Gui Shen Tang & Premature Ovarian Failure

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

Keywords: Chinese medicine, Chinese herbal medicine, gynecology, premature ovarian failure (POF), infertility

On pages 152-153 of issue #2, 2007 of the Zhong Yi Za Zhi (Journal of Chinese Medicine), Shi Li-jie of the gynecology department of the Tai An Municipal Chinese Medical Hospital in Shandong published an article titled “The Treatment of 30 Cases of Premature Ovarian Failure with Gui Shen Tang Jia Wei (Return the Kidneys Decoction with Added Flavors).” A summary of this article is presented below.

Cohort description:

A total of 50 patients with a confirmed diagnosis of premature ovarian failure were randomly divided into two groups: a treatment group of 30 and a comparison group of 20. All the women in the treatment group were 27-40 years of age, with an average age of 37.8 years, a disease duration of three months to three years, and an average disease duration of 1.5 years. In the comparison group, the women were 26-40 years old, with an average age of 38 years, a disease duration of 3.5 months to 2.8 years, and an average disease duration of 1.5 years. Therefore, these two groups were deemed statistically comparable for the purposes of this study. In terms of signs and symptoms, all these women had symptoms of menstrual irregularity or amenorrhea accompanied by hot flashes and sweating with possible low back and knee soreness and limpness, insomina, profuse dreams, vexatious heat in the five hearts, secondary infertility, and a dry vaginal tract. Serum estradiol (E2) was low, and follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were both high.

Treatment method:

Gui Shen Tang Jia Wei consisted of:

Tu Si Zi (Semen Cuscutae), 20g
Gou Qi Zi (Fructus Lycii), 15g
Du Zhong (Cortex Eucommiae), 12g
Shan Zhu Yu (Fructus Corni), 12g
Dang Gui (Radix Angelicae Sinensis), 12g
Shu Di Huang (cooked Radix Rehmanniae), 15g
Shan Yao (Radix Dioscoreae), 30g
Fu Ling (Poria), 30g
Gui Jia (Plastrum Testudinis), 15g, precooked
E Jiao (Gelatinum Corii Asini), 10g

One packet of these medicinals was decocted in water per day and administered in two divided doses.

If hot flashes and sweating were severe, 20 grams of Sheng Di Huang (uncooked Radix Rehmanniae), 15 grams of Xuan Shen (Radix Scrophulariae), and 12 grams of Dan Pi (Cortex Moutan) were added.

If insomnia or profuse dreams were severe, 15 grams of Zhen Zhu Mu (Concha Margaritaferae) were added.

If low back and knee soreness and limpness were severe, 20 grams of Xu Duan (Radix Dipsaci) were added.

All members of the comparison group were administered eight pills TID of Liu Wei Di Huang Wan (Six Flavors Rehmannia Pills) swallowed with warm water. Three months equaled one course of treatment for both groups. During this study, patients stopped taking any other medications.

Study outcomes:

Cure was defined as complete diappearance of all clinical symptoms, the return to normal of menstruation, and a return to normal parameters of serum E2, FSH, and LH. Improvement was defined as a continuance of menstruation, improvement in clinical symptoms, and an almost return of E2, FSH, and LH to within normal parameters. No effect meant that, after treatment, the menses still did not come, clinical symptoms were the same as before, and there was no improvement in E2, FSH, or LH. The following table shows the outcomes of the two groups based on these criteria.

Further, in the treatment group, the improvement rate for low back and knee soreness and limpness was 100%. The improvement rate for amenorrhea or infrequent menstruation was 86.7%. The improvement rate for hot flshes and sweating was 90%, the improvement rate for insomnia and profuse dreams was 83.3%, and the improvement rate for vaginal tract dryness was 65%. In the comparison group, those rates were 85%, 33.3%, 66.7%, 50%, and 50% respectively. And finally, in the treatment group, there was a marked increase in E2 from before to after treatment along with a marked decrease in FSH and LH. There were no adverse reactions seen in either group based on blood and urine analysis and liver and kidney function tests.

Discussion:

According to Dr. Shi, premature ovarian failure is not a disease category within Chinese medicine. However, its clinical menifestations correspond variously to delayed menstruation, scanty menstruation, blocked menstruation, and infertility. Within the above formula, Shu Di, Shan Zhu Yu, and Gou Qi Zi enrich the kidneys and nourish the liver. Tu Si Zi and Du Zhong supplement and boost the kidney qi. Shan Yao and Fu Ling fortify the spleen and harmonize the center. Dang Gui supplements the blood and regulates menstruation. To these are added Gui Jia and E Jiao, both bloody, meaty ingredients, which enrich yin and nourish the blood and help make the essence and blood full and sufficient. Taken as a whole, this formula enriches the kidneys at the same time as addressing the liver and spleen. Its emphasis is on boosting the essence and nourishing the blood.

Copyright © Blue Poppy Press, 2007. All rights reserved.