动不安者。沉香降气散。或四制香附一味为君。加归、艾为散。盐酒煎。和滓服。虚者。八珍去
茯苓加黄芩、紫苏、陈皮。名安胎饮。又气虚少食。四君子加紫苏、陈皮。血虚多热。四物加黄
芩、白术。胎气郁滞。紫苏饮。脾气虚弱。六君子。郁结伤脾。归脾汤。郁怒伤肝脾者。四七汤
加芎、归。怒动肝火者。小柴胡加术。安胎之法有二。有因母病以致胎动者。但治母病。其胎自
安。八珍汤加胶、艾、黄 。气滞者。去茯苓加苏、橘、黄芩。因胎动而致母病者。安胎而病自
愈。紫苏饮加茯苓、白术、阿胶、砂仁。千金治妊娠二三月至七八月胎动不安。腰痛已有所见者。
用胶艾汤服之则安。身有微热。去艾叶、甘草加续断、葱白。以葱能散客邪。兼安胎也。郑虚庵
曰。治胎前下血不止。用大剂参、术以安胎。芎、归、熟地、黄芩、白芍、阿胶以止血。砂仁行
气以止痛。不可行动。但安卧养胎自愈。若伤动胎气而下血不止。急用紫苏饮。若胎未损。服之
可安。已损。服之可下。若纯用四物汤阴药。不得阳生阴长之功。非但胎不能安。每致腹痛少食。
胎动不安者,可用沉香降气散。或者以经过四种方法炮制的香附一味作为主药,加入当归、艾叶研为散剂,用盐水酒煎煮,连同药渣一起服用。体质虚弱者,使用八珍汤去掉茯苓,加入黄芩、紫苏、陈皮,名为安胎饮。又有气虚导致食欲减退的,用四君子汤加入紫苏、陈皮;血虚且内热较多的,用四物汤加入黄芩、白术。胎气郁滞不畅的,用紫苏饮。脾气虚弱的,用六君子汤。忧思郁结损伤脾气的,用归脾汤。因忧郁愤怒损伤肝脾的,用四七汤加入川芎、当归。因愤怒引动肝火的,用小柴胡汤加入白术。
安胎的方法主要有两种:一种是因母亲患病而导致胎动的,只需治疗母亲的疾病,胎儿自然安定,可用八珍汤加入阿胶、艾叶、黄芩。若有气滞现象,则去掉茯苓,加入紫苏、陈皮、黄芩。另一种是因胎动不安进而导致母亲患病的,只要安胎,疾病自然痊愈,可用紫苏饮加入茯苓、白术、阿胶、砂仁。
《千金方》治疗妊娠二三个月至七八个月期间胎动不安,腰痛且已有阴道出血症状的,服用胶艾汤即可安定。若身体有轻微发热,则去掉艾叶、甘草,加入续断、葱白,因为葱能疏散外邪,兼有安胎的作用。
郑虚庵说:治疗胎前下血不止,应用大剂量的人参、白术来安胎,配合川芎、当归、熟地黄、黄芩、白芍、阿胶来止血,再用砂仁行气以止痛。此时孕妇不可活动,只需安静卧床养胎,病情自愈。如果是因外力或情绪等伤动胎气而导致下血不止,应紧急使用紫苏饮。如果胎儿未受损,服用此方可使胎儿安定;如果胎儿已受损,服用此方可促使流产排出。如果单纯使用四物汤这类阴寒性质的药物,无法达到“阳生阴长”的功效,不仅不能安胎,反而容易导致腹痛、食欲不振。
For restless fetus (Fetal Restlessness), Chenxiang Jiangqi San (Agarwood Qi-Reducing Powder) may be used. Alternatively, Xiangfu (Cyperi Rhizoma) processed by four methods can be used as the principal herb, combined with Danggui (Angelicae Sinensis Radix) and Aiyè (Artemisiae Argyi Folium) ground into a powder. It is decocted with salt and wine, and taken together with the dregs. For deficiency patterns, Bazhen Tang (Eight-Treasure Decoction) is modified by removing Fuling (Poria) and adding Huangqin (Scutellariae Radix), Zisu (Perillae Folium), and Chenpi (Citri Reticulatae Pericarpium), named Antai Yin (Fetus-Stabilizing Drink). In cases of Qi deficiency with poor appetite, Sijunzi Tang (Four-Gentlemen Decoction) is used with added Zisu and Chenpi. In cases of Blood deficiency with excessive heat, Siwu Tang (Four-Substance Decoction) is used with added Huangqin and Baizhu (Atractylodis Macrocephalae Rhizoma). For stagnation of fetal Qi, Zisu Yin (Perilla Leaf Infusion) is indicated. For Spleen Qi weakness, Liujunzi Tang (Six-Gentlemen Decoction) is used. For emotional constraint injuring the Spleen, Guipi Tang (Restore the Spleen Decoction) is applied. For Liver and Spleen injury due to depression and anger, Siqi Tang (Four-Seven Decoction) is used with added Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui. For Liver Fire stirred by anger, Xiaochaihu Tang (Minor Bupleurum Decoction) is used with added Baizhu.
There are two main methods for stabilizing the fetus: First, when fetal restlessness is caused by the mother's illness, treating the mother's illness will naturally stabilize the fetus. This can be treated with Bazhen Tang plus Ejiao (Colla Corii Asini), Aiyè, and Huangqin. If there is Qi stagnation, remove Fuling and add Zisu, Chenpi, and Huangqin. Second, when the mother's illness is caused by fetal restlessness, stabilizing the fetus will cure the illness. This can be treated with Zisu Yin plus Fuling, Baizhu, Ejiao, and Sharen (Amomi Fructus).
Qianjin Fang (Essential Prescriptions Worth a Thousand Gold) treats fetal restlessness occurring between the second or third month and the seventh or eighth month of pregnancy, accompanied by lower back pain and vaginal bleeding. Taking Jiao'ai Tang (Ejiao and Mugwort Decoction) will stabilize the fetus. If there is slight fever, remove Aiyè and Gancao (Glycyrrhizae Radix et Rhizoma), and add Xuduan (Dipsaci Radix) and Congbai (Allii Fistulosi Bulbus), because Congbai can disperse pathogenic factors and also has a fetus-stabilizing effect.
Zheng Xu'an stated: To treat continuous vaginal bleeding during pregnancy, large doses of Renshen (Ginseng Radix et Rhizoma) and Baizhu should be used to stabilize the fetus. Chuanxiong, Danggui, Shudi (Rehmanniae Radix Preparata), Huangqin, Baishao (Paeoniae Radix Alba), and Ejiao should be used to stop bleeding. Sharen should be used to move Qi and relieve pain. The patient should avoid movement and simply lie quietly to nourish the fetus, which will heal itself. If fetal Qi is injured causing continuous bleeding, Zisu Yin should be urgently administered. If the fetus is not damaged, taking this formula will stabilize it; if the fetus is already damaged, taking this formula will induce expulsion. If only Siwu Tang, a Yin-nourishing formula, is used exclusively, the principle of "Yang generating Yin" cannot be achieved. Not only will the fetus fail to stabilize, but abdominal pain and poor appetite often result.