Sterility refers to inability to conceive three years af-ter marriage with normal sexual life and without contra-ception, or inability to conceive for two years after giving birth to a baby or after abortion without contraception. It is usually caused by dysfunction of ovary secretion and o-vum formation or deformity of genital organs. TCM be-lieves that sterility is caused by kidney asthenia and dys-function of the thoroughfare and conception vessels due to as-thenia of kidney essence, liver depression and qi stagnation, blockage of the uterus by phlegm and dampness as well as blood stasis and cold coagulation.

[Syndrome differentiation]

1. Kidney asthenia type

Sterility long after marriage, aching and weakness of loins and knees; the symptoms in delayed menstruation are scanty menorrhea with light color, even amenorrhea, profuse clear urine, loose stool, light-colored tongue with whitish color, thin and deep or slow pulse due to asthenia of kidney yang; the symptoms of early menstruation are scanty menorrhea with red color and without blood clot, emaciation, dizziness, palpitation, insomnia, dry mouth, fever, reddish tongue with scanty fur as well as thin and rapid pulse due to asthenia of kidney yin.

2. Liver depression type

The symptoms are sterility for years, irregular men-struation, abdominal pain during menstruation, unsmooth scanty menorrhea with blackish color and clot, distending pain in the breasts before menstruation, mental depres-sion, dysphoria, susceptibility to anger, reddish tongue and taut pulse.

3. Phlegm-dampness type

The symptoms are sterility long after marriage, obe-sity, delayed menstruation, even amenorrhea, sticky leu-korrhea, palpitation, dizziness, chest oppression, nausea, whitish greasy tongue coating and slippery pulse.

4. Blood stasis type

The symptoms are sterility long after marriage, de-layed menstruation with scanty menorrhea, purplish men-orrhea with clot, dysmenorrhea, unpressable abdominal pain during menstruation, blackish tongue with ecchymo-ses, taut and unsmooth pulse.

[Treatment]

1. Body acupuncture

Prescription: Zhongji (CV 3 ), Sanyinjiao (SP 6), Qixue (Ext.) and Zigong (EX-CA 1).

Modification: For kidney asthenia, Shenshu (BL 23) and Rangu (KI 2) are added; for asthenia of kidney yang, Mingmen (GV 4) and Guanyuan (CV 4) are added; for asthenia of kidney yin, Taixi (KI 3) is added; for liver depression, Ganshu (BL 18), Taichong (LR 3) and Yang-lingquan (GB 34) are added; for phlegm-dampness, Yin-lingquan (SP 9), Fenglong (ST 40), Zusanli (ST 36) and Zhongwan (CV 12) are added; for blood stasis, Geshu (BL 17) and Xuehai (SP 10) are added.

Performance. Needling is given from the 12th day of the menstrual cycle. For the treatment of kidney asthenia, reinforcing needling technique is used; Mingmen (GV 4 ) and Guanyuan (CV 4) are needled with warmed needles or applied with moxa-cone or moxa-roll moxibustion. For the treatment of liver depression, mild reinforcing and reduc-ing needling techniques are used; Ganshu (BL 18) is nee-dled with reinforcing technique, Taichong (LR 3 ) and Yanglingquan (GB 34) are needled with reducing tech-nique. For the treatment of phlegm-dampness syndrome, reducing needling technique is used; Zusanli (ST 36 ) is needled with reinforcing technique and the rest acupoints are needled with reducing techniques. For the treatment of blood stasis, reducing needling technique is used; Ge-shu (BL 17) and Xuehai (SP 10) are tapped with cutane-ous needles and applied with cupping after needling.

2. Ear acupuncture

Prescription: Endocrine (CO18), Internal Genitalia (TF2), Kidney (CO10), Subcortical (A%) and Apex of tragus (A% .2.4i ).

Performance: Each time 2 - 3 acupoints are needled with moderate stimulation for 30 minutes. Or Wangbuli-uxingzi (Semen Vaccariae) is used for ear acupressure. The two ears are pressed alternatively and the sealed seeds are changed once every 3-4 days. The patient is advised to press the acupoints 3 - 4 times a day.

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