“辨体-辨病-辨证诊疗模式”在辅助生殖技术中的应用
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摘要
辅助生殖技术(ART)是目前解决不孕的重要治疗手段。但由于卵巢反应性低下、子宫内膜容受性不良及胚胎质量差等因素的影响,中医药治疗与ART相结合提高试管婴儿孕育率正在被越来越多的学者所关注。其关键问题是如何将中医诊治思维正确的应用于ART。王琦教授认为,"体质""疾病""证候"对个体所患疾病本质的反映各有侧重,三者结合有助于对疾病本质的全面认识,是中医诊治思维的全面体现。因此,本文探索将"辨体-辨病-辨证"诊疗模式与ART相结合,为中医药介入辅助生殖技术提高试管婴儿孕育率提供一定的研究思路。
Assisted reproductive technology(ART) is an important means of treatment for infertility. But due to the influence of poor ovarian response, poor endometrial receptivity, poor embryo quality and other factors, the combination of traditional Chinese medicine(TCM) therapy and ART, which can improve the pregnant rate,has attracted more and more attentions of scholars. The key problem is how to apply TCM diagnosis and treatment method to ART. Professor WANG Qi believes that ‘constitution', ‘disease' and ‘syndrome' reflect the naturerespectively, but combination of the three can contribute to the comprehensive understanding of the nature of the disease, which is a comprehensive reflection of traditional Chinese medicine diagnosis and treatment. Therefore, how to combine the differentiation of constitution, disease and syndrome and ART are explored in this paper,and some research ideas are provided for the improvement of the pregnant rate of ART in the intervention of TCM.
Assisted reproductive technology(ART) is an important means of treatment for infertility. But due to the influence of poor ovarian response, poor endometrial receptivity, poor embryo quality and other factors, the combination of traditional Chinese medicine(TCM) therapy and ART, which can improve the pregnant rate,has attracted more and more attentions of scholars. The key problem is how to apply TCM diagnosis and treatment method to ART. Professor WANG Qi believes that ‘constitution', ‘disease' and ‘syndrome' reflect the naturerespectively, but combination of the three can contribute to the comprehensive understanding of the nature of the disease, which is a comprehensive reflection of traditional Chinese medicine diagnosis and treatment. Therefore, how to combine the differentiation of constitution, disease and syndrome and ART are explored in this paper,and some research ideas are provided for the improvement of the pregnant rate of ART in the intervention of TCM.
引文
[1]李蓉,乔杰.助孕技术在输卵管性不孕的应用和评价.实用妇产科杂志,2011,27(8):570-572
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[6]毕礼明,陈英兰.辨体-辨病-辨证体系在慢性肾脏病中的应用探讨.辽宁中医杂志,2014,41(11):2314-2316
[7]姜敏.王琦教授辨体-辨病-辨证相结合学术思想与临床经验总结及治疗慢性失眠的临床研究.北京:北京中医药大学,2011
[8]袁冰.体质医学发展面临的问题及推进方略.中华中医药杂志,2016,31(3):917-921
[9]靳琦,王琦.“辨体-辨病-辨证诊疗模式”的理论要素与临床应用.北京中医药大学学报,2006,29(1):41-46
[10]王琦.9种基本中医体质类型的分类及其诊断表述依据.北京中医药大学学报,2005,28(4):1-8
[11]杨明,何燕萍,黄李双,等.不孕症中医体质流行病学调查及相关研究.新中医,2010,42(5):55-56
[12]陈超.女性不孕症与中医体质相关性的初步调查.福州:福建中医药大学,2010
[13]吴丽敏,付英,李赟,等.原因不明性不孕症中医证候分析.安徽中医学院学报,2011,30(3):12-15
[14]杨丹,谈珍瑜.123例不孕症患者的病因及中医证候分布特点分析.湖南中医杂志,2014,30(4):68-69
[15]谢佩儿(Tse Pui Yi).香港地区行IVF-ET妇女之中医证候、体质分型与心理因素对妊娠率的影响.广州:广州中医药大学,2014
[16]谭惠予,王学乾,梁路,等.辅助生殖技术失败女性患者中医证候分析.亚太传统医药,2016,12(19):55-56
[17]乔杰.人类辅助生殖技术的新进展.中国实用妇科与产科杂志,2008,24(1):33-34
[18]孙莹璞,王芳.辅助生殖技术方式的选择.中国实用妇科与产科杂志,2010,26(10):735-738
[19]何雅惠.卵巢储备功能低下相关特征及其中医证型分析.长沙:湖南中医药大学,2015
[20]程芳,张慧俭,卢路艳,等.多囊卵巢综合征中医证候相关因素初步探讨.河南中医,2015,35(5):1101-1103
[21]王琦.中国式的精准医学:九体医学健康计划.中华中医药杂志,2015,30(10):3407-3411
[22]卫爱武.浅论中医药与辅助生育技术的切入点.辽宁中医杂志,2016,43(6):1189-1190
[23]王波,李幸芳,孙丽荣.浅谈辨病与辨证.中国中医基础医学杂志,2010,9:740-741
[24]连方,辛明蔚.体外受精—胚胎移植患者降调节后肾虚本质探讨.山东中医药大学学报,2008,32(2):109-110
[25]郭佳,李东,刘承,等.补肾养血活血中药对超促排卵周期干预作用的随机对照研究.中国中西医结合杂志,2013,33(4):484-487
[26]郭佳,王丽娜,李东.改善子宫内膜血流状态提高提外受精-胚胎移植成功率的中医研究与思考.中西医结合学报,2011,9(12):1301-1306
[27]Guo J,Li D,Liu C,et al.Effect of Chinese Herbs combined with in vitro fertilization transplantation on infertility:a clinical randomized controlled trial.Journal of Traditional Chinese Medicine,2014,34(3):267-273
[28]Paulus W E,Zhang M M,Strehler Erwin,et al.Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.Fertil&Steril,2002,77:721-724
[29]张明敏,黄光英,陆付耳,等.针刺对胚胎移植怀孕率的影响及其机理:随机、安慰对照研究.中国针灸,2003,23(1):3-5
[30]武彩云,张文香,倪丰,等.体外受精-胚胎移植后早期妊娠丢失的相关因素分析.中华疾病控制杂志,2016,20(5):516-519,529
[31]马黔红.辅助生殖技术的研究进展.现代临床医学,2007,33(2):202-205
[2]C Garcíamoreno,HAFM Jansen,M Ellsberg,et al.Who multicountry study on women’s health and domestic violence against women:Initial results on prevalence,health outcomes and women’s responses.Geneva Switzerland Who,2005,39(154):195-212
[3]Edwards R G,Steptoe P C,Purdy J M,et al.Establishing full term human pregnancy using leaving embryos grown in vitro.Br J Obstet Gynaecol,1980,87(9):737-740
[4]曹泽毅.中华妇产科学.2版.北京:人民卫生出版社,2004:2614-2626
[5]田松.浅析冠心病辨体、辨病、辨证研究模式的优化.中华中医药杂志,2015,30(2):332-334
[6]毕礼明,陈英兰.辨体-辨病-辨证体系在慢性肾脏病中的应用探讨.辽宁中医杂志,2014,41(11):2314-2316
[7]姜敏.王琦教授辨体-辨病-辨证相结合学术思想与临床经验总结及治疗慢性失眠的临床研究.北京:北京中医药大学,2011
[8]袁冰.体质医学发展面临的问题及推进方略.中华中医药杂志,2016,31(3):917-921
[9]靳琦,王琦.“辨体-辨病-辨证诊疗模式”的理论要素与临床应用.北京中医药大学学报,2006,29(1):41-46
[10]王琦.9种基本中医体质类型的分类及其诊断表述依据.北京中医药大学学报,2005,28(4):1-8
[11]杨明,何燕萍,黄李双,等.不孕症中医体质流行病学调查及相关研究.新中医,2010,42(5):55-56
[12]陈超.女性不孕症与中医体质相关性的初步调查.福州:福建中医药大学,2010
[13]吴丽敏,付英,李赟,等.原因不明性不孕症中医证候分析.安徽中医学院学报,2011,30(3):12-15
[14]杨丹,谈珍瑜.123例不孕症患者的病因及中医证候分布特点分析.湖南中医杂志,2014,30(4):68-69
[15]谢佩儿(Tse Pui Yi).香港地区行IVF-ET妇女之中医证候、体质分型与心理因素对妊娠率的影响.广州:广州中医药大学,2014
[16]谭惠予,王学乾,梁路,等.辅助生殖技术失败女性患者中医证候分析.亚太传统医药,2016,12(19):55-56
[17]乔杰.人类辅助生殖技术的新进展.中国实用妇科与产科杂志,2008,24(1):33-34
[18]孙莹璞,王芳.辅助生殖技术方式的选择.中国实用妇科与产科杂志,2010,26(10):735-738
[19]何雅惠.卵巢储备功能低下相关特征及其中医证型分析.长沙:湖南中医药大学,2015
[20]程芳,张慧俭,卢路艳,等.多囊卵巢综合征中医证候相关因素初步探讨.河南中医,2015,35(5):1101-1103
[21]王琦.中国式的精准医学:九体医学健康计划.中华中医药杂志,2015,30(10):3407-3411
[22]卫爱武.浅论中医药与辅助生育技术的切入点.辽宁中医杂志,2016,43(6):1189-1190
[23]王波,李幸芳,孙丽荣.浅谈辨病与辨证.中国中医基础医学杂志,2010,9:740-741
[24]连方,辛明蔚.体外受精—胚胎移植患者降调节后肾虚本质探讨.山东中医药大学学报,2008,32(2):109-110
[25]郭佳,李东,刘承,等.补肾养血活血中药对超促排卵周期干预作用的随机对照研究.中国中西医结合杂志,2013,33(4):484-487
[26]郭佳,王丽娜,李东.改善子宫内膜血流状态提高提外受精-胚胎移植成功率的中医研究与思考.中西医结合学报,2011,9(12):1301-1306
[27]Guo J,Li D,Liu C,et al.Effect of Chinese Herbs combined with in vitro fertilization transplantation on infertility:a clinical randomized controlled trial.Journal of Traditional Chinese Medicine,2014,34(3):267-273
[28]Paulus W E,Zhang M M,Strehler Erwin,et al.Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.Fertil&Steril,2002,77:721-724
[29]张明敏,黄光英,陆付耳,等.针刺对胚胎移植怀孕率的影响及其机理:随机、安慰对照研究.中国针灸,2003,23(1):3-5
[30]武彩云,张文香,倪丰,等.体外受精-胚胎移植后早期妊娠丢失的相关因素分析.中华疾病控制杂志,2016,20(5):516-519,529
[31]马黔红.辅助生殖技术的研究进展.现代临床医学,2007,33(2):202-205