Uterine Endometriosis Formula - Nei Yi Fang
Formula Name: Nei Yi Fang【Function and Indications】
Function: Promote Qi movement, break up blood stasis, soften hardness, and eliminate masses. Indicated for uterine endometriosis.
【Prescription Composition】
Stir-fried Angelica root 9g, Salvia miltiorrhiza 12g, Red Peony root 9g, Prepared Cyperus rotundus 9g, Frankincense 3g, Sichuan Achyranthes root 9g, Cinnamon twig 3g, Processed Turtle Shell 9g, Spina Gleditsiae 12g, Dry Lacquer 4.5g, Poria 12g, Sea Algae 9g, decocted and taken orally.
【Differential Diagnosis and Modifications】
For severe dysmenorrhea, remove Processed Turtle Shell, Spina Gleditsiae, Rhizoma Curcuma, Sea Algae, and Dry Lacquer; add Corydalis tuber 9g, Myrrha 4.5g, Shixiao San (wrapped) 15g; for excessive menstruation, remove the above-mentioned herbs, additionally remove Cinnamon twig, change Sichuan Achyranthes to Huai Achyranthes, reduce Salvia miltiorrhiza to 6g, add White Peony root 9g, Flower Stone 15g, Charred Rheum palmatum 9g, Zhenling Dan (wrapped) 12g. Both modified formulas should be taken 2–3 days before menstruation begins, continuously for 7 doses, then resume the basic formula after menstruation ends. For liver Qi stagnation: add Bupleurum 4.5g, Toosendan fruit 9g, Peony bark 9g, Agalloch 9g; for rectal prolapse pain, add Areca seed 9g, Citrus aurantium shell 6g; for Qi deficiency, add Codonopsis 12g, Astragalus 12g; for Yin deficiency, add Rehmannia glutinosa 12g, Ophiopogon japonicus 9g, Ligustrum lucidum 9g, remove Cinnamon twig; for Kidney deficiency, add Eucommia 9g, Dogwood 9g, Taxillus 9g; for cold coagulation, add Evodiae fructus 3g, Prepared ginger 4.5g; for damp-heat, add Patrinia herb 30g, Commelina communis 30g.
【Clinical Efficacy】
Applied in 43 cases: 13 cases showed marked improvement (including 4 cured infertility), accounting for 30.2%; 25 cases effective, 58.2%; 5 cases ineffective (including recurrence), 11.6%. Total effective rate was 88.4%.
【Prescription Source】
Cai Xiaosun, Shanghai First People's Hospital.
【Comment】
This formula was compiled and published by Cai Zhuang. Dr. Cai believed that the main pathogenesis of endometriosis is retained blood stasis, thus treatment must focus on resolving stasis. For endometriotic lesions, this formula uses methods to resolve stasis and eliminate masses; for dysmenorrhea, it employs methods to resolve stasis and relieve pain. Notably, for excessive menstruation or menorrhagia due to endometriosis, simply using hemostatic methods proves ineffective—treatment should primarily focus on activating blood circulation and resolving stasis, supplemented with consolidating agents. Administering the formula 3 days before menstruation allows thorough removal of stagnant blood, thereby achieving hemostatic and analgesic effects.<Uterus>