medicine, urology and andrology, eugenic genetics, ultrasound imaging, etc., to provide patients with one-stop closed-loop management of pregnancy and child seeking. While saving time and money and eliminating the trouble of traveling to see a doctor, it is more important for each team to fully understand the treatment methods and advantages of other teams, make the most accurate judgment and management of patients at the first time, achieve seamless docking of "you have me, I have you", and successfully achieve the common goal of "conceiving, keeping, growing well, being born smoothly, and being able to regenerate" for more and more families who are seeking children.
Author: Wen Lexi
Professor of Hunan University of Traditional Chinese Medicine, master tutor. He studied under Professor You Zhaoling, a national gynecological famous Chinese medicine doctor, and has been engaged in the clinical, teaching and scientific research of traditional Chinese medicine for nearly 40 years. He is currently the executive director of the Maternal and Child Health Branch of the Chinese Association of Traditional Chinese Medicine Information Research, the director of the World Central Women's Research Association, the standing committee member of the Prescription Science Branch of the Chinese Association of Traditional Chinese Medicine, and the director of the World Joint Medicine Dietary Therapy Research Professional Committee. Clinical diagnosis and treatment pays attention to the combination of disease, evidence, symptom and time, and the prescription attaches importance to the relationship between the quantity- effect and poison of the drug compatibility; health and beauty promote the unity of nature and man, food, drink and sleep. Clinically good at the treatment of gynecological menstrual irregularities, polycystic ovary syndrome, infertility, premature ovarian failure, threatened miscarriage, endometriosis, pregnancy thyroid disease, in vitro fertilization - embryo transfer, artificial insemination of traditional Chinese medicine has also accumulated rich experience.
Instructor: You Zhaoling
Chief Physician Professor Doctoral Supervisor
Experts who enjoy special government allowances from the State Council
Chief Professor of Gynecology of Integrated Traditional Chinese and Western Medicine in Jiangwan Hospital
Tenured professor of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine
The fourth batch of national famous Chinese medicine experts inherit academic experience and guidance teachers
The 2nd National Famous Doctor of Gynecology of Traditional Chinese Medicine of Chinese Association of Traditional Chinese Medicine
President of the Gynecology Branch of the World Federation of Chinese Medicine
Honorary Chairman of the Gynecology Committee of the Chinese Association of Traditional Chinese Medicine
Honorary President of the Reproductive Medicine Association of the World Federation of Chinese Medicine
Honorary President of Maternal and Child Health Branch of China Association of Information on Traditional Chinese Medicine
Cheung Sha Jiangwan Reproductive and Genetics Specialist Hospital
Address: Changsha City, Hunan Province, Kaifu District Shengshi Road No. 3 (kaifu district government opposite)
Tel: 0731-8970 6399