岭南罗氏妇科治疗先兆流产合并绒毛膜下血肿的临证经验
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摘要
岭南罗氏妇科流派源远流长,在传承中不断创新,在调经、助孕、安胎方面颇具特色。先兆流产合并绒毛膜下血肿病因及发病机制尚不明确。岭南罗氏妇科认为先兆流产合并绒毛膜下血肿的基本病机为脾肾亏虚夹瘀,以补肾健脾、活血化瘀为基本治则,注重衷中参西,病证结合。强调养血活血而不动血,化瘀止血而不伤正。活血化瘀类药物宜选择平和之品,如丹参、鸡血藤、三七等;临证时亦需严格掌握剂量和用药时间,衰其大半而止,以免动胎伤胎。
Luo's Gynecology has a long history,constantly innovated in inheritance,and has its own characteristics in regulating menstruation,promoting gestation and miscarriage prevention. The etiology and pathogenesis of threatened abortion combined with subchorionic hematoma are not clear. It thinks that deficiency of spleen and kidney and blood stasis is the basic pathology of threatened abortion combined with subchorionic hematoma,and benefiting kidney and spleen,promoting blood circulation to remove blood stasis is the basic treating principle in Luo's Gynaecology's opinion. Integrating Chinese and western medicine,combining disease with syndrome are also valued. It is emphasized that the patients should be nourished the blood and promoted blood circulation but not burnned the blood,eliminated stasis and stopped bleeding but not damaged maternal health. Mild hurbs are elected during the activating microcirculation and removing stasis medicinal herbs,such as miltiorrhiza,lignum millettiae,pseudo-ginseng. In order to avoid fetal injuries,the dosage and medication time must be strictly controlled,and treatment only needs to eliminate most of the pathogenic factors.
Luo's Gynecology has a long history,constantly innovated in inheritance,and has its own characteristics in regulating menstruation,promoting gestation and miscarriage prevention. The etiology and pathogenesis of threatened abortion combined with subchorionic hematoma are not clear. It thinks that deficiency of spleen and kidney and blood stasis is the basic pathology of threatened abortion combined with subchorionic hematoma,and benefiting kidney and spleen,promoting blood circulation to remove blood stasis is the basic treating principle in Luo's Gynaecology's opinion. Integrating Chinese and western medicine,combining disease with syndrome are also valued. It is emphasized that the patients should be nourished the blood and promoted blood circulation but not burnned the blood,eliminated stasis and stopped bleeding but not damaged maternal health. Mild hurbs are elected during the activating microcirculation and removing stasis medicinal herbs,such as miltiorrhiza,lignum millettiae,pseudo-ginseng. In order to avoid fetal injuries,the dosage and medication time must be strictly controlled,and treatment only needs to eliminate most of the pathogenic factors.
引文
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[11]岳明明,罗颂平,谭宇蕙.补肾中药对肾虚黄体抑制流产大鼠的实验研究[J].中医药学报,2005,33(1):47-49.
[12]罗颂平,梁国珍,张玉珍,等.助孕3号方防治大鼠自然流产的机理研究[J].中国中西医结合杂志,2003,23(7):522-525.
[13]李小球.补肾健脾中药对妊娠大鼠孕激素及其受体的影响[J].广州中医药大学学报,1998(3):49-51.
[14]韩慧.助孕3号方对大鼠子宫收缩活动的影响[J].广州中医药大学学报,2002,19(1):33-35.
[15]赵红艳.肾虚型自然流产蜕膜黄体效应、TGF一β1表达及补肾中药对流产大鼠干预的研究[D].广州:广州中医药大学,2006.
[16]周英,罗颂平,许丽绵,等.助孕3号方对肾虚黄体抑制流产大鼠母胎界Th1/Th2细胞因子的影响研究[J].现代中西医结合杂志,2008,17(1):12-14.
[17]尤昭玲,王若光,李军,等.益气化瘀法对胎儿宫内发育迟缓患者子宫动脉、脐动脉血流影响的研究[J].中国中医药科技,2000,7(5):321.
[18]罗丹峰,汪锦飘,吴少焜.活血滋肾法治疗血栓前状态所致复发性流产临床研究[J].中国中医急症,2009,18(9):1426-1428.
[2]ALIMOHAMADIl S,JAVADIAN P,GHAREDAGHI MH,et al.Progesterone and threatened abortion:A randomized clinical trial on endocervical cytokine concentrations[J].Journal of Reproductive Immunology,2013,98(2):52-60.
[3]李清,朱瑾,华克勤.绒毛膜下血肿孕妇妊娠结局的荟萃分析[J].中华医学杂志,2016,96(17):1383-1385.
[4]岳洁,刘晓华,卢钺,等.早孕期绒毛膜下血肿的位置与大小对妊娠结局的影响[J].中国妇幼保健,2015,30(34):5983-5984.
[5]Sükür YE,GOC G,K0SE O,et al.The effects of subchorionic hematoma on pregnancy outcome in patients with threatened abortion[J].Journal of the Turkish German Gynecology Association,2014,15(4):239.
[6]卢如玲,陶莉莉,李莉.张玉珍教授变法安胎经验举隅[J].河北中医,2007,29(7):584-585.
[7]郜洁,罗颂平.寿胎丸不同提取部位对肾虚流产模型孕鼠补肾安胎的药效学筛选[J].中药材,2011,34(8):1253.
[8]张铭,梁国珍,罗颂平.助孕3号方对脾虚黄体抑制动物流产模型的作用[J].广州中医药大学学报,2000,17(1):64-68.
[9]刘昱磊,罗颂平,梁国珍,等.助孕3号方拆方防治肾虚黄体抑制动物流产模型的实验研究[J].生殖与避孕,2003,23(1):17-20.
[10]宁艳,罗颂平,梁国珍.补肾健脾中药复方对肾虚黄体抑制妊娠大鼠流产模型的实验研究[J].中国医药学报,2000,15(6):28-30,82.
[11]岳明明,罗颂平,谭宇蕙.补肾中药对肾虚黄体抑制流产大鼠的实验研究[J].中医药学报,2005,33(1):47-49.
[12]罗颂平,梁国珍,张玉珍,等.助孕3号方防治大鼠自然流产的机理研究[J].中国中西医结合杂志,2003,23(7):522-525.
[13]李小球.补肾健脾中药对妊娠大鼠孕激素及其受体的影响[J].广州中医药大学学报,1998(3):49-51.
[14]韩慧.助孕3号方对大鼠子宫收缩活动的影响[J].广州中医药大学学报,2002,19(1):33-35.
[15]赵红艳.肾虚型自然流产蜕膜黄体效应、TGF一β1表达及补肾中药对流产大鼠干预的研究[D].广州:广州中医药大学,2006.
[16]周英,罗颂平,许丽绵,等.助孕3号方对肾虚黄体抑制流产大鼠母胎界Th1/Th2细胞因子的影响研究[J].现代中西医结合杂志,2008,17(1):12-14.
[17]尤昭玲,王若光,李军,等.益气化瘀法对胎儿宫内发育迟缓患者子宫动脉、脐动脉血流影响的研究[J].中国中医药科技,2000,7(5):321.
[18]罗丹峰,汪锦飘,吴少焜.活血滋肾法治疗血栓前状态所致复发性流产临床研究[J].中国中医急症,2009,18(9):1426-1428.