夏天教授治疗胚胎移植中薄型子宫内膜的经验撷菁
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摘要
近代辅助生殖技术在不孕症中临床地位举足轻重,子宫内膜菲薄作为影响胚胎移植的棘手因素之一,日益受到临床医师的关注。文章将夏天教授中西医结合治疗本病的临床经验及验案整理。夏天教授治疗本病立足于脾肾两虚为本,气虚寒凝血瘀为标的基本病机,治疗以补肾健脾、补气活血化瘀为大法。
Recently Assisted Reproductive Technique( ART) plays an important role in treating infertility. As one of the thorny factors,the thin endometrium was received more attention from clinical physicians. The article collected the clinical experience and medical cases of Profess Xia Tian in treating thin endometrium in embryonic implantation. Professor Xia Tian considered pathogenesis of thin endometrium was rooted in deficiency of the spleen and kidney,and manifested as qi deficiency,cold coagulation and blood stasis. The treatment should tonify the kidney and invigorate the spleen,as well as tonify qi,activate blood and remove blood stasis.
Recently Assisted Reproductive Technique( ART) plays an important role in treating infertility. As one of the thorny factors,the thin endometrium was received more attention from clinical physicians. The article collected the clinical experience and medical cases of Profess Xia Tian in treating thin endometrium in embryonic implantation. Professor Xia Tian considered pathogenesis of thin endometrium was rooted in deficiency of the spleen and kidney,and manifested as qi deficiency,cold coagulation and blood stasis. The treatment should tonify the kidney and invigorate the spleen,as well as tonify qi,activate blood and remove blood stasis.
引文
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[3]郭欢欢,孙蓬明,林元.薄型子宫内膜的临床处理进展[J].国际妇产科学杂志,2015,42(4):417-420.
[4]余小英,马科,胡卫华,等.复方玄驹胶囊联合小剂量雌激素治疗肾阳虚型薄型子宫内膜不孕症患者的临床疗效观察[J].生殖与避孕,2015,35(9):612-617.
[5]李群.养膜汤对不孕症薄型子宫内膜的影响[J].河北中医,2016,38(3):378-380.
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[8]李林娟,王希浩.王希浩主任医师诊治输卵管性不孕的经验举隅[J].中国中医药现代远程教育,2014,12(6):26.
[9]肖承悰,刘雁峰,江媚.“补肾气,通胞脉”改善子宫内膜容受性[J].生殖与避孕,2014,34(7):595-597.
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[11]刘彩姣,王蔼明.干细胞在子宫内膜损伤修复中的研究进展[J].安徽医药,2017,21(5):781-784.
[12]张群芝,张静.不孕与子宫内膜的病理变化的相关性分析[J].中国妇幼保健,2013,28(17):2751-2752.
[13]Kodama M,Onoue M,Otsuka H,et al.Efficacy of dienogest in thinning the endometrum before hysteroscopic surgery[J].J Minim Invasive Gynecol,2013,20(6):790-795.
[14]Haritha S,Rajagopalan G.Follicular growth,endometrial thickness,and serum estradiol levels in spontaneous and clomiphene citrate-induced cycles[J].Int J Gynaecol Obstet,2003,81(3):287-292.
[15]汪离志.IVF-ET临床妊娠率和活产率及其影响因素研究[D].上海:复旦大学,2014.
[16]Amir W,Micha B,Arial H,et al.Predicting factors for endometrial thickness during treatment with assisted reproductive technology[J].Fertility and Sterility,2007,87(4):799-804.
[17]俞凌,王淑芳,叶明侠,等.薄型子宫内膜治疗新进展[J].国际生殖健康/计划生育杂志,2016,35(2):165-169.
[18]常亚杰,梁晓燕.辅助生殖技术周期中薄型子宫内膜的相关机制及临床对策[J].实用妇产科杂志,2014,30(11):820-823.
[19]金丹,朱亮.薄型子宫内膜的评价与改善措施[J].生殖与避孕,2012,32(1):49-53.
[20]潘萍,李予,杨冬梓.粒细胞集落刺激因子治疗薄型子宫内膜的研究进展[J].实用妇产科杂志,2017,33(1):20-23.
[21]张宇迪,卢丹,孙如意,等.仿生物电刺激对薄型子宫内膜患者作用的研究[J].中国临床医生杂志,2017,45(2):93-94.
[22]薛惠英,仲纪祥,左阳花,等.盆底仿生物电刺激干预治疗薄型子宫内膜患者的冷冻胚胎移植结局[J].生殖医学杂志,2015,24(1):12-16.
[23]符小航.人工流产后月经过少、闭经的机理探讨分析[J].陕西中医学院学报,2009,32(6):6-7.
[24]肖凤鑫,张建伟.补肾中药对IVF薄型子宫内膜种植失败者围着床期子宫内膜LIF、IL-1β时空表达的影响[D].济南:山东中医药大学,2011.
[2]俞凌,王淑芳,叶明侠,等.薄型子宫内膜治疗新进展[J].国际生殖健康/计划生育杂志,2016,35(2):165-169.
[3]郭欢欢,孙蓬明,林元.薄型子宫内膜的临床处理进展[J].国际妇产科学杂志,2015,42(4):417-420.
[4]余小英,马科,胡卫华,等.复方玄驹胶囊联合小剂量雌激素治疗肾阳虚型薄型子宫内膜不孕症患者的临床疗效观察[J].生殖与避孕,2015,35(9):612-617.
[5]李群.养膜汤对不孕症薄型子宫内膜的影响[J].河北中医,2016,38(3):378-380.
[6]张玉珍.中医妇科学[M].2版.北京:中国中医药出版社,2011:32-33.
[7]李冉,连方.连方治疗卵巢低反应性不孕症经验[J].湖南中医杂志,2016,32(9):38-40.
[8]李林娟,王希浩.王希浩主任医师诊治输卵管性不孕的经验举隅[J].中国中医药现代远程教育,2014,12(6):26.
[9]肖承悰,刘雁峰,江媚.“补肾气,通胞脉”改善子宫内膜容受性[J].生殖与避孕,2014,34(7):595-597.
[10]连方,辛明蔚.体外授精-胚胎移植患者降调节后肾虚本质探讨[J].山东中医药大学学报,2008,32(8):109-110.
[11]刘彩姣,王蔼明.干细胞在子宫内膜损伤修复中的研究进展[J].安徽医药,2017,21(5):781-784.
[12]张群芝,张静.不孕与子宫内膜的病理变化的相关性分析[J].中国妇幼保健,2013,28(17):2751-2752.
[13]Kodama M,Onoue M,Otsuka H,et al.Efficacy of dienogest in thinning the endometrum before hysteroscopic surgery[J].J Minim Invasive Gynecol,2013,20(6):790-795.
[14]Haritha S,Rajagopalan G.Follicular growth,endometrial thickness,and serum estradiol levels in spontaneous and clomiphene citrate-induced cycles[J].Int J Gynaecol Obstet,2003,81(3):287-292.
[15]汪离志.IVF-ET临床妊娠率和活产率及其影响因素研究[D].上海:复旦大学,2014.
[16]Amir W,Micha B,Arial H,et al.Predicting factors for endometrial thickness during treatment with assisted reproductive technology[J].Fertility and Sterility,2007,87(4):799-804.
[17]俞凌,王淑芳,叶明侠,等.薄型子宫内膜治疗新进展[J].国际生殖健康/计划生育杂志,2016,35(2):165-169.
[18]常亚杰,梁晓燕.辅助生殖技术周期中薄型子宫内膜的相关机制及临床对策[J].实用妇产科杂志,2014,30(11):820-823.
[19]金丹,朱亮.薄型子宫内膜的评价与改善措施[J].生殖与避孕,2012,32(1):49-53.
[20]潘萍,李予,杨冬梓.粒细胞集落刺激因子治疗薄型子宫内膜的研究进展[J].实用妇产科杂志,2017,33(1):20-23.
[21]张宇迪,卢丹,孙如意,等.仿生物电刺激对薄型子宫内膜患者作用的研究[J].中国临床医生杂志,2017,45(2):93-94.
[22]薛惠英,仲纪祥,左阳花,等.盆底仿生物电刺激干预治疗薄型子宫内膜患者的冷冻胚胎移植结局[J].生殖医学杂志,2015,24(1):12-16.
[23]符小航.人工流产后月经过少、闭经的机理探讨分析[J].陕西中医学院学报,2009,32(6):6-7.
[24]肖凤鑫,张建伟.补肾中药对IVF薄型子宫内膜种植失败者围着床期子宫内膜LIF、IL-1β时空表达的影响[D].济南:山东中医药大学,2011.
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