CLINICAL APPLICATIONS

* Fibrocystic disorders in the lower abdominal region, such as cysts and fibroids in the uterus and ovaries

* Masses, myomas, and benign tumors of the female reproductive organs

* Endometriosis

* Female infertility due to obstruction in the lower abdominal region (i.e., tubal obstruction)

* Pelvic pain due to obstruction in the lower abdominal region

* Scarring or blood stasis in the pelvic cavity from surgery

* Varicocele in men causing infertility

 

WESTERN THERAPEUTIC ACTIONS

* Antiproliferative effect to inhibit abnormal growth of connective tissue and dissolve masses and nodules

* Resolves cysts and fibroids in the uterus and ovaries

* Treats female infertility due to obstructions in the uterus and ovaries

* Antitumor effect to treat benign tumors of the female reproductive organs

* Analgesic and anti-inflammatory actions to relieve pain and swelling

* Relieves pain associated with gynecological disorders

 

CHINESE THERAPEUTIC ACTIONS

* Dispels blood stasis and disperses nodules and masses

* Invigorates the blood circulation and alleviates pain

 

DOSAGE

Take 3 to 4 capsules three times daily on an empty stomach with warm water. In cases of large fibroids, the dosage may be increased up to 8 to 10 capsules twice or three times daily. Resolve (Lower) should be taken continuously for one to two months prior to making a progress evaluation.

 

INGREDIENTS

Bie Jia (Carapax Trionycis)

Chi Shao (Radix Paeoniae Rubrae)

Chuan Xiong (Rhizoma Chuanxiong)

Dang Gui (Radix Angelicae Sinensis)

E Zhu (Rhizoma Curcumae)

Fu Ling (Poria)

Gui Zhi (Ramulus Cinnamomi)

Hong Hua (Flos Carthami)

Mu Dan Pi (Cortex Moutan)

Mu Li (Concha Ostreae)

Pu Huang (Pollen Typhae)

San Leng (Rhizoma Sparganii)

San Qi (Radix et Rhizoma Notoginseng)

Tao Ren (Semen Persicae)

Yan Hu Suo (Rhizoma Corydalis)

Zhe Bei Mu (Bulbus Fritillariae Thunbergii)

 

BACKGROUND

Cysts, fibroids, masses, myomas, endometriosis are all common gynecological disorders. Cysts are the growth of mucus-filled sacs. Fibroids are benign uterine growth of smooth muscles. Masses are abnormal growth of cysts and tumors. Myomas are smooth, benign tumors. Endometriosis is the growth of endometrial tissues outside the uterine cavity. Though the names differ in Western medicine, they all refer to abnormal growth of tissues in different places. According to traditional Chinese medicine, these abnormal tissues are diagnosed as ¡§blood stasis and phlegm stagnation.¡¨

 

FORMULA EXPLANATION

According to traditional Chinese medicine, a palpable mass in the lower abdominal region is often diagnosed as a stagnation of blood and phlegm. Fibrocystic disorders, such as endometriosis, fibroids, and cysts in the uterus and ovaries, are examples of blood and phlegm stagnation in the lower jiao. Resolve (Lower) contains herbs that activate blood circulation, remove blood and phlegm stagnation, warm the abdomen, and relieve pain.

        Gui Zhi (Ramulus Cinnamomi), Tao Ren (Semen Persicae), Hong Hua (Flos Carthami) and Chi Shao (Radix Paeoniae Rubrae) unblock the blood vessels and remove blood stasis by promoting circulation. Chuan Xiong (Rhizoma Chuanxiong), Dang Gui (Radix Angelicae Sinensis), and Mu Dan Pi (Cortex Moutan) activate circulation, remove blood stasis and relieve pain. Pu Huang (Pollen Typhae) has an excitatory action on the uterus and works to invigorate the blood and relieve pain by eliminating blood stasis. Yan Hu Suo (Rhizoma Corydalis) is a strong analgesic and produces effects similar to morphine and codeine to relieve pain. San Leng (Rhizoma Sparganii) and E Zhu (Rhizoma Curcumae) have strong blood invigorating functions to dispel masses and alleviate pain. Zhe Bei Mu (Bulbus Fritillariae Thunbergii), Mu Li (Concha Ostreae) and Bie Jia (Carapax Trionycis) eliminate phlegm, soften abdominal masses, and dissipate nodules. Fu Ling (Poria) further helps to dispel phlegm and prevent the formation of dampness by strengthening the Spleen. San Qi (Radix et Rhizoma Notoginseng) invigorates blood circulation and stops bleeding to prevent hypermenorrhea.

        In summary, these herbs work together to resolve blood stasis, eliminate phlegm stagnation, and remove abnormal and unhealthy growth of tissues.

 

CAUTIONS & CONTRAINDICATIONS

* This formula contains herbs that have strong blood-invigorating functions and should be used with caution in patients with deficiencies. Patients with underlying deficiencies should be treated concurrently with tonic formulas, such as Kidney Tonic (Yin), Kidney Tonic (Yang), C/R Support, Imperial Tonic, Schisandra ZZZ, or Immune +.

* This formula contains herbs that have strong blood-invigorating and stasis-removing functions. It is contraindicated for patients during pregnancy and nursing. It should be used with caution during menstruation, as bleeding may be increased.

* This formula should not be the only course of therapy. Consider surgical intervention if multiple masses exist, if the cyst is large, or if the fibroids do not respond to herbal therapy.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]^,[2],[3]

 

CLINICAL NOTES

* Resolve (Lower) should be taken every day of the month except during menstruation to avoid profuse bleeding. During menstruation, either reduce the dosage by half or temporarily discontinue the formula.

* If pain is present during the period, Mense-Ease should be administered starting the first day of menstruation. If pain is present before the onset of each cycle, both formulas can be taken together to invigorate blood and relieve pain.

* Resolve (Lower) should be taken for three months prior to making an evaluation on the progress of the treatment. If the cysts, fibroids or mass reduce in size, continue giving the formula until the conditions are completely resolved. On the other hand, if the size remains constant, increase the dosage by 30 to 50% and continue for another three months prior to making the final evaluation. If the conditions still remain the same, other treatment options should be considered.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Yinqiao pulse, a thin, long, wiry, and forceful pulse on or proximal to the left chi.

 

SUPPLEMENTARY FORMULAS

* For benign breast disorders, use with Resolve (Upper).

* For premenstrual syndrome (PMS) or irritability, use with Calm.

* For stress and insomnia in patients with deficiency, add Calm ZZZ.

* For dysmenorrhea, use Mense-Ease.

* To treat infertility, use Blossom (Phase 1-4).

* To clear hot flashes in menopausal patients, combine with Balance (Heat).

* For infection in the genital area, add V-Support.

* For presence of hardness and nodules in the chest area, combine with Resolve (AI).

* To improve blood circulation throughout the body and in severe cases of varicocele or varicose veins, add Circulation (SJ).

* With edema, water retention or swelling of the legs, add Herbal DRX.

* For patients with cancer who have extreme weakness and deficiency and cannot tolerate chemotherapy or radiation treatment, use CA Support.

* To minimize the side effects of chemotherapy and radiation treatment in patients with cancer, combine with C/R Support.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Neiguan (PC 6), Zhaohai (KI 6), Qimen (LR 14), Ganshu (BL 18), Taichong (LR 3), Xingjian (LR 2), Xuehai (SP 10), Geshu (BL 17)

 

Classic Master Tung's Points:

* Fibroids, cysts, myomas: Fuke (T 11.24), Jiemeiyi (T 88.04), Jiemeier (T 88.05), Jiemeisan (T 88.06), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07). Bleed in the sacral region with cupping. Bleed before needling for best result.

* Tumors of the fallopian tubes: Fuke (T 11.24), Huanchao (T 11.06), Sanzhong (T 77.07), Jiemeiyi (T 88.04), Jiemeier (T 88.05), Jiemeisan (T 88.06), Shuangling (T 11.28)*, Zhiwu (T 11.26). Bleed dark veins nearby Daling (PC 7) and Yinxi (HT 6). Bleed before needling for best result. The more the blood is let out, the better the effect.

* Tumor of the ovaries, cervix, uterus: Fuke (T 11.24), Huanchao (T 11.06), Zhiwu (T 11.26), Shuangling (T 11.28)*, Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03), Yunbai (T 44.11), Menjin (T 66.05), Waisanguan (T 77.27), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Jiemeiyi (T 88.04), Jiemeier (T 88.05), Jiemeisan (T 88.06), Mufu (T 88.38)*, Tongshen (T 88.09), Tongbei (T 88.11). Bleed the dark veins near the web between the first and second; and second and third toes. Bleed sacral area with cupping with cupping. Bleed before needling for best result. The more the blood is let out, the better the effect.

* Endometriosis: Fuke (T 11.24), Linggu (T 22.05), Menjin (T 66.05), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Jiemeiyi (T 88.04), Jiemeier (T 88.05)

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Ovarian / uterine cysts or fibroids: Mufu (T 66.02), Huanchao (T 11.06)

 

Balance Method by Dr. Richard Tan:

* Left side: Taichong (LR 3), Gongsun (SP 4), Zhaohai (KI 6), Waiguan (TH 5), Linggu (T 22.05)

* Right side: Tongli (HT 5), Neiguan (PC 6), Xiajuxu (ST 39), Fenglong (ST 40)

* Left and right sides can be alternated from treatment to treatment.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Endometritis: Uterus, Cervix, Kidney, Liver, Ovary, Pituitary, Thalamus, Endocrine, Gonadotropin, San Jiao. Bleed Ear Apex.

* Irregular menstruation: Gonadotropin, Uterus, Kidney, Liver, Pituitary, Ovary, Endocrine

* Hypomenorrhea and amenorrhea: Uterus, Ovary, Exciting, Pituitary, Endocrine, Kidney, Liver, Sympathetic, Gonadotropin, Coronary Vascular Subcortex, Nervous Subcortex

* Excessive menstruation or bleeding in between periods: Uterus, Spleen, Diaphgram, Endocrine, Pituitary, Liver, Kidney, Ovary, Adrenal Gland

 

NUTRITION

* Avoid red meat, tap water, processed foods, junk foods, alcohol, dairy products (except for unsweetened low-fat yogurt), and those fruits and vegetables sprayed with pesticides.

* Avoid eating meats that have been treated with hormones, which may stimulate the growth of fibroids.

* Eliminate coffee from the diet as it may contribute to the growth of fibroids.

* Avoid cold and raw foods, such as watermelon, citrus, and sushi. Also refrain from drinking cold beverages, such as ice water.

 

LIFESTYLE INSTRUCTIONS

* Avoid or reduce exposure to radiation whenever possible, such as from microwave, television and computer monitors.

* Relaxation, maintaining a positive outlook on life and regular exercise are important to the recovery of cancer and to the progress in resolving fibroids and cysts, and for preventing recurrences.

 

CASE STUDIES

* G.E., a 44-year-old female, presented with painful menstruation that starts and stops, and excessive flow with clotting. Other findings included pain upon palpation of the abdomen and a pulse that was deep, strong, and wiry. The Western diagnosis was menorrhagia; the TCM diagnosis was blood stasis. The patient was prescribed Mense-Ease and Resolve (Lower). Since this tends to happen every few months, the patient keeps the herbs on hand. The herbs resolve the pain each time; they are very helpful to her. Submitted by A.I., Hilo, Hawaii.

* N.K, a 48-year-old female, presented with pain in the lower quadrant as well as constipation. The patient showed a history of a right cyst present one year ago on her radiology exam. However, there is no current evidence. Her gynecologist had confirmed that bilateral ovarian cysts were present; the left one measuring out to be 8.65/5.6/5.5 inches. The TCM diagnosis was qi, blood, and phlegm accumulation in the lower abdomen. The patient was prescribed Resolve (Lower) at six capsules three times daily; however, the patient only took three capsules two to three times daily, which was lower than directed to take. After six months of taking the herbs, she reported that the constipation had improved, the right cyst was no longer visible, and the left one was varying in size from test to test. Submitted by N. H., Chatsworth, California.

* N.T., a 34-year-old female, who was told she wouldn¡¦t be able to have children, presented with a Western diagnosis of polycystic ovarian disease and fibroids. The patient had been taking levothyroxine after a thyroidectomy in 2004. Patient experienced constipation, poor sleep, heavy menses, cramps, fatigue, and weight gain. The practitioner diagnosed the condition as phlegm and blood stagnation. She was treated with Resolve (Lower) at four capsules three times daily and directed not to take them during her menses. After taking the herbs for three months, while also receiving acupuncture and cupping one to three times a week, she became unexpectedly pregnant. She and her husband were very happy and thankful. Submitted by L.W., Arroyo Grande, California.

* A 36-year-old female presented with extreme headaches and lower abdominal cramping one week before her period. She also had heavy bleeding. The practitioner diagnosed the condition as blood stagnation in the lower jiao and in the chong (thoroughfare) and ren (conception) channels. Her gynecologist confirmed the presence of fibroids and endometriosis. Laproscopy was done on fibroid tumors, which were found in both ovaries. After taking Resolve (Lower), 4 capsules three times daily, for four cycles along with acupuncture treatments one to two times a week for five months, the patient¡¦s headaches and abdominal cramping abated. Her periods were no longer painful. The practitioner concluded that regular prescriptions of Resolve (Lower) were quite effective for his patients with endometriosis and fibroids, especially those patients with underlying blood stagnation. Submitted by M.K., Sherman Oaks, California.

* A 42-year-old female medical doctor presented with uterine fibroids and painful menses. Upon further inquiry, the irritable patient also noted dark clots. Her pulse was wiry and her tongue was light purple. The practitioner diagnosed the condition as blood and phlegm stagnation. After taking Resolve (Lower), the patient¡¦s menstrual pain and excessive bleeding lessened. The clots were smaller and the patient felt that the fibroids were dwindling in size. She was recommended for an MRI for confirmation. Submitted by D.M., Raton, New Mexico.

* A 27-year-old female office worker presented with pain in her lower abdomen. The pain was more prominent before and during menses. She also had occasional bloody stools. The patient had a history of chronic yeast infections and endometriosis, which were resolved by surgeries. The practitioner diagnosed the condition as blood and qi stagnation with damp-heat in the lower jiao. After taking Mense-Ease and Resolve (Lower), menstrual pain reduced and rectal bleeding abated. Submitted by N.H., Boulder, Colorado.

* A 28-year-old female dental hygienist presented with a palpable lump on her lower abdomen near acupuncture point Zigongxue (Uterus). She had severe premenstrual syndrome (PMS) affecting her emotionally as well as large dark clots in her menstrual discharge. She had one week of constant dull pain on her left lower abdomen especially after her period. She described the pain as a grabbing, shooting type of pain as though someone was tightening a rope around her belly. She had a history of candida. She sought to get pregnant, and therefore discontinued taking her birth control pills. Laparoscopy was done in 1995 to remove her right ovary and in 1999 to remove endometriosis. Scar tissue was present in her left lower abdomen from a hernia operation when she was a youngster. Cysts were also present on her left ovary. Lastly, the patient also had a history of hypothyroidism and hay fever. Her tongue color was unremarkable and her tongue coating appeared moist. Her tongue root coating would alternate from white to yellow. Her sublingual region was also unremarkable. The patient¡¦s pulse was constantly deep, thready and soft. The practitioner diagnosed this clinical picture as damp-heat in the lower jiao and Spleen qi deficiency leading to the accumulation of dampness. The practitioner prescribed Mense-Ease to regulate her menstruation, and Resolve (Lower) to treat endometriosis. The patient was instructed to take 3 to 5 capsules of each formula three times daily, starting three days before her period and continue the dose throughout her menstrual flow and for one week afterwards. After taking the herbs, she became less emotional. She noted fewer episodes of cramps the first month and no pain during the second month of her herbal therapy. Although her lower abdominal pain lingered, the intensity lessened, the frequency reduced, and the affected area dwindled. The patient also finally discontinued her caffeine intake, which she also attributed to her pain. After three months of herbal treatment, surgery was done to remove two inches of tissue. Ultrasound confirmed the complete absence of ovarian cysts after three months of herbal therapy. Doppler ultrasound showed a favorable pulsatility index for uterine blood flow. There were no blockages present in her reproductive system. The practitioner concluded that Mense-Ease was quite effective in treating other patients with similar conditions. The efficacy of Resolve (Lower) was also proven clinically with ultrasound results. Submitted by T.K., Denver, Colorado.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Resolve (Lower) is designed to treat abnormal growth of cells and tissues in the lower abdominal regions, such as cysts, fibroids, masses, myomas, endometriosis and benign tumors. Resolve (Lower) contains herbs with significant functions to suppress the growth of abnormal cells and tissues, relieve pain, and reduce inflammation.

        Resolve (Lower) contains many herbs with a marked effect to inhibit the growth and proliferation of cells and tissues. Bie Jia (Carapax Trionycis) has an antiproliferative effect to inhibit proliferation of connective tissue, and dissolve masses and nodules.[4] Dang Gui (Radix Angelicae Sinensis) demonstrates an anticancer effect in a dose-dependent manner by inducing cell cycle arrest and apoptosis on various types of cancer cells.[5] The mechanism of this anticancer effect is attributed to its strong cytotoxic and antiproliferative activities.[6] Fu Ling (Poria) has an antineoplastic effect against a variety of cancer cells.[7] Yan Hu Suo (Rhizoma Corydalis) illustrates anticancer and antimetastatic activities.[8] Tao Ren (Semen Persicae) shows an antitumor effect in both in vitro and in vivo assays by delaying the two-stage carcinogenesis.[9] Lastly, San Leng (Rhizoma Sparganii) and E Zhu (Rhizoma Curcumae) have antineoplastic and antitumor effects.[10] E Zhu (Rhizoma Curcumae) exerts an antitumor effect by inducing apoptosis and inhibiting proliferation of human cervical cancer cells in vitro and in vivo in a dose-dependent manner.[11] Furanodiene, a sesquiterpene from E Zhu (Rhizoma Curcumae), showed strong growth inhibition on many human cancer cell lines, including cervical cancer, uterine cervical cancer, and others.[12] The mechanism of this action is attributed in part to its antiangiogenic effect, which blocks the formation of new blood vessels to suppress tumour growth, invasion, and metastasis.[13]

        Resolve (Lower) utilizes many herbs with analgesic effects to relieve pain. Yan Hu Suo (Rhizoma Corydalis) is one of the strongest and most potent herbs for treatment of pain, and is commonly used to treat chest and hypochondriac pain, epigastric and abdominal pain, hernial pain, amenorrhea or menstrual pain, and pain of the extremities. According to laboratory studies, the extract of Yan Hu Suo (Rhizoma Corydalis) is effective in both acute and chronic phases of pain and inflammation. With adjustment in dosage, the analgesic potency of Yan Hu Suo (Rhizoma Corydalis) has been compared to that of morphine. Though the maximum analgesic effect of Yan Hu Suo (Rhizoma Corydalis) is not as strong as morphine, it has been determined that the herb is much safer, with significantly fewer side effects, less risk of tolerance, and no evidence of physical dependence even with long-term use.[14] In addition to Yan Hu Suo (Rhizoma Corydalis), other herbs with analgesic effects include San Leng (Rhizoma Sparganii) and Dang Gui (Radix Angelicae Sinensis).[15]^,[16]

        Resolve (Lower) also incorporates many herbs with anti-inflammatory effects to reduce swelling and inflammation. Mu Dan Pi (Cortex Moutan) exerts strong anti-inflammatory actions through the inhibition of prostaglandin synthesis and decreased permeability of the blood vessels.[17]^,[18] San Qi (Radix et Rhizoma Notoginseng) illustrates anti-inflammatory effects via the inhibition of nitric oxide and prostaglandin E2 production.[19] Tao Ren (Semen Persicae) and Hong Hua (Flos Carthami) are commonly used together as they both exert anti-inflammatory functions.[20]^,[21] Lastly, Dang Gui (Radix Angelicae Sinensis) and Chuan Xiong (Rhizoma Chuanxiong) both have analgesic and anti-inflammatory effects. In fact, the analgesic effect of Dang Gui (Radix Angelicae Sinensis) is approximately 1.7 times stronger than acetylsalicylic acid, and its anti-inflammatory effect is approximately 1.1 times stronger than acetylsalicylic acid.[22]

        Clinically, one formula showed 81% rate of effectiveness for treatment of endometriosis in 58 patients. The herbal formula contained San Leng (Rhizoma Sparganii), E Zhu (Rhizoma Curcumae), Chi Shao (Radix Paeoniae Rubra), Zhe Bei Mu (Bulbus Fritillariae Thunbergii), Dang Gui (Radix Angelicae Sinensis), Bie Jia (Carapax Trionycis) and others. The treatment protocol was to administer the herbs in decoction starting on the second or third day after the period ends, and continue until the period begins in the following menstrual cycle.[23]

        In summary, Resolve (Lower) is an excellent formula that contains herbs to suppress the growth of abnormal cells and tissues, such as cysts, fibroids, masses, myomas, endometriosis and other similar gynecological disorders.

 

COMPARATIVE ANALYSIS

Fibrocystic disorders in the lower abdomen, such as fibroids, cysts and endometriosis, are very common among women. These disorders may cause irregular menstruation, severe pain, and infertility.

        These conditions are usually treated with hormonal drugs that suppress growth of these tissues. Unfortunately, these drugs have limited benefits but serious side effects, including breast tenderness, swelling, bleeding, thrombosis, embolism, depression, weight gain, elevated cholesterol and triglycerides, and many others. In many cases, an invasive procedure such as surgery is recommended to remove fibroids, cysts, and endometrial tissues.

        These fibrocystic conditions are diagnosed as qi, blood, and phlegm stagnation. Use of these herbs has been shown to be extremely effective to dissolve, disperse, and disintegrate these tissues. These herbs have a potent and consistent effect, and generally show a marked effect after three months of therapy. However, the length of treatment may be longer depending on the size of the masses and the severity of the condition.

        The best treatment for these fibrocystic conditions is the integration of Western and traditional Chinese medicine. Since drug benefits are often less than satisfactory and have significant side effects, herbs should be used as the first line of therapy. In most cases, improvements are noted within three to six months. If so, herbal therapy should be continued until the condition is resolved. If herbs do not work, then surgery may be employed as the last alternative.