abstracted & trasnslated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On pages 39-40 of issue #5, 2008 of Fu Jian Zhong Yi Yao (Fujian Chinese Medicine & Pharmacology), Zheng Hui-ying published an article titled, “The Treatment of 72 Cases of Early-stage Threatened Miscarriage with the Formula Shou Tai Yin Jia Jian.” A summary of this article is presented below.

Cohort description:

All the women in this two-wing comparison study presented with early-stage threatened miscarriage or spontaneous abortion. Altogether, there were 145 cases randomly divided into two groups – a treatment group and a comparison group. In the treatment group, there were 72 cases aged 23-42 years, with an average age of 29.3 years. Twenty-three of these cases had a history of one previous spontaneous abortion, 11 had had two spontaneous abortions, five had had three miscarriages, two had had four miscarriages, and 31 had never had a previous miscarriage. In the comparison group, there were 73 cases aged 22.5-43 years, with an average age of 29.1 years. Twenty-five of these women had previously had one miscarriage, 10 had had two, four had had three, and one had had four miscarriages, while 33 cases had never had a previous miscarriage. Therefore, for the purposes of this study, these two groups were judged statistically comparable.

All these women had been pregnant for only 12 weeks or less and all either had only a small amount of bleeding or low back soreness and lower abdominal sagging, distention, and pain. All tested positive for being pregnant, and ultrasound showed that the fetus was moving and the fetal heart beat was normal. Exclusion criteria included pregnancy of more than 12 weeks, being less than 20 and more than 35 years old, an abnormally sized uterus for the stage of pregnancy, a dilated cervix, psychiatric abnormalities, and inability to continue treatment.

Treatment method:

All members of the comparison group were orally administered 100 milligrams BID of vitamin E. They all were put to bed rest and were forbidden sexual activity. If the bleeding increased, they were administered 0.3 grams of P-aminomethylbenzoic acid and 1.0 grams of etamsylate in 250 milliliters of a 5% glucose solution administered intravenously to stop the bleeding. If the duration of bleeding was relatively long, patients were administered Shuang Huang Liang Zhu She Ye (Double Coptis Injectible Fluid) in 500 milliliters of saline solution given intravenously to prevent infection.

All members of the treatment group received the same basic treatment as the comparison group. However, they also received Shou Tai Yin (Long-life Fetus Beverage) with additions and subtractions orally as follows:

Xu Duan (Radix Dipsaci), 15g
Tu Si Zi (Semen Cuscutae), 20g
E Jiao (Gelatinum Corii Asini), 15g
Shan Ji Sheng (Herba Taxilli), 15g
If bleeding was profuse, 12 grams of Zhu Ma Gen (Radix Bohemeriae), 10 grams of blackened Di Yu (Radix Sanguisorbae), 10 grams of carbonized Ce Bai Ye (Cacumen Platycladi), 15 grams of Xian He Cao (Herba Agrimoniae), 10 grams of Han Lian Cao (Herba Ecliptae), and 10 grams of Nu Zhen Zi (Fructus Ligustri Lucidi) were added to stop bleeding and quiet the fetus.

If there was anemia, 15 grams each of Gou Qi Zi (Fructus Lycii), processed He Shou Wu (Radix Polygoni Multiflori), and Shu Di Huang (cooked Radix Rehmanniae) were added to nourish the blood.

If there was blood heat with dark, blackish, sticky blood, six grams of Huang Qin (Radix Scutellariae), 10 grams of Sheng Di Huang (uncooked Radix Rehmanniae), and 10 grams of Bai Shao (Radix Alba Paeoniae) were added to clear heat and resolve toxins.

In addition, depending on the situation, 10 grams of Su Gen (Caulis Perillae) and 10 grams of Sha Ren (Fructus Amomi) were added to normalize the flow of qi and quiet the fetus.

One packet of these medicinals was boiled in 500 milliliters water for approximately 30 minutes. After the water was brought to a boil by a high fire, the decoction was cooked at a gentler fire for 20 minutes. This first decoction was administered in the morning and then the medicinals were reboiled in the evening for a night-time dose.

Study outcomes:

Study outcomes were based on the criteria found in Zhong Yi Bing Zheng Zhen Duan Liao Xiao Biao Zhun (Criteria for Chinese Medical Disease & Pattern Diagnosis and Therapeutic Effects). Thus cure was defined as stoppage of bleeding, quieting of the fetus, the disappearance of accompanying signs and symptoms, and, after stopping treatment, examination showing a normal pregnancy. Improvement was defined as reduction in the bleeding, improvement in accompanying signs and symptoms, and examination showing a normal pregnancy. No effect was defined as non-stoppage of the bleeding with the situation proceeding to miscarriage or the death of the fetus within the abdomen. The following table shows the outcomes of the two groups based on these criteria.

Thus the integrated Chinese-Western medical protocol was significantly more effective than the Western medical treatment alone.

Discussion:

According to Dr. Zheng, early-stage threatened miscarriage corresponds to the traditional Chinese medical disease categories of fetal leakage and fetus stirring restlessly. Its mechanisms are kidney vacuity, blood heat, qi and blood vacuity weakness, and/or blood stasis resulting in loss of regulation of the chong and ren. Hence the fetal source is not secure and this condition develops. The kidneys store the essence, govern reproduction, and ligate to the uterus and fetus. Therefore, the kidney qi’s exuberance or decline affect the fetus’s growth and formation. If the kidney qi is exuberant, the fetal source is secure and, automatically, there is no fetal leakage or fetus stirring restlessly. Shou Tai Yin is composed of Tu Si Zi, Xu Duan, Sang Ji Sheng, and E Jiao. These all supplement the kidneys and enrich yin. If bleeding was profuse, medicinals which clear heat and stop bleeding and supplement the qi and stop bleeding were added.  If bleeding was due to heat in the blood aspect, medicinals which specifically clear heat from the blood were added. In addition, Xu Duan, Sang Ji Sheng, Zhu Ma Gen, Huang Qin, Su Gen, and Sha Ren are all empirically effective for forestalling a threatened miscarriage under the rubric of “quieting the fetus.”

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