赵薇教授治疗多囊卵巢综合征导致的不孕症经验举隅
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摘要
[目的]总结分析赵薇教授治疗多囊卵巢综合征导致的不孕症的临床经验与学术思想。[方法]通过跟随赵薇教授参加临床诊疗活动,收集整理赵薇教授治疗多囊卵巢综合征导致不孕症的病案,对赵薇教授关于多囊卵巢综合征导致的不孕症的病因病机、治疗方法及遣方用药之独特之处加以归纳总结,并列举验案一则以佐证。[结果]赵薇教授认为多囊卵巢综合征导致不孕症之病因虽杂,然究其根本,多与"虚""郁""瘀""痰"相关,当以"补、消"为大法,同时根据女性生理周期变化特点,分期论治,注重"治未病"思想,中西医结合,辅以情志疏导。所举验案中患者诊断为不孕症,辨证为肾虚血瘀,经后期予滋阴健脾补肾治疗,以促卵子排出;月经期养血疏肝、温补肾阳,助经血运行;妊娠期以中药护胎方加减安胎治疗,周期论治获得良好效果。[结论]赵薇教授治疗多囊卵巢综合征导致的不孕症,强调补虚除邪,分期论治,先调其经,而后有子,同时注重"治未病"及情志调节,收效颇佳,值得临床推广。
[Objective]To sum up the clinical experience and academic thought of Professor ZHAO Wei on treating the infertility caused by polycystic ovarian syndrome(PCOS).[Methods]By learning from Professor ZHAO Wei and studying the medical record of the infertility caused by PCOS, the clinical experience, therapeutic methods, administered medical herbs and prescription of Professor ZHAO, and characteristics of the clinical treatment was summarized from the aspects of etiology and pathogenesis.[Results]Professor ZHAO believes that the pathogenesis of infertility caused by PCOS is complex and varied, but it is closely related to"weakness""melancholy""blood-stasis""phlegm". The principles of treatment are tonifying and removing. At the same time, according to the features of menstrual cycle, Professor ZHAO is deft at staging treatment, paying attention to the theory of preventing disease before its occurrence, integrating traditional Chinese and western medicine and combing with emotional therapy. The patient in the case was diagnosed as infertility, and syndrome differentiation was kidney deficiency and blood stasis. Treatment of nourishing Yin, strengthening spleen and tonifying kidney was used during postmenstrual period, and nourishing blood, soothing liver, warming and tonifying kidney-Yang therapy was used during menstrual period. Hutai Prescription was used for miscarriage prevention during pregnancy. The case achieved good results after cycle therapy. [Conclusion]Professor ZHAO emphasizes in tonifying the weakness of body, removing the pathogenic factors in treatment of the infertility caused by PCOS, and staging treatment to condition menstruation firstly in order to get pregnant, and pays attention to prevent disease before its occurence and emotional regulation.The therapeutic effect of the infertility caused by PCOS is remarkable, which is worthy of promoting.
[Objective]To sum up the clinical experience and academic thought of Professor ZHAO Wei on treating the infertility caused by polycystic ovarian syndrome(PCOS).[Methods]By learning from Professor ZHAO Wei and studying the medical record of the infertility caused by PCOS, the clinical experience, therapeutic methods, administered medical herbs and prescription of Professor ZHAO, and characteristics of the clinical treatment was summarized from the aspects of etiology and pathogenesis.[Results]Professor ZHAO believes that the pathogenesis of infertility caused by PCOS is complex and varied, but it is closely related to"weakness""melancholy""blood-stasis""phlegm". The principles of treatment are tonifying and removing. At the same time, according to the features of menstrual cycle, Professor ZHAO is deft at staging treatment, paying attention to the theory of preventing disease before its occurrence, integrating traditional Chinese and western medicine and combing with emotional therapy. The patient in the case was diagnosed as infertility, and syndrome differentiation was kidney deficiency and blood stasis. Treatment of nourishing Yin, strengthening spleen and tonifying kidney was used during postmenstrual period, and nourishing blood, soothing liver, warming and tonifying kidney-Yang therapy was used during menstrual period. Hutai Prescription was used for miscarriage prevention during pregnancy. The case achieved good results after cycle therapy. [Conclusion]Professor ZHAO emphasizes in tonifying the weakness of body, removing the pathogenic factors in treatment of the infertility caused by PCOS, and staging treatment to condition menstruation firstly in order to get pregnant, and pays attention to prevent disease before its occurence and emotional regulation.The therapeutic effect of the infertility caused by PCOS is remarkable, which is worthy of promoting.
引文
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[9]杨梅萍.中西医结合治疗肾虚肝郁型多囊卵巢综合征所致不孕症的临床观察[D].合肥:安徽中医药大学,2017:31-49.
[10]王婷婷,付翰林,陈立章,等.中国多囊卵巢综合征患者妊娠并发症发生率的Meta分析[J].中南大学学报(医学版),2017,42(11):1300-1310.
[11]孙巧霞,随璐,徐艳霜.多囊卵巢综合征患者507不良妊娠结局分析[J].中国基层医药,2016,23(2):298-300.
[2]刘思南,张晓甦.促排卵药物的中西医临床研究进展[J].现代中西医结合杂志,2017,26(2):215-217,228.
[3]沈金鳌.妇科玉尺[M].北京:中医古籍出版社,1996:8-9.
[4]叶天士.临床指南医案[M].北京:中国中医药出版社,2008:491-495.
[5]皇甫谧.针灸甲乙经[M].郑州:河南科学技术出版社,2017:206-207.
[6]吴谦.医宗金鉴[M].北京:人民卫生出版社,1980:1145-1146.
[7]楼英.医学纲目[M].北京:中国中医药出版社,1998:796-797.
[8]傅山.傅青主女科[M].天津:天津科学技术出版社,1999:14-15.
[9]杨梅萍.中西医结合治疗肾虚肝郁型多囊卵巢综合征所致不孕症的临床观察[D].合肥:安徽中医药大学,2017:31-49.
[10]王婷婷,付翰林,陈立章,等.中国多囊卵巢综合征患者妊娠并发症发生率的Meta分析[J].中南大学学报(医学版),2017,42(11):1300-1310.
[11]孙巧霞,随璐,徐艳霜.多囊卵巢综合征患者507不良妊娠结局分析[J].中国基层医药,2016,23(2):298-300.