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Posts Tagged ‘Use different treatment’

Sometime, patient, who has tried to conceive, asked me the question–“Dr.Fan, for infertility treatments, do you think it is necessary to use different acupuncture points, based on different period phases?”

Similar question we could ask–“Dr.Fan, using Chinese herbology, what do you comment to using different herbs according to women period phases?”

My answer is:

TCM treatments based on period phases, either acupuncture or Chinese herbology in Chinese Gynecology, actually was based on my two teachers, Dr.Xia Gui Cheng (some books published in western countries in recent years  in English language may reflect Dr. Xia’s experiences and theories) and Dr. Sun Ning Quan (he died in early of 1990s), who clearly mentioned the relationship between women period phases and Yin-Yang cycle in 1970s.  They clearly mentioned using different Chinese herbs/ formula to treat the illness/disorders which are related to women’s period cycle, or adjust the irregular period to reach the aim of conceiving.  Before them, almost all Chinese medicine doctors use traditional Pattern differeciation (Bian Zheng Lun Zhi) to treat female patients.

So, we could have two different ways / strategies to handle same problem, i.e.infertility–either traditional Bian Zheng Lun Zhi or according to period phases(actually another style Bian Zheng Lun Zhi).  For teaching in class or writing / publishing a book, the practitioners (TCM doctors, teachers) may prefer to using different methods to treat patients in different period phases.  Such as in period flow time, using certain methods; in estrogen phase, using certain methods; during ovulation, using certain methods; and during progestrone phase, using certain methods.

In theory, we prefer that, but we need to consider the real practice condition.  This rule/method could adjust according to fit different conditions.

Using only one set of treatment strategy may not fit to everyone, esp. to patient who has some experience from other practitioners’ office or reading some books. However, sometime, we have to use it, of course, still need modify accordingly.

Talking acupuncture first.

For fertility issue, we, indeed,could do different “menu” for different phases of period, however, some patients are not like certain positions or some points.  I mean we face some challenge sometime. So we have to use equievlant points in a patient’s confortable position.

Second, we find it is not uncommon–when patients come to see me, sometime they forget the exact days in their period cycle. When I ask– “today, what day is in your period cycle?” Patients may reply–” Oop! I need ask my husband”, or ” I need look for my calender” (today I met two!).

And it is very common–” I have/had a travelling”, “I am/was busy…..”, “I am sorry to miss the appointments”.  So it seems we could not do something in real time in some patients.

Sometime, doing acupuncture according to patients’ period cycle seems very difficult.

So, based on 25 years of my clinical experience, I feel basing on traditional strategy sometime is also a good option.  I use one bigger acupuncture formula to adjust according to specific condition, which includes a few things (here, we use conventional words / terms, although we do consider it in TCM theory and terms, the original thinking style):

1. Adjusting the energy level to handle the stress or mental issue, which affects gynecological function;

2. Adjusting hypothalamus and pitutary function which is upper center for ovaries and uterus functions;

3. Adjusting the local function of ovaries and uterus functions, and circulation of pelvic area.

Total how many needles for this formula? 25-30 per time.

Each time, we basically do not want to adjust the formula totally, may be adjusting 3-5 needles based on new condition or phases issue.  One reason is about half of our patients don’t like to use less needles (“why last time used 25, today use 21?”)–they paid, so they want to use more, at least same amount needles; And, explanation takes too much time. However, we do adjust if different patterns, or patients’ different reactions occur.

The results from our center for fertility is good, over 40 ladies got pregnant, either acupuncture alone or with IVF, IUI since 2007.

Talking about Chinese herbology.

In China, the herbology for infertility treatments has been a main therapy since 2000 years ago.  Before my teachers, “the great master”, Dr. Xia Gui Cheng (who helped Chinese president Hu Jing Tao to get his grandchild) and his former colleague Dr. Sun Ning Quan (he was the first one who mentioned using TCM herbs to adjust patients’ period based on patient’ s period phases), in history, TCM gynecologists almost all using single method to treat infertility, such as adjusting Live Qi, Regulating the Blood, or Tonifying the Kidney and Spleen…… Since my teachers, the rule has been changed–adjusting women’s period according to period phases.  It is sure, I am their “good student”.

However, in United States, the culture is very different.  Using herbs meet some challenges in present time.

No.1 issue is patients seem not like the tastes, and using too much time to cook; and it is not uncommon–forgot to take in time.  “Too busy” is one of their stories.

No.2. FDA still treats herbs as food, so any side or adverse effect is not allowed for herbs.  And, conventional MDs are not welcome new remedies which may have a competition with them–they have no training in herbology too, so they might always give negative advices to patients for herbs.

So, 2/3 patients could not use herbal tea regularly, 1/2 patients could not use herbal pills in time.

For getting more positive results, I have been working on more herbal application combining with acupuncture.

Following the Big Tao(Dao), Making Everything Real Simple” (Da Dao Zhi Jian).  Using one set of treatment plan to modify in fertility treatment is my current main method.

I heard famous TCM gynecologist Dr. Bei Run Fu in California also has simplified his treatment strategies. In China(15 years ago), he prefered the Dr.Xia’s theory and published many papers; but when he came in USA, he gradually comes back to the traditional Bian Zheng Lun Zhi, to use one strategy to modify the formula in fertility Chinese herbology practice today.

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