Efecto de la adición de glucosa en sangre

A 42 year-old woman presented with a history of pelvic infections lead-ing to obstruction of her fallopian tubes and infertility. While acupunc-ture and Chinese medicinals alone did not clear this blockage and enable this patient to become pregnant without the use of IVF, the treatments did, however, significantly improve her ovarian function and contributed to the patient’s successful IVF procedure. After six months of treatment, the patient produced an unusually large number of follicles with IVF. On average, a woman of her age produces less than 10 follicles in a given IVF cycle. This patient produced 35 folli-cles, 28 eggs, and 21 embryos. These were excellent results. The patient had four transfers before she became pregnant. The first trans-fer of six fresh embryos failed, as well as two consecutive attempts with frozen embryos. Her fourth transfer was successful. In December 2002, she gave birth to healthy twin boys.

This woman’s Chinese medical pattern discrimination was liver blood-kidney yin vacuity with qi stagnation and blood stasis. Signs and symp-toms included a pale tongue with teeth-marks on its edges and a red tip, and a bowstring, slippery pulse. She also had painful menstruation and was emotionally irritable. In addition, the woman experienced premenstrual breast distention and pain.

There were two goals of treatment for this patient with acupuncture and Chinese medicinals. First, I addressed the obstruction in her fal-lopian tubes. Second, if she were unable to become pregnant naturally, I prepared her for IVF and pregnancy. In order to improve circulation and remove the obstruction in her fallopian tubes, a modified Xiao Yao Fang (Rambling Formula), i.e., Chai Hu (Radix Bupleuri), Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Albus Paeoniae Lactiflorae), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Sclerotium Poriae Cocos), and Gan Cao (Radix Glycyrrhizae Uralanesis), was prescribed. This formula courses the liver, rectifies the qi, and nourishes and quickens the blood. Before her menstruation began, Suan Zao Ren (Semen Zizyphi Spinosae), Gou Qi Zi (Fructus Lycii Chinensis), Zhi Ke (Fructus Citri Aurantii), and Dan Shen (Radix Salviae Miltiorrhizae) were added to further course the liver and resolve depression, eliminate vexation and quiet the spirit, quicken the

blood and stop pain. Acupuncture points used during the premenstru-um were Zu San Li (St 36), San Yin Jiao (Sp 6), Xue Hai (Sp 10), Tai Xi (Ki 3), Tai Chong (Liv 3), He Gu (LI 4), Guan Yuan (CV 4), Qi Hai (CV 6), and Zi Gong Xue (M-CA-18). Ear points Kidney, Spleen, and Shen Men were also included. Xue Hai (Sp 10) and Bai Hui (GV 20) with Guan Yuan (CV 4) and Qi Hai (CV 6) are a useful combina-tion for increasing hormonal balance as well as for quickening and transforming blood stasis both during and after menstruation.

During her menstrual period itself, the patient was placed on (Menstruation-smoothing Formula), i.e., Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Albus Paeoniae Lactiflorae), Shu Di Huang (cooked Radix Rehmanniae Glutinosae), Chuan Xiong (Radix Ligustici Wallichii), Niu Xi (Radix Achyranthis Bidentae), Dan Shen (Radix Salviae Miltiorrhizae), Xiang Fu (Rhizoma Cyperi Rotundi), and Gou Qi Zi (Fructus Lycii Chinensis), to nourish the blood and emolliate the liver as well as course the liver and rectify the qi. Lu Lu Tong (Fructus Liquidambaris Taiwaniae), which moves the qi, and Wang Bu Liu Xing (Semen Vaccariae Segetalis), which quickens the blood, were also added. Rou Gui (Cortex Cinnamomi Cassiae) was also added to invigorate yang, while Suan Zao Ren (Semen Zizyphi Spinosae) was included to quiet the spirit. The same acupuncture points were used as above as well as infrared heat on her abdomen.

Post-menstruation, Xiao Yao Fang (Rambling Formula) was modified with Dang Shen (Radix Codonopsitis Pilosulae) to supplement the spleen and boost the qi, Zhi Ke (Fructus Citri Aurantii) to harmonize the qi, Shu Di Huang (cooked Radix Rehmanniae Glutinosae) to sup-plement the liver and kidneys, nourish the blood and enrich yin, and Ba Ji Tian (Radix Morindae Officinalis) to supplement and invigorate kidney yang. After six months of treatment, the patient was still unable to become pregnant with only acupuncture and herbs. Even so, the treatments had been preparing her for IVF.

When she started the IVF program, she took Huo Jing Zhong Zi Fang (Quicken the Essence & Plant the Seed Formula), i.e., Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Albus Paeoniae Lactiflorae), Chai Hu (Radix Bupleuri), Fu Ling (Sclerotium Poriae Cocos), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Dan Shen

(Radix Salviae Miltiorrhizae), Zhi Ke (Fructus Citri Aurantii), and Gan Cao (Radix Glycyrrhizae Uralanesis), while she was taking oral con-traceptive pills. This formula was modified with Dang Shen (Radix Codonopsitis Pilosulae) to supplement the spleen and boost the qi and Gou Qi Zi (Fructus Lycii Chinensis) to supplement the liver and nour-ish the blood. Acupuncture points Zu San Li (St 36), San Yin Jiao (Sp 6), Xue Hai (Sp 10), Tai Xi (Ki 3), Tai Chong (Liv 3), He Gu (LI 4), Guan Yuan (CV 4), and Qi Hai (CV 6) were needled and infrared heat was used on her abdomen.

Once stimulation began for follicular development, she was placed on Ding Jing Fang (Stabilize the Menses Formula), i.e., Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Albus Paeoniae Lactiflorae), Chai Hu (Radix Bupleuri), Fu Ling (Sclerotium Poriae Cocos), Shan Yao (Radix Dioscoreae Oppositae), Dang Shen (Radix Codonopsitis Pilosulae), Ba Ji Tian (Radix Morindae Officinalis), Tu Si Zi (Semen Cuscutae), Shu Di Huang (cooked Radix Rehmanniae Glutinosae), and mix-fried Gan Cao (Radix Glycyrrhizae Uralanesis), to supple-ment the kidneys and spleen, course the liver and rectify the qi, nour-ish the blood and emolliate the liver. Additional modifications were Chen Pi (Pericarpium Citri Reticulatae) to aid digestion and Gou Qi Zi (Fructus Lycii Chinensis) to nourish the blood. The formula and its modifications helped stimulate and balance the patient’s hormonal response to the Western supplements for IVF.

While transferring embryos, the patient was again placed on Huo Jing Zhong Zi Fang (Quicken the Essence & Plant the Seed Formula) plus Dang Shen (Radix Codonopsitis Pilosulae) and Suan Zao Ren (Semen Zizyphi Spinosae) to further boost the qi and quiet her spirit. Her acupuncture prescription remained the same with the addition of Zi Gong Xue (M-CA-18) to benefit the uterus, Bai Hui (GV 20) to bene-fit the secretion of pituitary hormones, and ear points Kidney, Spleen, and Shen Men.

After transfer of the embryos, An Tai Fang (Safety Fetus Formula), i.e., Sang Ji Sheng (Ramulus Sangjisheng), Xu Duan (Radix Dipsaci Asteri), Tu Si Zi (Semen Cuscutae Chinensis), Gou Qi Zi (Fructus Lycii Chinensis), Shan Zhu Yu (Fructus Corni Officinalis), Dang Shen (Radix Codonopsitis Pilosulae), Bai Shao (Radix Albus Paeoniae

Lactiflorae), and Bai Zhu (Rhizoma Atractylodis Macrocephalae), was prescribed to protect and encourage implantation. It was modified with the addition of Huang Qi (Radix Astragali Membranacei) and Suan Zao Ren (Semen Zizyphi Spinosae).

Once I knew the patient had conceived, An Tai Fang (Safety Fetus Formula) was continued as the base formula for another seven months in order to prevent miscarriage and encourage healthy development of the fetus. Modifications to this formula during this time included the addition of Huang Qi (Radix Astragali Membranacei) and Dang Shen (Radix Codonopsitis Pilosulae) to fortify the spleen and supplement the qi, Suan Zao Ren (Semen Zizyphi Spinosae) to nourish the blood and quiet the spirit, and Bai Shao (Radix Albus Paeoniae Lactiflorae) to nourish blood and relax the uterine muscles to prevent uterine con-traction. Mai Men Dong (Tuber Ophiopogonis Japonici) was also added to enrich yin. The patient’s acupuncture prescription was limit-ed to Bai Hui (GV 20), Yin Tang (M-HN-3), Si Shen Cong (M-HN-1), and ear points Kidney, Spleen, and Shen Men to avoid overstimulation and prevent miscarriage.