2. 手术后肠粘连、肠梗阻

2. Examining Differences Between Chinese and Western Medicine Through Conditions Like Adnexitis, Pelvic Inflammatory Disease, Pelvic Congestion Syndrome, and Gynecological Tumors

The female reproductive system is particularly susceptible to infection and inflammation due to factors such as the bladder, rectum, and sexual activity. Common gynecological conditions include cervical inflammation, adnexitis, endometritis, and more. Western medicine uses colposcopy, laparoscopy, hysteroscopy, ultrasound, CT scans, and PET-CT scans to diagnose organ abnormalities, employing tissue biopsies, enzyme-linked assays, immunological tests, blood coagulation tests, and PCR techniques to analyze microscopic changes in lesions. As a result, Western medicine provides a clear picture of inflammation. Adnexitis can lead to hydrosalpinx, ovarian hydrosalpinx, and ovarian cysts. When inflammation spreads to the soft tissues surrounding the uterus, it may cause perimetritis—a condition affecting the connective tissue around the uterus. Inflammation can also spread through the peritoneum in the uterine rectal pouch and uterine vesical pouches, reaching the cervix and causing cervical edema, erosion, and hypertrophy—eventually extending into the uterine cavity, leading to pelvic inflammatory disease. Pelvic inflammatory disease is often rooted in congestion, so nearly all cases of pelvic inflammatory disease are accompanied by pelvic congestion syndrome. Together, pelvic congestion syndrome and pelvic inflammatory disease can lead to tubal obstruction, ultimately resulting in infertility. Additionally, pelvic congestion syndrome and pelvic inflammatory disease can disrupt hormonal balance, causing menstrual irregularities, dysmenorrhea, placenta previa, and premature rupture of the membranes. Furthermore, endometriosis, ectopic pregnancy, and ovarian cysts are closely linked to pelvic inflammatory disease and pelvic congestion syndrome—and even trophoblastic disorders such as hydatidiform mole, malignant hydatidiform mole, and choriocarcinoma are associated with gynecological inflammation and congestion. Therefore, gynecological clinicians cannot overlook the presence of inflammation. Traditional Chinese Medicine, however, diagnoses these conditions through pulse patterns, tongue color, and patient interviews. Early menstruation is often attributed to heat, and using methods that clear heat and cool blood proves effective. Late or reduced periods may indicate coldness, and warming the meridians and dispersing cold, while regulating the Chong and Ren channels, can help restore balance. Personally, I believe that early menstruation is often caused by inflammation, while late menstruation is frequently linked to estrogen deficiency. Heat-related early menstruation can be treated with Danzhi Xiaoyao San, Taohong Siwu Tang, or Gui Zhi Fulu Wan; cold-related late menstruation can be addressed with Da Wen Jing Tang. Abdominal pain during menstruation is often due to blood stasis, requiring blood circulation and stasis resolution—methods like Jinling Zi San and Shixiao San are effective in alleviating pain. Severe abdominal pain may indicate endometriosis, necessitating the addition of leeches and Sanqi. Leeches promote blood circulation, reduce blood clotting, and their effects are similar to those of Western medications like urokinase and heparin. As for vaginal discharge, ancient practitioners believed that white discharge was due to cold, triggered by hormonal changes; itching associated with white discharge was often caused by wind, and Fu Qing Zhu’s Wanjie Tang proved effective in treating this condition. Yellow discharge often indicates heat, and clearing heat is essential—Fu Qing Zhu’s Yi Huang Tang and Zhu Dan Xi’s Gu Jing Wan are both effective remedies for clearing heat and treating vaginal discharge. Traditional Chinese Medicine believes that abdominal pain in gynecology is caused by blood stasis, and therefore requires methods that promote blood circulation and resolve stasis. Qi governs blood, and blood is the mother of Qi; when Qi stagnates, blood becomes stagnant. Thus, Qi-moving medicines and blood-circulating medicines should be used simultaneously. Why do Western doctors treat gynecological inflammation with antibiotics, when they often fail to address blood circulation and stasis? Because Western medicine lacks a comprehensive approach to promoting blood circulation and resolving stasis. Antibiotics lack the concept of blood circulation and stasis; treating pelvic inflammatory disease with low-molecular-weight heparin or urokinase is inappropriate—these medications, while beneficial in some cases, can actually be harmful. Traditional Chinese Medicine, however, employs a simple method of promoting blood circulation and resolving stasis, achieving comparable or even superior therapeutic results in non-surgical gynecological conditions! Of course, Western medicine also uses hormones like estrogen and progesterone alongside antibiotics to help manage certain issues—but in the end, when treating non-organic inflammatory pelvic diseases, Western medicine lacks the diverse therapeutic options available in Traditional Chinese Medicine. In addition to promoting blood circulation and resolving stasis, TCM also offers methods to regulate the Chong and Ren channels. Regulating the Chong and Ren channels essentially means regulating hormone levels, primarily addressing imbalances in the Chong and Ren channels—also known as hormonal imbalances. The combination of TCM’s blood circulation and stasis-reducing therapies with Chong and Ren regulation proves highly effective in treating non-organic inflammatory gynecological conditions. Moreover, TCM incorporates methods to support and strengthen the body’s fundamental forces. Gynecological conditions are not limited to infections; infections can trigger chain reactions. Women’s menstrual cycles often experience weakened immune function, and coupled with existing pelvic inflammation, if we treat inflammation solely with herbs like Dahuā, Lianqiao, Gongying, and Baishang without using tonifying herbs like Dangshen, Huangqi, and Danggui to support the body’s defenses against inflammation, the therapeutic effect is often unsatisfactory. Therefore, TCM possesses three powerful tools for treating non-organic gynecological conditions: promoting blood circulation and resolving stasis, regulating the Chong and Ren channels, and supporting and strengthening the body’s fundamental forces. Gynecological conditions can affect the bladder, causing frequent urination and urgency, or impact the rectum, leading to constipation or diarrhea. Thus, methods like clearing heat and detoxifying, cooling the heat and reducing fire, and drawing out the root cause are commonly used in gynecology. TCM employs the “draw out the root cause” approach by using herbs like rhubarb, magnesium sulfate, or peach kernel Chengqi Tang to promote bowel movements and relieve heat. In cases of acute pelvic inflammation, patients may develop septicemia, characterized by confusion, coma, high fever, chills, elevated blood counts, increased C-reactive protein, elevated calcitonin, and accelerated erythrocyte sedimentation rate. As stated in “Shanghan Lun”: “If a Sunlight disease does not improve, heat accumulates in the bladder, causing delirium, and blood flows downward—those who experience this will recover. If the exterior remains unhealed, treatment should begin with external treatment; once the exterior is treated, if there is still tightness in the lower abdomen, then treatment can proceed with Tao Ren Cheng Qi Tang.” Therefore, Tao Ren Cheng Qi Tang, with its “draw out the root cause” approach, can be used to treat acute pelvic inflammatory disease. But what about organic lesions? For instance, uterine fibroids, ovarian cysts, ectopic pregnancies, and hydatidiform moles—Western medicine has a clear understanding of these conditions, focusing primarily on surgical treatment. Although TCM does not offer surgery, it still recognizes these conditions. The “Golden Chamber Essentials” records: “Women who have previously suffered from various ailments, whose menstrual cycles have not yet passed three months, but who experience prolonged bleeding, with fetal movement above the navel, are considered to suffer from chronic conditions. If fetal movement occurs in the sixth month of pregnancy, and the bleeding occurs during the third month of the menstrual cycle, then the fetus is present. If bleeding occurs after the third month of the menstrual cycle, then the fetus is absent.” Therefore, if bleeding persists, it is because the underlying condition has not been resolved—so, treat the underlying condition with Gui Zhi Fulu Wan. “Women who have previously suffered from various ailments are those who often carry lumps in their abdomens; ‘zheng’ refers to the accumulation of masses, and prolonged bleeding is defined as vaginal bleeding that does not stop.” Uterine fibroids, ovarian cysts, thickening of the endometrium, teratomas, hydatidiform moles, ovarian cancer—all can manifest as such conditions. While TCM’s treatment for these conditions may not match Western surgical procedures, most small uterine fibroids and ovarian cysts can be resolved in 70–80% of cases. Over the decades, I’ve used Gui Zhi Fulu Wan with modifications in clinical practice to treat these conditions—especially serous cysts and mucinous cysts, which have shown remarkable efficacy. Chocolate cysts, though small, are often challenging to treat. Of course, the gynecological conditions TCM treats do not include cervical cancer, ovarian cancer, endometrial cancer, or malignant hydatidiform moles—these gynecological cancers, once diagnosed, are typically treated surgically. Post-surgical radiation and chemotherapy can benefit from the assistance of traditional Chinese medicine, offering promising therapeutic outcomes.