基于子宫发育不良临床病证特点的动物模型分析
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摘要
子宫发育不良即幼稚子宫,主要是指女子青春期以后甚至进入到生育期子宫体积明显比正常小的一种病理状态。是妇科常见疾病,多因发育过程相关激素低下导致,主要表现为经迟、月经稀少、痛经、甚至发展为闭经,婚后常表现为不孕等。本文基于子宫发育不良的中医、西医临床病证特点,总结归纳目前现有的子宫发育不良的动物模型。根据子宫发育不良的病因病机、中西医诊断标准,分析动物模型的优缺点及模型与子宫发育不良中西医临床病证特点的吻合情况,提出相应动物模型评价指标体系及现有子宫发育不良动物模型的完善思路及改进方法。而目前子宫发育不良建模方法不多,现子宫发育不良模型为病理性模型,以西医指标为主。已有模型从一些方面反映了子宫发育不良的临床情况,但缺少子宫发育不良模型的评价指标体系,缺少体现中医病因的动物模型。通过与现有的单因素动物模型相结合,建立与临床病证相结合的、更接近人类子宫发育不良典型症状的复合动物模型,复制出能更加吻合临床病证特点的动物模型。同时完善子宫发育不良动物模型评价指标体系,建立具有中医证型的子宫发育不良病证结合模型是未来研究重点。
Uterine dysplasia or naive uterus mainly refers to a pathological state in which the uterus volume is significantly smaller than normal after adolescence. It is a common gynecological disease,which is caused by low levels of hormones during development process. The main symptoms are delayed menstruation,scanty menstruation,dysmenorrhea and even amenorrhea,and often manifested as infertility after marriage. The article summarizes existing animal models of uterine dysplasia based on clinical symptom characteristics of uterine dysplasia according to clinical diagnostic standard of traditional Chinese medicine( TCM) and western medicine.According to etiology and pathogenesis of uterine dysplasia and diagnostic criteria of TCM and Western medicine,advantages and disadvantages and coincidence of animal models with characteristics of uterine dysplasia and clinical symptoms of uterine dysplasia were proposed. The corresponding animal model evaluation index system and existing uterine dysplasia animal models were proposed to improve ideas and methods. At present,there are not many methods for establishing uterus dysplasia models. The existing models of uterine dysplasia are pathological models based on western medicine indexes. The existing models reflect clinical situations of uterine dysplasia in some aspects,but there is no evaluation index system of uterine dysplasia model and animal model reflecting cause of TCM. Based on existing single-factor animal models,a composite animal model with clinical conditions and similar typical symptoms of human uterine dysplasia is established,which is more consistent with characteristics of clinical symptoms. At same time,it is focus of future researches to improve evaluation index system of uterine animal models and establish a combination model of dysplasia of uterus with TCM syndromes.
Uterine dysplasia or naive uterus mainly refers to a pathological state in which the uterus volume is significantly smaller than normal after adolescence. It is a common gynecological disease,which is caused by low levels of hormones during development process. The main symptoms are delayed menstruation,scanty menstruation,dysmenorrhea and even amenorrhea,and often manifested as infertility after marriage. The article summarizes existing animal models of uterine dysplasia based on clinical symptom characteristics of uterine dysplasia according to clinical diagnostic standard of traditional Chinese medicine( TCM) and western medicine.According to etiology and pathogenesis of uterine dysplasia and diagnostic criteria of TCM and Western medicine,advantages and disadvantages and coincidence of animal models with characteristics of uterine dysplasia and clinical symptoms of uterine dysplasia were proposed. The corresponding animal model evaluation index system and existing uterine dysplasia animal models were proposed to improve ideas and methods. At present,there are not many methods for establishing uterus dysplasia models. The existing models of uterine dysplasia are pathological models based on western medicine indexes. The existing models reflect clinical situations of uterine dysplasia in some aspects,but there is no evaluation index system of uterine dysplasia model and animal model reflecting cause of TCM. Based on existing single-factor animal models,a composite animal model with clinical conditions and similar typical symptoms of human uterine dysplasia is established,which is more consistent with characteristics of clinical symptoms. At same time,it is focus of future researches to improve evaluation index system of uterine animal models and establish a combination model of dysplasia of uterus with TCM syndromes.
引文
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[25]吴可心,付正英.针药结合治疗子宫发育不良个案分析[J].哈尔滨医药,2016,36(5):582-583.
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[2]刘玉辉,杜娇娇,邢彦娟.中西医结合治疗不孕不育的临床价值研究[J].河北中医用药指南,2013,25(30):2236-2237.
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[4]唐华龙.补肾调冲法拟方治疗子宫发育不良所致不孕症62例体会[J].中医药临床杂志,2010,22(1):61.
[5]王冰,刘维娜,吕延冬,等.谢萍治疗子宫发育不良性不孕症经验[J].实用中医药杂志,2012,28(3):206-207.
[6]张建玲.中西医结合治疗子宫发育不良型不孕症的疗效分析[J].中西医结合心血管病电子杂志,2015,3(8):99-100.
[7]齐绍霞,张华,孙卫国,等.子宫发育不良之不孕症的中西结合治疗[J].四川中医,2007,25(5):80-81.
[8]杜建层,周秀芹.中西医结合治疗子宫发育不良30例疗效观察[J].四川中医,2005,23(1):74-75.
[9]刘金华.雌激素直接作用靶器官联合扩宫术治疗子宫发育不良的临床应用[J].现代诊断与治疗,2013,24(19):4512.
[10]夏天.补肾方药对下丘脑-垂体-卵巢轴作用的研究概述[J].北京中医,2004,23(6):374-376.
[11]葛翠莲,王希浩,刘方洲,等.补肾健脾方对下丘脑-垂体-卵巢轴功能的影响[J].中医研究,2010,23(1):28-29.
[12]陈梅,杨鉴冰,贺丰杰,等.子宫发育不良与免疫低下关系探微[J].陕西中医学院学报,2006,29(3):7-9.
[13]罗克燕,杨丹莉,徐敏.菟丝子总黄酮对大鼠排卵障碍的治疗作用及其机制研究[J].现代中西医结合杂志,2013,22(20):2184-2186,2188.
[14]吴瑕,杨薇,张磊,等.下丘脑-垂体-性腺轴阻断对淫羊藿促性激素作用的影响[J].中国实验方剂学杂志,2011,17(5):161-164.
[15]常小丽.补肾药治疗子宫发育不良的实验研究概况[J].陕西中医学院学报,2002,25(4):66-68.
[16]李艳.鹿角胶治疗子宫发育不良的药效机制研究[D].郑州:河南中医药大学,2017.
[17]秦彩霞.中西医结合诊治子宫发育不良引起不孕症的临床观察[J].社区医学杂志,2006,4(6):47-48.
[18]胡颖,罗俊,黄能慧.妇科再造丸对雌孕激素负荷大鼠子宫病理形态学的影响[J].中国实验方剂学杂志,2011,17(23):140-144.
[19]刘元军.苁蓉菟丝子丸治疗子宫发育不良不孕症30余例[J].中国中医药现代远程教育,2011,9(13):131-132.
[20]杨晓海.从肾论治子宫发育不良32例[J].陕西中医,2008,29(7):803-804.
[21]崔雅婷,丁彩飞.紫河车复方改善子宫发育及子宫内膜容受性研究概述[J].浙江中医杂志,2011,46(10):772-773.
[22]马洪艳.加味归肾汤治疗肾虚型子宫发育不良的临床分析[J].中西医结合心血管病电子杂志,2016,4(15):136-137.
[23]吴可心,齐军.补肾药治疗子宫发育不良的研究概况[J].陕西中医学院学报,2003,26(6):1-4.
[24]邱丽,骆世存,黄剑美.益肾调冲中药对卵泡发育不良肾虚型不孕症患者的卵泡发育及子宫内膜容受性影响的观察[J].临床和实验医学杂志,2015,14(9):761-763.
[25]吴可心,付正英.针药结合治疗子宫发育不良个案分析[J].哈尔滨医药,2016,36(5):582-583.
[26]陈梅,杨鉴冰,贺丰杰,等.子宫发育不良与免疫低下关系探微[J].陕西中医学院学报,2006,29(3):7-9.
[27]翟凤霞,张爱芳,苗明三.助宫胶囊促进子宫发育的药效学研究[J].中国实验方剂学杂志,2002,8(5):47-48,64.
[28]乐杰.妇产科学[M]. 7版.北京:人民卫生出版社,2004:69.
[29]罗丽兰.不孕与不育[M]. 2版.北京:人民卫生出版社,2009:238-241.
[30]靳松,杨业洲.子宫疾病对女性生育力的影响及其检查方法[J].实用妇产科杂志,2015,31(1):9-12.
[31]郭玲,郭社珂.实时三维彩超对幼稚子宫临床诊断的价值分析[J].中国医学工程,2012,20(12):53,55.
[32]孙旸,陈亚琼,侯海燕,等.中药治疗子宫内膜发育不良疗效的系统评价[J].中国循证医学杂志,2015,15(2):215-222.
[33]何启会,文斌.中西医结合治疗子宫发育不良性不孕症的临床观察[J].湖北中医杂志,2007,29(8):25.
[34] Miller E S,Sakowicz A,Grobman W A. The association between cervical dysplasia,a short cervix,and preterm birth[J]. Am J Obstet Gynecol,2015,213(4):543-551,554.
[35]陈梅,刘霞.杨鉴冰教授治疗子宫发育不良用药规律探析[J].辽宁中医药大学学报,2010,12(6):239-240.
[36]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:9-10.
[37]邓铁涛.中医诊断学[M].上海:上海科学技术出版社,2000:72.
[38]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:244-245.
[39]曹小燕.妇产科疾病诊断与治疗[M].西安:西安交通大学出版社,2014:345-382.
[40]马程功,马跃荣.中医药证候动物模型的研究进展[J].成都中医药大学学报,2018,41(1):119-123.
[41]杨鉴冰,崔晓萍,王宗柱.肾阳虚型大鼠子宫发育不良动物模型的建立[J].中国中医基础医学杂志,2002,8(9):17-19.
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