Acupuncture & Uterine Myomas

abstracted & translated by

Bob Flaws, Lic. Ac., Dipl. Ac. & C.H., FNAAOM (USA), FRCHM (UK)

Uterine myomas (more commonly called fibroids by laypersons) are a benign reproductive system tumor which are categorized as concretions and conglomerations in Chinese medicine or as glomus lumps. In issue #9, 2003 of Xin Zhong Yi (New Chinese Medicine) , Hai Ri-han, of the Acupuncture Department of Third Affiliated Hospital of Zhongshan University in Guangzhou, published an article titled, "an Anlysis of the Therapeutic Effects of Treating 16 Cases of Uterine Myoma with Acupuncture." This article appeared on page 44 of that journal. A summary of its main clinical points is given below.

Keywords: Chinese medicine, acupuncture, gynecology, uterine myomas

Cohort description

All 16 patients in this clinical trial were 21-48 years of age, with most between 30-40 years. All these women had previously been diagnosed with uterine myomas at the author's hospital via ultrasound. These myomas were from 4.5cm x 3.4cm x 5.0cm to 1.2cm x 1.0cm x 0.8cm in size. There were eight cases of intramural myomas, three cases of subserosal myomas, three cases of submucosal myomas, and two cases of multiple myomas.

Treatment method

Acupuncture consisted of needling the following main points: Zu San Li (St 36), Qi Hai (CV 6), and Tai Xi (Ki 3). Auxiliary points included Zi Gong (M-CA-18), San Yin Jiao (Sp 6), and Tai Chong (Liv 3) or Qu Gu (CV 2), Guan Yuan (CV 4), or Yin Ling Quan (Sp 9). On Zi Gong , a 1.5 inch needle was used angled towards the uterus and stimulated with twisting and turning hand technique. At Qi Hai and Guan Yuan, a 1.5 inch needle was used angled downward and stimulated with even supplementing-even draining hand technique. At Qu Gu , a one inch needle was inserted perpendicularly. At Zu San Li and Tai Xi , twisting and turning supplementation hand technique was used. At San Yin Jiao, Tai Chong, and Yin Ling Quan , twisting and turning draining hand technique was used. After obtaining the qi, the needles were retained for 40 minutes. The main points were treated once each day, while the auxiliary points were alternated every other day. Ear point stimulation consisted of affixing Semen Vaccariae Segetalis ( Wang Bu Liu Xing ) at Pelvic Cavity, Liver, Kidney, Spleen, Internal Secretion, Uterus, and Subcortex and then pressing these seeds. Ear points were switched from ear to ear every other day. Ten treatments equaled one course of therapy, and four course were given in succession. After every other course, a one week rest was allowed.

Treatment outcomes

Cure was defined as disappearance of clinical and bodily symptoms with disappearance of the myoma(s) demonstrated by ultrasonography. Marked effect was defined as complete disappearance of clinical and bodily symptoms with ultrasound showing the myoma had shrunk by half. Some effect was defined as improvement in clinical and bodily symptoms with shrinkage of the myomas by less than one half. No effect meant that there was no improvement in symptoms and not change in the size of the myoma(s). Based on these criteria, four out of 16 cases were judged cured, six got a marked effect, four got some effect, and two got no effect. Therefore, the total effectiveness rate was 87.49%. In terms of the different locations of myomas, of the eight intramural tumors, three were cured, two got a marked effect, two got some effect, and one got no effect. Of the three subserosal tumors, one was cured, one got a marked effect, and one got some effect. Of the three submucosal tumors, three got some effect, and of the two multiple myomas, one got some effect and one got no effect. Unfortunately, the outcomes based on size of myomas was not given. Dr. Hai does say that the best outcomes were seen in those with the shortest course of disease. He also says that this protocol was not able to completely eliminate the tumors in any of the menopausal or soon to be menopausal women. In these cases, the best that can be expected is remission of symptoms and stoppage of any further growth of the tumors.

Discussion

According to Dr. Hai, this condition's disease mechanisms are a mixture of vacuity, blood stasis, and phlegm. As it says in the Zheng Zhi Hui Bu (Patterns & Treatments Collected Supplement) , "Strong, replete persons do not have accumulations, [while] vacuity persons tend to have phlegm mixed with blood and fluid congelation and binding which produces [tumors]." Therefore, Dr. Hai believes that it is vacuity which is the root of this disease and that it is mainly loss of regulation of the function of the three viscera of the liver, spleen, and kidneys which is to blame. Therefore, the qi and blood becomes disharmonious and binding is produced in the uterus. While many Chinese doctors believe that treatment of uterine myomas should primarily course and free the flow of the channels and network vessels, quicken the blood and transform stasis, Dr. Hai believes that it is also important to support the righteous in this condition, meaning to boost the qi and nourish the blood. This is based on his view that the root is one of vacuity and repletion is merely the tip or branches of this condition. This is also very much my own opinion and experience.

Copyright © Blue Poppy Press, 2004. All rights reserved.

For more information on the Chinese medical treatment of uterine myomas, see Bob Flaws on Gynecology, a Distance Learning program available from Blue Poppy Institute. Also see The Essence of Liu Feng-wu's Gynecology available from Blue Poppy Press as well as Research Reports #32, 173, 328, and 356.