尤昭玲辨治子宫内膜功能障碍不孕经验浅析
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摘要
尤昭玲教授巧用阴道四维彩超,将子宫内膜出现的各类异常情况归之为"子宫内膜功能障碍",认为其病机为"肾虚血瘀,冲任损伤",与脾、肝、心密切相关。在此基础上,倡导"尤氏调膜七法":病则疗膜、压则舒膜、厚则敛膜、薄则增膜、差则养膜、阻则宣膜、缺则补膜。中西合参,分期而治,构建了独特的"调膜助孕五步法":第一步全面评估,第二步调膜痼疾,第三步调膜助孕,第四步调膜纳胚,第五步调膜固胎。在临床上获得了良好的治疗效果,为子宫内膜容受性降低所致的不孕症提供了新的思路与方法。
Professor YOU Zhao-ling skillfully uses vaginal four-dimensional color doppler ultrasound to classify the abnormal conditions of endometrium as ‘endometrial dysfunction'. She believes that the pathogenesis of this disease is ‘kidney deficiency and blood stasis, thoroughfare and conception channels injury', which is closely related to the spleen, liver and heart.On this basis, we advocate the ‘Seven principles of recuperating endometrium by YOU': treating endometrium for diseases,relaxing endometrium for pressure, converging endometrium for thick ones, increasing endometrium for thin ones, nourishing endometrium for poor ones, promoting endometrium for resistance ones, and mending endometrium for deficiency ones. A unique five-step method of regulating endometrium and assisting pregnancy was established by combining Chinese and western medicines in different stages: the first step is comprehensive evaluation, the second step is to cure endometrium and chronic diseases, the third step is to adjust the endometrium and help with pregnancy, the fourth step is to condition the endometrium and accommodate the embryo, and the fifth step is to nurse the endometrium and strengthen the embryo. Good therapeutic effect has been achieved in clinic, which provides a new idea and method for infertility caused by endometrial receptivity reduction.
Professor YOU Zhao-ling skillfully uses vaginal four-dimensional color doppler ultrasound to classify the abnormal conditions of endometrium as ‘endometrial dysfunction'. She believes that the pathogenesis of this disease is ‘kidney deficiency and blood stasis, thoroughfare and conception channels injury', which is closely related to the spleen, liver and heart.On this basis, we advocate the ‘Seven principles of recuperating endometrium by YOU': treating endometrium for diseases,relaxing endometrium for pressure, converging endometrium for thick ones, increasing endometrium for thin ones, nourishing endometrium for poor ones, promoting endometrium for resistance ones, and mending endometrium for deficiency ones. A unique five-step method of regulating endometrium and assisting pregnancy was established by combining Chinese and western medicines in different stages: the first step is comprehensive evaluation, the second step is to cure endometrium and chronic diseases, the third step is to adjust the endometrium and help with pregnancy, the fourth step is to condition the endometrium and accommodate the embryo, and the fifth step is to nurse the endometrium and strengthen the embryo. Good therapeutic effect has been achieved in clinic, which provides a new idea and method for infertility caused by endometrial receptivity reduction.
引文
[1]马彩虹,杨艳.宫腔病变与不孕症.中国实用妇科与产科杂志,2013,29(9):703-707
[2]曹华斌,涂灵.子宫内膜息肉性状与不孕症关系的研究.重庆医学,2012,41(32):3422-3423
[3]赵一,冯力民,张君妍.宫内病变与妊娠的关系.实用妇产科杂志,2017,33(4):12-15
[4]Yoshino O,Hayashi T,Osuga Y,et al.Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids.Human Reproduction,2010,25(10):2475-2479
[5]岳静,靳镭.子宫内膜异位症对女性生育力的影响及评估方法.实用妇产科杂志,2015,31(1):7-9
[6]Fanchin R,Ayoubi J M.Uterine dynamics:Impact on the human reproduction process.Reprod Biomed Online,2009,18(supp-S2):57-62
[7]Pritts E A,Parker W H,Olive D L.Fibroids and infertility:An updated systematic review of the evidence.Fertility&Sterility,2009,91(4):1215-1223
[8]冯苗,李素春,潘弹,等.着床窗期宫腔镜下子宫内膜形态与性激素及其受体表达的研究.实用妇产科杂志,2009,25(5):285-288
[9]申萌萌,刘雁峰,赵青竹,等.二补助育汤对胚胎着床障碍小鼠子宫内膜胞饮突及环氧合酶-2表达的影响.中华中医药杂志,2018,33(5):389-393
[10]张媛,占海英,李红发,等.黄体功能不全患者着床期子宫内膜整合素β3的表达及超微结构改变.华中科技大学学报:医学版,2009,38(4):473-476
[11]Tocci A,Greco E,Ubaldi F M.Adenomyosis and ‘endometrialsubendometrial myometrium unit disruption disease’ are two different entities.Review,2008,17(2):281-291
[12]梁靓,李蓉,吕笑冬,等.子宫内膜容受性的超声评估方法研究进展.生殖与避孕,2015,35(12):873-878
[13]Weissman A.The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program.Fertility and Sterility,1999,71(1):147-149
[14]刘珊珊,朱斌.电影MRI对子宫内膜蠕动的研究进展.中国医学影像技术,2016,32(4):632-634
[15]王丽,文新强,张文轲,等.三维能量多普勒超声检测黄体血流对高龄女性妊娠的作用.西安交通大学学报(医学版),2018,39(4):567-572
[16]谢梦.评估不孕症患者子宫内膜容受性的超声研究进展.实用妇产科杂志,2013,29(8):583-585
[17]Uysal S,Ozun Ozbay E P,Ekinci T,et al.Endometrial spiral artery Doppler parameters in unexplained infertility patients:is endometrial perfusion an important factor in the etiopathogenesis?.Journal of the Turkish German Gynecological Association,2012,13(3):169-171
[18]杨永琴,尤昭玲,游卉,等.尤昭玲辨治泡膜发育异常不孕症经验.中华中医药杂志,2017,32(4):193-196
[19]尤昭玲,冯桂玲,叶秀英,等.卵泡发育异常中医诊疗方案的构建和临床实践.中医杂志,2013,54(13):1105-1107
[20]李俊敏,尤昭玲.尤昭玲“安胎前移法”在体外受精-胚胎移植技术中的应用.中医杂志,2015,56(9):737-739
[21]周夏芸,尤昭玲,游卉.浅谈体外受精-胚胎移植之尤氏养胎二步法.中华中医药杂志,2016,31(9):3572-3574
[22]曾倩,尤昭玲,钟燕梅,等.由“天人相应”浅析尤昭玲教授的安胎精髓.中华中医药杂志,2014,29(12):3724-3726
[2]曹华斌,涂灵.子宫内膜息肉性状与不孕症关系的研究.重庆医学,2012,41(32):3422-3423
[3]赵一,冯力民,张君妍.宫内病变与妊娠的关系.实用妇产科杂志,2017,33(4):12-15
[4]Yoshino O,Hayashi T,Osuga Y,et al.Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids.Human Reproduction,2010,25(10):2475-2479
[5]岳静,靳镭.子宫内膜异位症对女性生育力的影响及评估方法.实用妇产科杂志,2015,31(1):7-9
[6]Fanchin R,Ayoubi J M.Uterine dynamics:Impact on the human reproduction process.Reprod Biomed Online,2009,18(supp-S2):57-62
[7]Pritts E A,Parker W H,Olive D L.Fibroids and infertility:An updated systematic review of the evidence.Fertility&Sterility,2009,91(4):1215-1223
[8]冯苗,李素春,潘弹,等.着床窗期宫腔镜下子宫内膜形态与性激素及其受体表达的研究.实用妇产科杂志,2009,25(5):285-288
[9]申萌萌,刘雁峰,赵青竹,等.二补助育汤对胚胎着床障碍小鼠子宫内膜胞饮突及环氧合酶-2表达的影响.中华中医药杂志,2018,33(5):389-393
[10]张媛,占海英,李红发,等.黄体功能不全患者着床期子宫内膜整合素β3的表达及超微结构改变.华中科技大学学报:医学版,2009,38(4):473-476
[11]Tocci A,Greco E,Ubaldi F M.Adenomyosis and ‘endometrialsubendometrial myometrium unit disruption disease’ are two different entities.Review,2008,17(2):281-291
[12]梁靓,李蓉,吕笑冬,等.子宫内膜容受性的超声评估方法研究进展.生殖与避孕,2015,35(12):873-878
[13]Weissman A.The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program.Fertility and Sterility,1999,71(1):147-149
[14]刘珊珊,朱斌.电影MRI对子宫内膜蠕动的研究进展.中国医学影像技术,2016,32(4):632-634
[15]王丽,文新强,张文轲,等.三维能量多普勒超声检测黄体血流对高龄女性妊娠的作用.西安交通大学学报(医学版),2018,39(4):567-572
[16]谢梦.评估不孕症患者子宫内膜容受性的超声研究进展.实用妇产科杂志,2013,29(8):583-585
[17]Uysal S,Ozun Ozbay E P,Ekinci T,et al.Endometrial spiral artery Doppler parameters in unexplained infertility patients:is endometrial perfusion an important factor in the etiopathogenesis?.Journal of the Turkish German Gynecological Association,2012,13(3):169-171
[18]杨永琴,尤昭玲,游卉,等.尤昭玲辨治泡膜发育异常不孕症经验.中华中医药杂志,2017,32(4):193-196
[19]尤昭玲,冯桂玲,叶秀英,等.卵泡发育异常中医诊疗方案的构建和临床实践.中医杂志,2013,54(13):1105-1107
[20]李俊敏,尤昭玲.尤昭玲“安胎前移法”在体外受精-胚胎移植技术中的应用.中医杂志,2015,56(9):737-739
[21]周夏芸,尤昭玲,游卉.浅谈体外受精-胚胎移植之尤氏养胎二步法.中华中医药杂志,2016,31(9):3572-3574
[22]曾倩,尤昭玲,钟燕梅,等.由“天人相应”浅析尤昭玲教授的安胎精髓.中华中医药杂志,2014,29(12):3724-3726