补肾活血法治疗子宫内膜异位症不孕的临床经验
Clinical experience of Bushen Huoxue therapy in treatment of infertility due to endometriosis
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1.中国中医科学院西苑医院,北京 100091
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马堃, 陈燕霞, 李敏. 补肾活血法治疗子宫内膜异位症不孕的临床经验[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=19769998&Fpath=home&index=0
Kun MA, Yan-xia CHEN, Min LI. Clinical experience of Bushen Huoxue therapy in treatment of infertility due to endometriosis[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=19769998&Fpath=home&index=0
马堃, 陈燕霞, 李敏. 补肾活血法治疗子宫内膜异位症不孕的临床经验[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=19769998&Fpath=home&index=0 DOI:
Kun MA, Yan-xia CHEN, Min LI. Clinical experience of Bushen Huoxue therapy in treatment of infertility due to endometriosis[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=19769998&Fpath=home&index=0 DOI:
子宫内膜异位症是妇科常见的疑难病,其发病率呈逐年上升趋势,由于该病多发生在育龄期,可对患者的生育力造成持续性破坏,是引起不孕的重要原因。内异症虽是良性疾病,但有恶性行为,具有易复发、易转移的特点,临床治疗较困难。早期诊断、综合评估、制定方案、及时治疗对于保护患者生育力具有重要作用。现代医学有关内异症的发病机制尚不明确,治疗主要以药物、手术和辅助生殖技术为主。笔者在长期治疗子宫内膜异位症不孕临证中取得了良好的疗效,认为该病以肾虚为本,血瘀为标,二者互为因果,形成恶性循环。针对其肾虚血瘀的基本病机,善用补肾活血法,强调分期论治:月经期活血化瘀,通因通用;经后期滋肾养血,调理冲任;经间期温肾助阳,通络促排;经前期补肾健脾,理气活血。临证处方善用水蛭,去除宿瘀积聚,注重调畅情志,并配合中药灌肠、热敷等外治法增强疗效。
Endometriosis is a common and difficult gynecological disease.The incidence of endometriosis has been increasing year by year.Because endometriosis mostly occurs in childbearing age, it can cause persistent damage to the fertility of patients, and is an important cause of infertility.Although endometriosis is a benign disease, it has malignant behavior, and is easy for relapse and metastasis and difficult to treat in clinic.Early diagnosis, comprehensive evaluation, formulation of programs and timely treatment play an important role in protecting patients'fertility.The pathogenesis of endometriosis is still unclear in modern medicine.Drugs, surgery and assisted reproductive technology are the main therapies.The author has achieved a good efficacy in the long-term treatment of infertility due to endometriosis.She believes that the disease is caused by kidney deficiency and blood stasis.They are cause and effect to each other, which form a vicious circle.In view of the basic pathogenesis of kidney deficiency and blood stasis, we should make good use of the method of Bushen Huoxue, and emphasize the treatment by stages:promoting blood circulation and removing blood stasis, and treating diarrhea with purgative in the menstrual stage;nourishing kidney and blood, and regulating thoroughfare and conception vessels in the postmenstrual stage;warming kidney and supporting Yang, and dredging collaterals and hastening excretion in the interval stage;and tonifying kidney and spleen, and managing Qi and activating blood in the premenstruum stage.Leech is commonly adopted in clinic prescriptions to remove accumulation of persistent blood stasis and regulate mood, and combined with enema of traditional Chinese medicine, hot compress and other external therapies to enhance the curative effect.
子宫内膜异位症不孕症肾虚血瘀分期论治
endometriosisinfertilitykidney deficiency and blood stasistreatment by stages
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