Beijing Journal of TCM.  November 2007. Vol. 26, No. 11
“Advancement in Traditional Chinese Medicine’s Treatment of Uterine Fibroids”
by Wang Ze Min

Lyle Pannell

Uterine fibroids are the most common benign tumor of women’s reproductive organs.  The incidence rate (of fibroids) is approximately 20-25%.  They are more often seen in women between the ages of 30-50 years old.  In the age range of 40- 50 years old the incidence rate is the highest.  Fibroids are rarely seen in women under 20 years old.  The majority of uterine fibroids have no obvious symptoms.  They are only found at the time of pelvic exam.  The size of the fibroids is not necessarily correlated to severity of symptoms.  However, the position of the fibroid is intimately connected to the symptoms.  According to positional differences (of the fibroids), [women] will have symptoms of vaginal bleeding, abdominal masses, increased vaginal discharge, pain as well as infertility.  These symptoms seriously influence a woman’s quality of life.  This disease belongs to the traditional Chinese medicine category of  jia (abdominal mass) .  It is written about as far back as the “Su Wen: Gu Kong Lun”.  The “Jin Gui Yao Lue” contains the first herbal prescription to treat zheng jia (abdominal masses) , Gui Zhi Fu Ling Wan.  Recently, people are giving uterine fibroids more serious notice.  On the foundation of TCM forefathers, Chinese medicine is achieving continuous advancement.  The following is a general summary of the last five years of Chinese medicine’s treatment of this disease.

Disease Causes and Mechanisms

The main disease mechanism of this disease is Qi and Blood not moving smoothly, localized Qi and Blood obstruction and stagnation and loss of regulation of the functioning of the organs channels and collaterals.  Over time this (Qi and Blood) becomes bound together to form a zheng (abdominal mass).  The main causative factors of the disease usually are Qi stagnation, blood stasis, phelgm-dampness and damp-heat.  Xia Chen thinks uterine fibroids belong to phelgm stagnation in lower jiao luo vessels.  Spleen and Kidney deficiency and Liver depression lead to water, dampness, phelgm and rheum binding together, which then follows the merdian and flows into the lower jiao luo vessels.  Then it joins with and blocks the uterus.  This congealed mass becomes a fibroid.  Ceng Fei Ying thinks that uterine fibroids are due to deficient Qi lacking the strength to transport blood.  Then static blood is internally obstructed.  Deficient Qi does not transport and transform water and dampness.  Water gathers together and becomes phelgm.  As a result, phelgm stasis binds together and forms zheng jia (addominal masses).  Xu Quan Xiang brought forward the importance of emotional factors as significant in causing uterine fibroid disease.  Qi Nan Deng points out that the Nei Jing reports that shi jia (stone tumors) are often caused by congealed cold, blood stasis remains stopped in the uterus and forms a lump.  Shi jia  (stone tumors) includes all gynecological abdominal mass diseases and mainly uterine fibroids.

Treatment Based on Pattern Differientiation

2.2 Treatment based on stages
When treating gynecological disease patterns treat according to a woman’s menstrual cycle.  During each phase of the cycle the uterus has differences in storing and draining.   In the clinic use the method of treating according the phase of the cycle.
Ye Yu Mei likewise divided the time period between the menses and the actual time of the menstrual period into two stages for treatment.  During the time between menses, he uses Gui Zhi Fu Ling Wan, which is acrid to disperse and warm to open.  This formula breaks stasis, moves blood and dispels zheng (masses).

During the menstrual period because it is possible for women [with fibroids] to already have excessive bleeding, a condition similiar to benglou (flooding and spotting), he stresses that at this time one cannot simply astringe and stop bleeding
It is appropriate to “put priority on the root and secondarily stop bleeding” .  So in the treatment one should still focus on mainly transforming stasis and the method of “freeing the cause by freeing” .
The formula:
Chao Dang Gui 9g
Dan Shen 6g
Chi Shao 9g
Bai Shao 9g
Sheng Pu Huang 30g
Xue Jie 3g
Hua Rai Shi  15g
Shu Da Huang 9g
Yi Mu Cao 9g
Xian He Cao 20g
Zhen Ling Dan 12g



Wang Nuo Mei thinks that the crux of uterine fibroid disease mechanism is in the static blood stuck interally.  He treats using the method of treating according to the phase of the cycle.  When the woman is not menstruating, he focuses on invigorating the blood, transforming stasis, softening hardness and dispelling zheng     (abdominal masses).  During the menses, he focuses on invigorating blood, regulating the menses, expelling stasis and stopping bleeding.  He has outstanding clinical results.