中医辨证论治免疫性不孕的临床研究概述
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摘要
免疫性不孕辨证分型主要可归纳为肝肾阴虚型、脾肾两虚型、湿邪热扰型、血瘀气滞型四型。基于免疫性不孕虚实夹杂的特点,本综述归纳了各医家的治疗原则与治疗经验。中医辨治免疫性不孕,大多在滋养肾阴的基础上配合活血化瘀、补气健脾、清利湿热、滋阴降火等方法综合治疗。中医周期疗法是根据肾的阴阳消长和女性气血的周期性变化,在不同时期用药有所侧重。经后期着重益气滋阴、经间期活血为主、经前期侧重助肾阳、月经期着重调经。针灸能够运行全身气血、调和冲任,亦可结合中药双重改善机体的免疫平衡,有些文献重视发挥针药结合的优势。
The immune infertility is mainly divided into 4 types: liver-kidney yin deficiency,deficiency of spleen and kidney, dampness pathogen and heat disturbance, blood stasis and qi stagnation.Because of its pathogenesis which is intermingled deficiency and excess, this paper summarized the treatment principles and experience of all medical schools. TCM syndrome differentiation and treatment in immune infertility is on the basis of nourishing kidney yin, to activate blood circulation to dissipate blood stasis, replenish qi to invigorate the spleen, clear dampness heat and nourish yin to descend fire. TCM cycle therapy is based on the waxing and waning of yin-yang of the kidney and the periodic changes of the woman ' s qi and blood, and the medication is taken into account in different period, for example,benefiting qi and nourishing yin after menstruation, activating blood circulation during intermenstruum, recuperating kidney yang before menstruation, regulating meridians during menstruation. Acupuncture and moxibustion can exercise qi and blood in the whole body, regulate the function between Chong and Ren. It can also be combined with traditional Chinese medicine to improve the immune balance of the body. Some literatures attach importance to the advantages of combining acupuncture and medicine.
The immune infertility is mainly divided into 4 types: liver-kidney yin deficiency,deficiency of spleen and kidney, dampness pathogen and heat disturbance, blood stasis and qi stagnation.Because of its pathogenesis which is intermingled deficiency and excess, this paper summarized the treatment principles and experience of all medical schools. TCM syndrome differentiation and treatment in immune infertility is on the basis of nourishing kidney yin, to activate blood circulation to dissipate blood stasis, replenish qi to invigorate the spleen, clear dampness heat and nourish yin to descend fire. TCM cycle therapy is based on the waxing and waning of yin-yang of the kidney and the periodic changes of the woman ' s qi and blood, and the medication is taken into account in different period, for example,benefiting qi and nourishing yin after menstruation, activating blood circulation during intermenstruum, recuperating kidney yang before menstruation, regulating meridians during menstruation. Acupuncture and moxibustion can exercise qi and blood in the whole body, regulate the function between Chong and Ren. It can also be combined with traditional Chinese medicine to improve the immune balance of the body. Some literatures attach importance to the advantages of combining acupuncture and medicine.
引文
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[12]王金萍.中西医结合治疗免疫性不孕不育的临床效果浅析[J].现代诊断与治疗,2016,27(19):3547-3548.
[13]袁爽.中西医结合治疗免疫性不孕不育的疗效观察[J].实用妇科内分泌杂志(电子版),2016,3(17):37-39.
[14]陆杉,倪运萍.强体种子方对不孕不育患者生殖道免疫功能的影响.中医药学报,2014,42(4);112-114.
[15]许小风,顾颖,顾灵,等.中医药干预在女性不孕症促排卵治疗中的优势探析[J].中华中医药学刊,2012,30(3):467.
[16]周建中.六味地黄汤加减治疗免疫性不孕症临床评价[J].中国药业,2017,26(13):55-56.
[17]付楝,黄年平.滋阴补肾助孕汤治疗女性免疫性不孕疗效观察[J].现代中西医结合杂志,2017,26(32):3592-3594.
[18]吴宁,孟宝丽.李祥云补肾清解调周法治疗免疫性不孕经验[J].上海中医药杂志,2010,44(9):8-9.
[19]高兰,陈启亮,黄碧欣.活血促孕方治疗免疫性不孕不育的疗效观察[J].中国现代药物应用,2017,11(9):20-22.
[20]许丽绵,杨凌,罗颂平.免疫性不孕症与慢性生殖道炎症的相关性及中药干预的临床研究[J].广州中医药大学学报,2007,24(5):363-367.
[21]郝智霞,路凤阳,仇亚慧,等.免疫性不孕中医病机及辨治浅探[J].云南中医中药杂志,2016,37(4):14-16.
[22]张丽娟.妇科再造胶囊治疗免疫性不孕症的临床疗效分析[J].中国医药指南,2013,11(28):206.
[23]张丁丹.中西医联合治疗免疫性不孕不育疗效及安全性评价[J].医药前沿,2016,6(5):94-95.
[24]余琼琼,陈敏,苏齐.逐瘀消癥汤配合西药治疗瘀阻胞宫型免疫性不孕症疗效观察[J].陕西中医,2013,34(11):1446-1447.
[25]许振,许子春,吴炳坤.中医药周期疗法治疗免疫性不孕110例[J].中国中医药科技,2010,17(4):368-369.
[26]宋淑华.补肾活血法人工周期疗法治疗免疫性不孕32例[J].陕西中医,2007,28(7):800-801.
[27]范欢欢.夏桂成教授“经间排卵期”理论及诊治不孕症临床经验研究[D].南京:南京中医药大学,2017.
[28]赵可宁.夏桂成治疗免疫性不孕症经验撷要[J].实用中医药杂志,2000,16(5):38.
[29]张秋仔.吕绍光主任运用简化中药人工周期治疗不孕症经验介绍[J].福建中医药,2012, 43(1):20-21.
[30]叶敦敏,邱淑丽,赵颖.辨证分期治疗慢性盆腔炎合并免疫性不孕症18例疗效观察[J].新中医,2003, 35(5):22-23.
[31]吕荣华.抑抗散配合针灸治疗免疫性不孕症[J].中医临床研究,2016,8(30);88-89.
[32]王学兰.艾灸三阴交联合中药补肾活血在免疫性不孕治疗中的应用体会[J].国医论坛,2013,28(3)54-55.
[33]王学兰.中西医结合治疗排卵功能障碍性不孕症60例临床疗效分析[J].中医临床研究,2013,5(7):26.
[34]黄奕涵,黄舒娥,李素荷.穴位埋线法治疗抗精子免疫性不孕临床研究[J],光明中医,2014,29(5):1008-1010.
[35]肖达,张群.针灸治疗不孕症的研究进展[J].上海针灸杂志,2015,34(1):80-84.
[36] LIAO Y N, HU W L, HUNG Y C. Complementary and Alternative Therapy with Traditional Chinese Medicine for Infertility[M]//Chinese Medical Therapies for Diabetes,Infertility, Silicosis and the Theoretical Basis. In Tech, 2017.
[2]郭勇义.中医药辨证施治女性免疫性不孕不育的临证研究[J].环球中医药,2015,8(S1):135-136.
[3]方红哲.辨证施治免疫性不孕[J].实用中医内科杂志,2013,27(4):90-91.
[4]张君探,郑祖峰,邹雪梅,等.免疫性不孕症的中医研究进展[J].世界最新医学信息文摘,2016,16(67):54-54.
[5]赵静静,蔡平平.女性抗精子抗体阳性不孕症中医药治疗进展[J].湖南中医杂志,2018,34(2):162-164.
[6]曹亚芳,刘普勇,严春玲,等.王成荣从血分郁热论治免疫性不孕[J].四川中医,2016,34(4):5-6.
[7]景彦林,杨修昭.夏桂成论治免疫性不孕临床经验[J].光明中医,2011,26(10):1974-1975.
[8]张晓峰.辨证与辨病结合治疗免疫性不孕46例临床分析[J].中国中医药信息杂志,2006,13(6):60.
[9]刘慧聪,刘敛,徐莲薇,等.李祥云从肾虚血瘀辨治免疫性不孕经验[J].上海中医药杂志,2013,47(12):13-15.
[10]章茂森.徐福松教授治疗男子不育症经验[J].中医学报,2015,30(12):1798-1800.
[11]汪巧燕,叶平.免疫性不孕中医药治疗概述[J].辽宁中医药大学学报,2014,16(12):217-219.
[12]王金萍.中西医结合治疗免疫性不孕不育的临床效果浅析[J].现代诊断与治疗,2016,27(19):3547-3548.
[13]袁爽.中西医结合治疗免疫性不孕不育的疗效观察[J].实用妇科内分泌杂志(电子版),2016,3(17):37-39.
[14]陆杉,倪运萍.强体种子方对不孕不育患者生殖道免疫功能的影响.中医药学报,2014,42(4);112-114.
[15]许小风,顾颖,顾灵,等.中医药干预在女性不孕症促排卵治疗中的优势探析[J].中华中医药学刊,2012,30(3):467.
[16]周建中.六味地黄汤加减治疗免疫性不孕症临床评价[J].中国药业,2017,26(13):55-56.
[17]付楝,黄年平.滋阴补肾助孕汤治疗女性免疫性不孕疗效观察[J].现代中西医结合杂志,2017,26(32):3592-3594.
[18]吴宁,孟宝丽.李祥云补肾清解调周法治疗免疫性不孕经验[J].上海中医药杂志,2010,44(9):8-9.
[19]高兰,陈启亮,黄碧欣.活血促孕方治疗免疫性不孕不育的疗效观察[J].中国现代药物应用,2017,11(9):20-22.
[20]许丽绵,杨凌,罗颂平.免疫性不孕症与慢性生殖道炎症的相关性及中药干预的临床研究[J].广州中医药大学学报,2007,24(5):363-367.
[21]郝智霞,路凤阳,仇亚慧,等.免疫性不孕中医病机及辨治浅探[J].云南中医中药杂志,2016,37(4):14-16.
[22]张丽娟.妇科再造胶囊治疗免疫性不孕症的临床疗效分析[J].中国医药指南,2013,11(28):206.
[23]张丁丹.中西医联合治疗免疫性不孕不育疗效及安全性评价[J].医药前沿,2016,6(5):94-95.
[24]余琼琼,陈敏,苏齐.逐瘀消癥汤配合西药治疗瘀阻胞宫型免疫性不孕症疗效观察[J].陕西中医,2013,34(11):1446-1447.
[25]许振,许子春,吴炳坤.中医药周期疗法治疗免疫性不孕110例[J].中国中医药科技,2010,17(4):368-369.
[26]宋淑华.补肾活血法人工周期疗法治疗免疫性不孕32例[J].陕西中医,2007,28(7):800-801.
[27]范欢欢.夏桂成教授“经间排卵期”理论及诊治不孕症临床经验研究[D].南京:南京中医药大学,2017.
[28]赵可宁.夏桂成治疗免疫性不孕症经验撷要[J].实用中医药杂志,2000,16(5):38.
[29]张秋仔.吕绍光主任运用简化中药人工周期治疗不孕症经验介绍[J].福建中医药,2012, 43(1):20-21.
[30]叶敦敏,邱淑丽,赵颖.辨证分期治疗慢性盆腔炎合并免疫性不孕症18例疗效观察[J].新中医,2003, 35(5):22-23.
[31]吕荣华.抑抗散配合针灸治疗免疫性不孕症[J].中医临床研究,2016,8(30);88-89.
[32]王学兰.艾灸三阴交联合中药补肾活血在免疫性不孕治疗中的应用体会[J].国医论坛,2013,28(3)54-55.
[33]王学兰.中西医结合治疗排卵功能障碍性不孕症60例临床疗效分析[J].中医临床研究,2013,5(7):26.
[34]黄奕涵,黄舒娥,李素荷.穴位埋线法治疗抗精子免疫性不孕临床研究[J],光明中医,2014,29(5):1008-1010.
[35]肖达,张群.针灸治疗不孕症的研究进展[J].上海针灸杂志,2015,34(1):80-84.
[36] LIAO Y N, HU W L, HUNG Y C. Complementary and Alternative Therapy with Traditional Chinese Medicine for Infertility[M]//Chinese Medical Therapies for Diabetes,Infertility, Silicosis and the Theoretical Basis. In Tech, 2017.