1.Exploration of Deng Gaopi's Diagnostic and Therapeutic Approach for Cesarean Scar Pregnancy
Genping ZENG ; Peiyin LI ; Xijing LU ; Lei ZENG ; Gaopi DENG
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(9):2314-2320
Cesarean scar pregnancy(CSP)is a special type of ectopic pregnancy(EP)that poses a serious threat to women's reproductive health.Professor Deng Gaopi,a renowned traditional Chinese medicine(TCM)expert of Guangdong Province,has extensive experience in the diagnosis and treatment of EP.He believes that the key pathogenesis of EP is due to the obstruction of blood stasis in the lower abdomen and the disharmony of chong-ren meridians,with the core pathogenic factor of blood stasis and with the disease location in the uterus.As a special type of EP,CSP shares the similar pathogenesis to that of EP.The occurrence of CSP is attributed to the obstruction of qi,blood and body fluids induced by insufficient healthy qi after cesarean delivery,and then phlegm-turbidity and blood stasis congealing in the chong-ren meridians and uterus,resulting in blood vessel stasis and collateral damage,which causes the fertilized egg to implant in the scar.The treatment of CSP should start from the pathogenesis of phlegm blended with blood stasis and stasis developing into masses,with the main therapeutic methods of supplementing qi,activating blood,resolving stasis,and removing masses.The foundational prescriptions include Huayu Xiaozheng Granules(composed of Salviae Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra,Persicae Semen,Achyranthis Bidentatae Radix,Moutan Cortex,Trichosanthis Radix,Arnebiae Radix,etc.)and Lichong Decoction(composed of Astragali Radix,Codonopsis Radix,Atractylodis Macrocephalae Rhizoma,Dioscoreae Rhizoma,Sparganii Rhizoma,Curcumae Rhizoma,Anemarrhenae Rhizoma,Trichosanthis Radix,Galli Gigerii Endothelium Corneum,etc.).Based on the relationship between qi and blood,i.e.,the enrichment of qi promoting the generation of blood,and the movement of qi promoting the removal of stasis,he emphasizes the importance of treatment based on qi-blood differentiation.Additionally,he is skillful in using genuine Lingnan medicinal herbs such as Microctis Folium and Guangdong Pheretima based on regional characteristics and following the principle of individualization.In terms of preventing CSP and its complications,Professor Deng advocates for strengthening the spleen and promoting granulation to fundamentally eliminate to the endometrial damage caused by cesarean section.For complications caused by damp-heat accumulation in the lower energizer which results from the obstruction of blood stasis in the uterus,heat-clearing,dampness-removing,and blood-activating actions should be enhanced in the clinical prescriptions for treatment.

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