妊娠期人巨细胞病毒感染的中医药研究进展
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摘要
妊娠期人巨细胞病毒感染宫内传播可导致流产、胎儿生长受限、小头畸形及子代出生后渐进性感音神经性耳聋、认识障碍等严重并发症,严重危害母儿健康。西药治疗妊娠期人巨细胞病毒感染存在致畸、耐药等风险,目前尚未建立理想的对妊娠期活动性巨细胞病毒感染一级预防方案。在中医古籍中,该病病因病机多与"毒""虚""湿热"密切相关。中医药治疗妊娠期巨细胞病毒感染有肯定的疗效,安全性高,本文对目前妊娠期巨细胞病毒感染的中医药治疗理论基础、治疗方案进行了总结。
Intrauterine transmission of human cytomegalovirus infection during pregnancy can lead to abortion, fetal growth restriction, microcephaly and progressive complications such as progressive deafness and neurological deafness after birth, and cognitive impairment, which seriously endangers maternal and child health. Western medicine for the treatment of human cytomegalovirus infection during pregnancy is teratogenic, drug-resistant and other risks, and has not yet established an ideal primary prevention program for active cytomegalovirus infection during pregnancy. In the ancient books of traditional Chinese medicine, the pathogenesis of the disease is closely related to "poison", "virtual" and "damp heat". Traditional Chinese medicine has a positive effect on the treatment of gestational cytomegalovirus infection, and it has high safety. This paper summarizes the theoretical basis and treatment plan of traditional Chinese medicine treatment for gestational cytomegalovirus infection.
Intrauterine transmission of human cytomegalovirus infection during pregnancy can lead to abortion, fetal growth restriction, microcephaly and progressive complications such as progressive deafness and neurological deafness after birth, and cognitive impairment, which seriously endangers maternal and child health. Western medicine for the treatment of human cytomegalovirus infection during pregnancy is teratogenic, drug-resistant and other risks, and has not yet established an ideal primary prevention program for active cytomegalovirus infection during pregnancy. In the ancient books of traditional Chinese medicine, the pathogenesis of the disease is closely related to "poison", "virtual" and "damp heat". Traditional Chinese medicine has a positive effect on the treatment of gestational cytomegalovirus infection, and it has high safety. This paper summarizes the theoretical basis and treatment plan of traditional Chinese medicine treatment for gestational cytomegalovirus infection.
引文
[1]谢幸,孔北华,段涛.妇产科学[M].第9版.北京:人民卫生出版社,2018:114-116.
[2]James SH,Kimberlin DW.Advances in the prevention and treatment of congenital cytomegalovirus infection[J].Curr Opin Pediatr,2016,28(1):81-85.
[3]Jin HD,Demmler-Harrison GJ,Coats DK,et al.Long-term Visual and Ocular Sequelae in Patients With Congenital Cytomegalovirus Infection[J].Pediatr Infect Dis J,2017,36(9):877-882.
[4]张玲,王刚,赵晓科,等.宫内巨细胞病毒感染与小儿脑性瘫痪临床特征的关系[J].山东医药,2016,56(44):51-52.
[5]王文雯,吴德,唐久来.巨细胞病毒感染对全面性发育迟缓婴幼儿听力、智力及运动功能发育的影响[J].山东医药,2018,58(29):17-19.
[6]Wood AM,Hughes BL.Detection and Prevention of Perinatal Infection:Cytomegalovirus and Zika Virus[J].Clin Perinatol,2018,45(2):307-323.
[7]Fortner KB,Nieuwoudt C,Reeder CF.Infections in Pregnancy and the Role of Vaccines[J].Obstet Gynecol Clin North Am,2018,45(2):369-388.
[8]王垒,彭贵主,叶殷发.肾移植术后抢先治疗和普遍预防对预防巨细胞病毒感染的Meta分析[J].中华泌尿外科杂志,2018(4):294-299.
[9]王慧英,于松,于莎莎,等.晚发性宫内人巨细胞病毒感染致新生儿死亡三例报告并文献复习[J].中国全科医学,2015,18(31):3881-3884,3892.
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[11]汪筱谢,黄筱竑,徐彬,等.妊娠期不良妊娠结局和不同孕期弓形虫和风疹病毒及巨细胞病毒和单纯疱疹病毒感染的关系[J].中华医院感染学杂志,2017,27(07):1539-1542.
[12]余世2),罗文,栾树清,等.金樱冲剂对不良孕产史妇女HCMV感染的疗效观察[J].中国优生与遗传杂志,2000,8(3):72-73.
[13]贺漪,杨丹.黄蓝颗粒体外的抗巨细胞病毒、风疹病毒作用[J].中国医院药学杂志,2007(06):717-720.
[14]张琼,周琦,李祥云.李祥云治疗巨细胞病毒宫内感染验案1则[J].江西中医药,2015,46(08):49-51.
[15]何贵翔,孙洋.补肾培脾法治疗孕期巨细胞病毒感染初探[J].江苏中医药,2007,39(2):52-53.
[16]王素霞,杨丽珍,陈惠铮,等.中药山桔颗粒抑制人巨细胞病毒感染的体外实验研究[J].中医药学报,2005,33(6):20-21.
[17]姜宏,闻良珍,凌霞珍,等.中药“热毒清”对人巨细胞病毒抑制作用的实验与临床研究[J].中华实验和临床病毒学杂志,1999,24(2):175-179.
[18]刘殿芹,孙世安.清热解毒燥湿中药治疗人巨细胞病毒感染的临床观察[J].中国中西医结合杂志,2015,35(11):1401-1402.
[19]陈素华,闻良珍,王迎春.孕期中药治疗对巨细胞病毒感染孕妇子代生长发育的影响[J].中国实用妇科与产科杂志,2003(10):36-38.
[20]李伟,熊锦文,陈娟娟,等.金叶败毒颗粒防治妊娠中期巨细胞病毒宫内感染的实验研究[J].医药导报,2015,34(05):585-588.
[21]李伟,陈琢,陈娟娟,等.复方中药二黄丹安方抗巨细胞病毒的体外实验研究[J].中国妇幼保健,2011,26(30):4761-4763.
[22]王昕荣,陈素华,乔福元,等.金银花抗豚鼠巨细胞病毒的体外实验研究[J].中国妇幼保健,2005(17):2241-2243.
[23]陈娟娟,方建国,万进,等.绿原酸体外抗人巨细胞病毒的实验研究[J].医药导报,2009,28(09):1138-1141.
[24]张丹丹,方建国,陈娟娟,等.连翘及其主要有效成分槲皮素体外抗人巨细胞病毒的实验研究[J].中国中药杂志,2010,35(08):1055-1059.
[25]秦欢,鄢素琪,周俪姗,等.大黄素体外抗人巨细胞病毒药效实验研究[J].中华医院感染学杂志,2018,28(06):822-826,847.
[2]James SH,Kimberlin DW.Advances in the prevention and treatment of congenital cytomegalovirus infection[J].Curr Opin Pediatr,2016,28(1):81-85.
[3]Jin HD,Demmler-Harrison GJ,Coats DK,et al.Long-term Visual and Ocular Sequelae in Patients With Congenital Cytomegalovirus Infection[J].Pediatr Infect Dis J,2017,36(9):877-882.
[4]张玲,王刚,赵晓科,等.宫内巨细胞病毒感染与小儿脑性瘫痪临床特征的关系[J].山东医药,2016,56(44):51-52.
[5]王文雯,吴德,唐久来.巨细胞病毒感染对全面性发育迟缓婴幼儿听力、智力及运动功能发育的影响[J].山东医药,2018,58(29):17-19.
[6]Wood AM,Hughes BL.Detection and Prevention of Perinatal Infection:Cytomegalovirus and Zika Virus[J].Clin Perinatol,2018,45(2):307-323.
[7]Fortner KB,Nieuwoudt C,Reeder CF.Infections in Pregnancy and the Role of Vaccines[J].Obstet Gynecol Clin North Am,2018,45(2):369-388.
[8]王垒,彭贵主,叶殷发.肾移植术后抢先治疗和普遍预防对预防巨细胞病毒感染的Meta分析[J].中华泌尿外科杂志,2018(4):294-299.
[9]王慧英,于松,于莎莎,等.晚发性宫内人巨细胞病毒感染致新生儿死亡三例报告并文献复习[J].中国全科医学,2015,18(31):3881-3884,3892.
[10]江国花,吴璇华.人支原体和巨细胞病毒感染对妊娠结局的影响[J].河北医药,2018,40(09):1290-1295.
[11]汪筱谢,黄筱竑,徐彬,等.妊娠期不良妊娠结局和不同孕期弓形虫和风疹病毒及巨细胞病毒和单纯疱疹病毒感染的关系[J].中华医院感染学杂志,2017,27(07):1539-1542.
[12]余世2),罗文,栾树清,等.金樱冲剂对不良孕产史妇女HCMV感染的疗效观察[J].中国优生与遗传杂志,2000,8(3):72-73.
[13]贺漪,杨丹.黄蓝颗粒体外的抗巨细胞病毒、风疹病毒作用[J].中国医院药学杂志,2007(06):717-720.
[14]张琼,周琦,李祥云.李祥云治疗巨细胞病毒宫内感染验案1则[J].江西中医药,2015,46(08):49-51.
[15]何贵翔,孙洋.补肾培脾法治疗孕期巨细胞病毒感染初探[J].江苏中医药,2007,39(2):52-53.
[16]王素霞,杨丽珍,陈惠铮,等.中药山桔颗粒抑制人巨细胞病毒感染的体外实验研究[J].中医药学报,2005,33(6):20-21.
[17]姜宏,闻良珍,凌霞珍,等.中药“热毒清”对人巨细胞病毒抑制作用的实验与临床研究[J].中华实验和临床病毒学杂志,1999,24(2):175-179.
[18]刘殿芹,孙世安.清热解毒燥湿中药治疗人巨细胞病毒感染的临床观察[J].中国中西医结合杂志,2015,35(11):1401-1402.
[19]陈素华,闻良珍,王迎春.孕期中药治疗对巨细胞病毒感染孕妇子代生长发育的影响[J].中国实用妇科与产科杂志,2003(10):36-38.
[20]李伟,熊锦文,陈娟娟,等.金叶败毒颗粒防治妊娠中期巨细胞病毒宫内感染的实验研究[J].医药导报,2015,34(05):585-588.
[21]李伟,陈琢,陈娟娟,等.复方中药二黄丹安方抗巨细胞病毒的体外实验研究[J].中国妇幼保健,2011,26(30):4761-4763.
[22]王昕荣,陈素华,乔福元,等.金银花抗豚鼠巨细胞病毒的体外实验研究[J].中国妇幼保健,2005(17):2241-2243.
[23]陈娟娟,方建国,万进,等.绿原酸体外抗人巨细胞病毒的实验研究[J].医药导报,2009,28(09):1138-1141.
[24]张丹丹,方建国,陈娟娟,等.连翘及其主要有效成分槲皮素体外抗人巨细胞病毒的实验研究[J].中国中药杂志,2010,35(08):1055-1059.
[25]秦欢,鄢素琪,周俪姗,等.大黄素体外抗人巨细胞病毒药效实验研究[J].中华医院感染学杂志,2018,28(06):822-826,847.