卵巢早衰型不孕的中医论治
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摘要
卵巢早衰型不孕是当前女性高发疾病,病因证情复杂,诊治难度高,近年来临床研究较多。本文就近5年中医对卵巢早衰型不孕的病因病机及论治进展进行了综合整理,发现与古书记载略有不同。目前认为该病主要责之于心肝脾肾四脏,肾虚、脾虚、肝郁、心火是本病的主要病因,四脏往往合而为病,病机属虚实夹杂、以虚为主。治疗时多数医家主要以补益气血、温肾填精为大法并随证加减,肝郁佐以疏肝解郁,脾虚佐以健脾益气,气滞血瘀则辅以行气活血化瘀,痰湿内阻行以健脾化痰除湿,心火较旺则清心安神,适时配以一些辅助疗法亦可提高临床疗效。
Premature ovarian failure infertility is a high incidence of female disease,whose reason is complex and difficult to diagnosis and treatment. In this paper,the etiology,pathogenesis and treatment progress of premature ovarian failure infertility caused by traditional Chinese medicine has been synthesized in the five years,which has a slightly different from the ancient records.Nowadays the disease is mainly related to the heart,liver,spleen,kidney.Deficiency of the kidney,spleen deficiency,liver Qi and heart fire are the main cause of this disease,which is often combined together.The pathogenesis is mainly mixed with the deficiency and excess. In the treatment,most physicians mainly focus on replenishing Qi and blood,including warming the kidney,tonifying the liver and relieving depression,and invigorating the spleen and replenishing Qi.Qi and blood stasis treated with activating Qi and blood circulation,phlegm and dampness resistance to invigorate the spleen,heart fire hyperactivity,and timely with some adjuvant therapy which can also improve the clinical efficacy.
Premature ovarian failure infertility is a high incidence of female disease,whose reason is complex and difficult to diagnosis and treatment. In this paper,the etiology,pathogenesis and treatment progress of premature ovarian failure infertility caused by traditional Chinese medicine has been synthesized in the five years,which has a slightly different from the ancient records.Nowadays the disease is mainly related to the heart,liver,spleen,kidney.Deficiency of the kidney,spleen deficiency,liver Qi and heart fire are the main cause of this disease,which is often combined together.The pathogenesis is mainly mixed with the deficiency and excess. In the treatment,most physicians mainly focus on replenishing Qi and blood,including warming the kidney,tonifying the liver and relieving depression,and invigorating the spleen and replenishing Qi.Qi and blood stasis treated with activating Qi and blood circulation,phlegm and dampness resistance to invigorate the spleen,heart fire hyperactivity,and timely with some adjuvant therapy which can also improve the clinical efficacy.
引文
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[3]滕秀香.中医辨证治疗卵巢早衰———1例病例的启示[J].中国临床医生杂志,2016,44(4):27-28.
[4] KATE MACLARAN,NICK PANAY. Premature ovarian failure[J].FamPlannReprod Health Care,2011,37(2):35-42.
[5]段飞燕,李芹,柳露,等.卵巢早衰诊治进展[J].中国医药科学,2016,6(7):38.
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[7]马颖,夏亦冬.卵巢储备功能下降中医治疗的现状与进展[J].内蒙古中医药,2016,3(137):120-121.
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[18]张岩,谈勇.夏桂成调心补肾治疗卵巢早衰经验[J].广州中医药大学学报,2015,32(5):934-935.
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[25]滕秀香,李宏田,姚海洋.基于差异矩阵算法的卵巢早衰中医证候特点的聚类分析研究[J].北京中医药,2016,35(4):291-293.
[26]张雪芝,韩延华,朱小琳,等.韩氏妇科诊治卵巢早衰之经验刍议[J].世界中西医结合杂志,2015,10(10):1355-1356.
[27]刘禹彤.王翠霞补肾填精-疏肝理气“调经方”治疗肝郁肾虚月经后期[J].实用中医内科杂志,2016,30(4):17-18.
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[29]陈静,王春艳.胡国华教授治疗卵巢早衰及卵巢储备功能低下的经验[J].世界中西医结合杂志,2013,8(10):988-989.
[30]宁桂君.连方治疗卵巢早衰所致不孕的经验[J].湖北中医杂志,2016,38(10):27-29.
[31]李阳,丛慧芳,徐晓宇,等.丛慧芳从心论治不孕症经验[J].江西中医药,2016,10(47):33-34.
[32]杨云艳,张烨.助卵汤治疗卵巢早衰性不孕30例临床观察[J].湖南中医杂志,2014,30(4):73-75.
[33]王玉洁.四物合剂治疗56例卵巢早衰的疗效观察[J].社区中医药,2013,15(9):224-225.
[34]徐海霞,胡国华,夏亦冬.育肾养血方治疗卵巢早衰的实验研究[J].上海交通大学学报:医学版,2011,31(5):571-573.
[35]闫晓彤.滋肾育胎丸临床应用及作用机制研究进展[J].上海中医药杂志,2016,50(8):98-100.
[36]王雪,韩开梅.夏天中西医结合治疗卵巢储备功能下降所致不孕症经验[J].山东中医杂志,2016,35(4):334-335.
[37]刘妍,王翠霞.从肾肝脾论治在卵巢早衰患者IVF-ET中应用[J].光明中医,2016,31(7):1006-1007.
[38]胡颖,许良智,谭卓林.左归丸加减治疗卵巢早衰的系统评价[J].中华中医药杂志,2013,28(8):2305-2308.
[39]华方方,夏永华,杨君,等.补水柔木方加安宫黄体酮治疗肾虚肝郁型卵巢早衰的临床观察[J].中国中西医结合杂志,2012,32(8):1028-1030.
[40]张毅敏,于斌,陈佳,等.针刺治疗对卵巢早衰大鼠PI3K/Akt/m TOR信号通路的影响[J].中国针灸,2015,35(1):53-55.
[41]王飞,房繄恭,陈滢如,等.针刺治疗卵巢早衰的前瞻性病例序列研究[J].中国针灸,2014,34(7):653-654.
[42]孔素平,王元耕,李明月,等.补肾疏肝针刺法对卵巢早衰模型大鼠性激素的影响[J].世界中西医结合杂志,2016,11(1):114-115.
[43]董彩英,常素玲,李秀梅.芒针针刺治疗卵巢早衰临床研究[J].中医学报,2013,11(28):1706-1707.
[44]李卫东,许华群,唐敬强,等.穴位埋线联合人工周期疗法治疗卵巢早衰:随机对照研究[J].中国针灸,2014,34(1):29-33.
[45]马学玲.杨宗孟教授治疗卵巢早衰经验[J].长春中医药大学学报,2011,27(1):45-46.
[46]王占利,李坤寅.张玉珍用膏方调治卵巢早衰经验[J].辽宁中医杂志,2011,38(12):2341-2342.
[2]穆玉兰,陈子江.卵巢性不孕诊治[J].中国实用妇科与产科杂志,2013,29(9):696.
[3]滕秀香.中医辨证治疗卵巢早衰———1例病例的启示[J].中国临床医生杂志,2016,44(4):27-28.
[4] KATE MACLARAN,NICK PANAY. Premature ovarian failure[J].FamPlannReprod Health Care,2011,37(2):35-42.
[5]段飞燕,李芹,柳露,等.卵巢早衰诊治进展[J].中国医药科学,2016,6(7):38.
[6] ARIFKOKCU.Premature ovarian failure from current perspective[J].Gynecological Endocrinology,2010,26(8):555-562.
[7]马颖,夏亦冬.卵巢储备功能下降中医治疗的现状与进展[J].内蒙古中医药,2016,3(137):120-121.
[8]郭霭春.黄帝内经素问校注[M].北京:人民卫生出版社,2013:8-23.
[9]薛己.校注妇人良方[M].太原:山西科学技术出版社,2012:243.
[10]朱玲,罗颂平.卵巢早衰病因病机再认识[J].新中医,2015,47(4):327-329.
[11]陈莞苏,施艳秋.卵巢早衰病因病机及中医治疗研究概况[J].辽宁中医药大学学报,2014,16(12):205-206.
[12]万全.万密斋医学全书[M].北京:中国中医药出版社,1999:256.
[13]武之望.济阴纲目[M].北京:人民卫生出版社,2006:73.
[14]唐容川.血证论[M].北京:中国医药科技出版社,2011:112.
[15]韩兰香,杜娟,郭杨志,等.丛慧芳辨治卵巢早衰治疗经验[J].四川中医,2012,30(2):16-17.
[16]李云波,李玲,毛燕茹,等.金哲教授治疗卵巢早衰经验述要[J].环球中医药,2014,7(3):215-216.
[17]陈思,王佩娟.王佩娟治疗卵巢早衰经验总结[J].中国中医基础医学杂志,2015,21(4):469-470.
[18]张岩,谈勇.夏桂成调心补肾治疗卵巢早衰经验[J].广州中医药大学学报,2015,32(5):934-935.
[19]黄欲晓,段青,杨智杰,等.蔡连香治疗卵巢早衰经验[J].中国中医基础医学杂志,2014,20(10):1424-1422.
[20]阳伟红,韩冰.韩冰教授治疗卵巢早衰临证经验[J].天津中医药,2014,31(1):5-6.
[21]黄宏丽,董莉.浅述卵巢早衰证型分布特点[J].光明中医,2015,30(5):1146-1148.
[22]肖承悰.中医妇科临床研究[M].北京:人民卫生出版社,2009:118.
[23]中华中医药学会.中华中医药学会中医妇科常见病诊疗指南[M].北京:中国中医药出版社,2012:449.
[24]刘晓莉.基于卵巢早衰中医证型与临床治疗方法研究[J].中医临床研究,2016,8(7):64-66.
[25]滕秀香,李宏田,姚海洋.基于差异矩阵算法的卵巢早衰中医证候特点的聚类分析研究[J].北京中医药,2016,35(4):291-293.
[26]张雪芝,韩延华,朱小琳,等.韩氏妇科诊治卵巢早衰之经验刍议[J].世界中西医结合杂志,2015,10(10):1355-1356.
[27]刘禹彤.王翠霞补肾填精-疏肝理气“调经方”治疗肝郁肾虚月经后期[J].实用中医内科杂志,2016,30(4):17-18.
[28] THIPVARINTORN DUSITASIRISAKUL,陈莹.陈莹补肾健脾柔肝治疗卵巢早衰不孕[J].实用中医内科杂志,2015,29(1):27-28.
[29]陈静,王春艳.胡国华教授治疗卵巢早衰及卵巢储备功能低下的经验[J].世界中西医结合杂志,2013,8(10):988-989.
[30]宁桂君.连方治疗卵巢早衰所致不孕的经验[J].湖北中医杂志,2016,38(10):27-29.
[31]李阳,丛慧芳,徐晓宇,等.丛慧芳从心论治不孕症经验[J].江西中医药,2016,10(47):33-34.
[32]杨云艳,张烨.助卵汤治疗卵巢早衰性不孕30例临床观察[J].湖南中医杂志,2014,30(4):73-75.
[33]王玉洁.四物合剂治疗56例卵巢早衰的疗效观察[J].社区中医药,2013,15(9):224-225.
[34]徐海霞,胡国华,夏亦冬.育肾养血方治疗卵巢早衰的实验研究[J].上海交通大学学报:医学版,2011,31(5):571-573.
[35]闫晓彤.滋肾育胎丸临床应用及作用机制研究进展[J].上海中医药杂志,2016,50(8):98-100.
[36]王雪,韩开梅.夏天中西医结合治疗卵巢储备功能下降所致不孕症经验[J].山东中医杂志,2016,35(4):334-335.
[37]刘妍,王翠霞.从肾肝脾论治在卵巢早衰患者IVF-ET中应用[J].光明中医,2016,31(7):1006-1007.
[38]胡颖,许良智,谭卓林.左归丸加减治疗卵巢早衰的系统评价[J].中华中医药杂志,2013,28(8):2305-2308.
[39]华方方,夏永华,杨君,等.补水柔木方加安宫黄体酮治疗肾虚肝郁型卵巢早衰的临床观察[J].中国中西医结合杂志,2012,32(8):1028-1030.
[40]张毅敏,于斌,陈佳,等.针刺治疗对卵巢早衰大鼠PI3K/Akt/m TOR信号通路的影响[J].中国针灸,2015,35(1):53-55.
[41]王飞,房繄恭,陈滢如,等.针刺治疗卵巢早衰的前瞻性病例序列研究[J].中国针灸,2014,34(7):653-654.
[42]孔素平,王元耕,李明月,等.补肾疏肝针刺法对卵巢早衰模型大鼠性激素的影响[J].世界中西医结合杂志,2016,11(1):114-115.
[43]董彩英,常素玲,李秀梅.芒针针刺治疗卵巢早衰临床研究[J].中医学报,2013,11(28):1706-1707.
[44]李卫东,许华群,唐敬强,等.穴位埋线联合人工周期疗法治疗卵巢早衰:随机对照研究[J].中国针灸,2014,34(1):29-33.
[45]马学玲.杨宗孟教授治疗卵巢早衰经验[J].长春中医药大学学报,2011,27(1):45-46.
[46]王占利,李坤寅.张玉珍用膏方调治卵巢早衰经验[J].辽宁中医杂志,2011,38(12):2341-2342.