Theoretical Origin and Application of the Method of Promoting Blood Circulation to Prevent Miscarriage in Recurrent Spontaneous Abortion Induced by Blood Stasis

Abstract

Recurrent spontaneous abortion (RSA) represents a significant reproductive health challenge affecting women of childbearing age, characterized by complex etiology and pathogenesis. In Traditional Chinese Medicine (TCM), RSA falls under the categories of “habitual abortion” and “recurrent miscarriage.” Beyond traditional pathological mechanisms such as kidney deficiency and qi-blood deficiency, the theoretical framework centering on “blood stasis” as a core pathological factor has evolved through long-term clinical practice and continues to be refined. This paper systematically reviews the historical development of the “blood stasis leading to miscarriage” theory, tracing its origins from the “administering treatment for a specific cause without inducing harm” concept in the Synopsis of the Golden Chamber to Wang Qingren’s “blood stasis occupying the uterine territory” theory, and further to its correlation with modern medical mechanisms including microcirculation disorders, thrombophilia, and ferroptosis. Furthermore, this study explores the modern mechanisms of the “promoting blood circulation to prevent miscarriage” method, including its roles in improving endometrial receptivity, regulating the maternal-fetal immune microenvironment, inhibiting trophoblast ferroptosis, and correcting hypercoagulable states. Clinical applications demonstrate that formulas such as Bushen Huoxue Decoction and Danggui Powder significantly improve coagulation function, uterine artery blood flow, and sex hormone levels, embodying the therapeutic principles of “treatment based on pattern differentiation” and “cessation upon symptom resolution.” Future research should focus on utilizing modern technological methods to further elucidate the specific targets and pathways through which blood-activating and miscarriage-preventing formulas regulate the maternal-fetal microenvironment, thereby providing more robust scientific evidence for this ancient therapeutic approach. This will not only benefit more RSA patients but also contribute to enriching the field of global reproductive medicine.