马红霞治疗多囊卵巢综合征复发性流产经验
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摘要
马红霞教授认为多囊卵巢综合征多囊卵巢综合征~([1])(polycystic ovary syndrome,PCOS)复发性流产的发生机制与肾脾两虚、肝郁气滞密切相关,其病位主要发生在肝肾脾三脏,从而提出辨证论治方式来有效去除病因,遵照患者实际情况选择合适的治疗方案,其中肾虚血瘀证患者中,其肾主生殖,内寓元阴及元阳,患病后由于肾精亏虚导致卵子缺少物质基础,从而无法发育成熟,虽然能够与精子结合,但无法充盛胎元,使其不固,增加自然流产几率,瘀血产生,最终引发肾虚血瘀证;痰湿阻滞患者主要是因为肥胖造成脾胃功能运化异常,脾气亏虚后无法将水谷之精运化,痰湿阻滞气血运行,导致胎元不固;肝郁化火患者伴情怀不畅、肝郁化火、火热动血情况,从而热侵胞宫,下惹血海。因此临床应全面掌握病情后给予辨证施治,随症加减方药,提升疗效。
Professor MA Hongxia considers that the genesis mechanism of polycystic ovarian syndrome( PCOS)-induced recurrent abortion has a close correlation with spleen and kidney deficiency,and liver-Qi stagnation. The disease is mainly located in the liver,kidney and spleen. The syndrome differentiation and treatment is good to find out the pathogenesis,and select the proper treatment schemes according to patients' actual conditions. For kidney deficiency and blood stasis patients,the kidney governs reproduction with kidney-Yin and kidney-Yang syndrome. Owing to kidney essence deficiency,the ovum will be short of material base,resulting in the immature growth. Although ovum may unite with sperm,the fetal vigour may not be filled to cause the fetal instability,increase the spontaneous labor rate,generate the blood stasisand produce the kidney deficiency and blood stasis syndrome. For phlegm stagnation patients,the obesity will bring about the abnormal spleen and gastric function. Upon spleen deficiency,the food-stuff essence can not be transported while phlegm stagnation may block the blood circulation. The liver depression patients may have bad feelings and pathogenic fire,and infiltrate into the uterus. The comprehensive understanding of patients' illness state is good to make clinical diagnosis and treatment,modify the prescriptions based on the clinical symptoms and increase the clinical efficacy.
Professor MA Hongxia considers that the genesis mechanism of polycystic ovarian syndrome( PCOS)-induced recurrent abortion has a close correlation with spleen and kidney deficiency,and liver-Qi stagnation. The disease is mainly located in the liver,kidney and spleen. The syndrome differentiation and treatment is good to find out the pathogenesis,and select the proper treatment schemes according to patients' actual conditions. For kidney deficiency and blood stasis patients,the kidney governs reproduction with kidney-Yin and kidney-Yang syndrome. Owing to kidney essence deficiency,the ovum will be short of material base,resulting in the immature growth. Although ovum may unite with sperm,the fetal vigour may not be filled to cause the fetal instability,increase the spontaneous labor rate,generate the blood stasisand produce the kidney deficiency and blood stasis syndrome. For phlegm stagnation patients,the obesity will bring about the abnormal spleen and gastric function. Upon spleen deficiency,the food-stuff essence can not be transported while phlegm stagnation may block the blood circulation. The liver depression patients may have bad feelings and pathogenic fire,and infiltrate into the uterus. The comprehensive understanding of patients' illness state is good to make clinical diagnosis and treatment,modify the prescriptions based on the clinical symptoms and increase the clinical efficacy.
引文
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[10]和梦珂,张静,李昕,等.苍附导痰汤对米非司酮诱导PCOS大鼠卵巢形态及雄激素的影响[J].湖南中医药大学学报,2018,38(8):862-865.
[11]田丹,戴海青,李兆萍,等.补中益气汤联合配偶淋巴细胞体外诱生免疫疗法治疗封闭抗体阴性所致复发性流产疗效评价[J].海南医学,2018,29(15):2178-2180.
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[13]王晓鹏,陈腾飞,卢幼然,等.刘清泉教授"调肝理脾、活血化瘀"治疗多囊卵巢综合征验案举隅[J].世界中医药,2018,13(10):2381-2383.
[14]庄爱文,王英,江凌圳,等.《丹溪心法》气血痰郁四伤学说在杂病治疗中的运用特色[J].浙江中医药大学学报,2015,39(4):274-275.
[15]王春艳,陈静.《傅青主女科》诊治妇科痛证学术特色探析[J].贵阳中医学院学报,2015,37(4):5-7.
[16]朱佳卿,车玉霞.《傅青主女科》调经方剂组方用药挖掘分析[J].中国中药杂志,2015,40(8):1610-1613.
[17]张敏,宗惠.《傅青主女科》痛经辨治浅析[J].浙江中医药大学学报,2016,40(8):599-601.
[18]伍娟娟,邓海婷,尤昭玲,等.《傅青主女科》从肾与五脏关系论治妇科疾病探析[J].江苏中医药,2019,51(4):14-15.
[19]陈四茹,侯莉莉.《傅青主女科》脏腑辨证理论治疗卵巢功能减退探析[J].长春中医药大学学报,2017,33(3):345-347.
[20]曹保利,姚建波.开郁种玉汤临床新应用[J].亚太传统医药,2017,13(6):103-104.
[21]韩鲜梅.胰岛素抵抗和高胰岛素血症与多囊卵巢综合征的关系[J].现代中西医结合杂志,2015,24(11):1179-1181.
[22]刘玲玲,韩东,侯丽辉,等.针刺治疗肥胖型多囊卵巢综合征患者伴高胰岛素血症和胰岛素抵抗的临床机制探讨[J].针灸临床杂志,2015,31(3):82-84.
[23]褚蕴,赵宏利.复发性流产血栓前状态中医辨证临床应用浅析[J].浙江临床医学,2018,20(11):1907-1908.
[24]傅娇,郭慧梅.黄体酮联合寿胎丸加减治疗复发性流产[J].世界中医药,2015,10(5):720-723.
[25]华彬.补中益气汤联合盆底康复治疗仪在产妇盆底肌功能康复中的应用[J].医药导报,2016,35(s1):41-42.
[2]吴宾雁,陈丽笙,林岚,等.《傅青主女科》瘦人不孕的探析[J].云南中医中药杂志,2018,39(8):100-101.
[3]刘春生.《傅青主女科》医方集解系列(18)温经摄血汤[J].中国中医药现代远程教育,2017,15(23):73-75.
[4]楼毅云,吴晓婷,傅萍,等.《黄帝内经》胎孕理论钩玄[J].浙江中医杂志,2016,51(10):709-710.
[5]姚娅丹,陆金霞.少腹逐瘀汤治疗妇科疾病验案举隅[J].黑龙江中医药,2016,45(2):42-43.
[6]张秀,鲁雅娟,王佩娟,等.从《傅青主女科》“年未老经水断”谈卵巢早衰治疗思想[J].浙江中医药大学学报,2016,40(8):596-598.
[7]王欣,吴维城.养精种玉汤治疗女性肾亏血虚型不孕的疗效机制分析[J].中医临床研究,2017,9(11):122-123.
[8]廖风娇,苏靖,黎洁,等.浅析中医名方养精种玉汤[J].黑龙江中医药,2015,44(1):6.
[9]于婷儿,陈莉,刘丽琴,等. IVF-ET长方案联合养精种玉汤对性激素及妊娠率结局的影响[J].长春中医药大学学报,2015,31(5):1028-1031.
[10]和梦珂,张静,李昕,等.苍附导痰汤对米非司酮诱导PCOS大鼠卵巢形态及雄激素的影响[J].湖南中医药大学学报,2018,38(8):862-865.
[11]田丹,戴海青,李兆萍,等.补中益气汤联合配偶淋巴细胞体外诱生免疫疗法治疗封闭抗体阴性所致复发性流产疗效评价[J].海南医学,2018,29(15):2178-2180.
[12]贾丹,李娜,陈璐,等.肾虚血瘀型多囊卵巢综合征、复发性流产、不孕症的治疗研究进展[J].中医药学报,2017,45(2):128-130.
[13]王晓鹏,陈腾飞,卢幼然,等.刘清泉教授"调肝理脾、活血化瘀"治疗多囊卵巢综合征验案举隅[J].世界中医药,2018,13(10):2381-2383.
[14]庄爱文,王英,江凌圳,等.《丹溪心法》气血痰郁四伤学说在杂病治疗中的运用特色[J].浙江中医药大学学报,2015,39(4):274-275.
[15]王春艳,陈静.《傅青主女科》诊治妇科痛证学术特色探析[J].贵阳中医学院学报,2015,37(4):5-7.
[16]朱佳卿,车玉霞.《傅青主女科》调经方剂组方用药挖掘分析[J].中国中药杂志,2015,40(8):1610-1613.
[17]张敏,宗惠.《傅青主女科》痛经辨治浅析[J].浙江中医药大学学报,2016,40(8):599-601.
[18]伍娟娟,邓海婷,尤昭玲,等.《傅青主女科》从肾与五脏关系论治妇科疾病探析[J].江苏中医药,2019,51(4):14-15.
[19]陈四茹,侯莉莉.《傅青主女科》脏腑辨证理论治疗卵巢功能减退探析[J].长春中医药大学学报,2017,33(3):345-347.
[20]曹保利,姚建波.开郁种玉汤临床新应用[J].亚太传统医药,2017,13(6):103-104.
[21]韩鲜梅.胰岛素抵抗和高胰岛素血症与多囊卵巢综合征的关系[J].现代中西医结合杂志,2015,24(11):1179-1181.
[22]刘玲玲,韩东,侯丽辉,等.针刺治疗肥胖型多囊卵巢综合征患者伴高胰岛素血症和胰岛素抵抗的临床机制探讨[J].针灸临床杂志,2015,31(3):82-84.
[23]褚蕴,赵宏利.复发性流产血栓前状态中医辨证临床应用浅析[J].浙江临床医学,2018,20(11):1907-1908.
[24]傅娇,郭慧梅.黄体酮联合寿胎丸加减治疗复发性流产[J].世界中医药,2015,10(5):720-723.
[25]华彬.补中益气汤联合盆底康复治疗仪在产妇盆底肌功能康复中的应用[J].医药导报,2016,35(s1):41-42.