俞瑾治疗子宫内膜异位症验案一则
An Effective Case of YU Jin's Treatment of Endometriosis
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1.复旦大学附属妇产科医院中西医结合科,上海 200090
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曹琦, 王莉, 俞瑾. 俞瑾治疗子宫内膜异位症验案一则[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539407&Fpath=home&index=0
CAO Qi, WANG Li, YU Jin. An Effective Case of YU Jin's Treatment of Endometriosis[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539407&Fpath=home&index=0
曹琦, 王莉, 俞瑾. 俞瑾治疗子宫内膜异位症验案一则[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539407&Fpath=home&index=0 DOI:
CAO Qi, WANG Li, YU Jin. An Effective Case of YU Jin's Treatment of Endometriosis[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539407&Fpath=home&index=0 DOI:
病史摘要,2,朱某,31岁,2006年3月25日初诊,痛经10余年,未避孕6年未孕。平素经时下腹痛,在外院输卵管造影(HSG)示输卵管通而不畅,外院行腹腔镜检查及输卵管通液术,见盆腔内多个内异灶,输卵管通液示通畅。术后予达菲林治疗3个月,停药后仍未孕,继用尿促性素(human menopausal gonadotropin, HMG)超促排卵治疗后,行人工受精(AIH),但流产。此后行10次丈夫淋巴细胞免疫治疗,仍未孕。1个月前再次进行AIH,AIH排卵前子宫内膜7.5 mm,结果失败。末次月经2006年3月13日,此次经时下腹痛,疼痛表现以刺痛为主,伴头痛。测血促卵泡激素(FSH)15.68 mIU/mL,较正常值偏高。诉口干,心烦,乏力,纳差。舌淡暗,苔薄,脉细。中医诊断 痛经;不孕症(证型:气阴两虚,瘀阻胞宫)西医诊断 子宫内膜异位症,继发不孕;卵巢功能减退干预措施 中医治法:益气养阴,化瘀通络。处方:党参15 g,白术12 g,知母15 g,生地18 g,山茱萸12 g,茯苓15 g,白芍15 g,龟甲12 g,枸杞子15 g,淫羊藿15 g,补骨脂15 g,菟丝子15 g,当归12 g,桃仁12 g,蒲黄15 g,五灵脂15 g,莪术12 g,三棱12 g,麦冬12 g,黄精15 g,玉竹15 g,石菖蒲15 g。水煎服,每日2次。西医治疗:月经第6天起口服炔雌醇0.0375 mg,每日1次,连服20日。生活方式干预:告知病情,科学宣教,指导饮食和运动,嘱规律生活。疗效转归 予上法治疗后患者自然妊娠,随访胎儿发育正常,足月分娩。
Summary of case history, Zhu, 31 years old, was first diagnosed on March 25, 2006. Dysmenorrhea for more than 10 years, no contraception for 6 years without pregnancy. In other hospital, salpingography (HSG) showed that the fallopian tube was unsmooth. The other hospital performed laparoscopy and salpingo fluid drainage operation. Multiple endometriosis lesions were found in the pelvic cavity. The salpingo fluid drainage showed that the fallopian tube was unobstructed. After the operation, she was treated with Diphereline for 3 months, but she was still not pregnant after the withdrawal of the drug. Then she was treated with HMG for hyperstimulation of ovulation and given artificial insemination (AIH), but she had a miscarriage. After 10 times of husband lymphocyte immunotherapy, still no pregnancy. Last month, AIH was done again, and the preovulatory endometrium was 7.5mm, AIH failed again. Her last menstruation was on March 13, 2006. She had abdominal pain, mainly tingling pain, accompanied by headache. The serum follicle stimulating hormone (FSH) was 15.68 mIU/ml, which was higher than the normal value. She complained of dry mouth, upset, fatigue, and poor appetite. The tongue is light and dark, the moss is thin, and the pulse is fine.,TCM diagnosis, Dysmenorrhea, infertility (syndrome type: deficiency of Qi and Yin, blood stasis blocking the uterus).,Western medicine diagnosis, Endometriosis, secondary infertility, ovarian dysfunction.,Therapeutic methods, TCM treatment: invigorating Qi and nourishing Yin, removing blood stasis and channeling collaterals.Prescription:Codonopsis pilosula 15 g, Atractylodes macrocephala 12 g, Anemarrhena asphodeloides 15 g, Rehmannia glutinosa 18 g, Cornus officinalis 12 g, Poria cocos 15 g, Radix paeoniae alba 15 g, Testudinis carapax et plastrum 12 g, Lycium chinense miller 15 g, Epimedium brevicornu 15 g, Psoralea corylifolia 15 g, Cuscuta chinensis 15 g, Angelica sinensis 12 g, Persicae semen 12 g, Typha angustifolia 15 g, Faeces Trogopterpri 15 g, Curcuma zedoaria 12 g, Sparganii Rhizoma 12 g, Ophiopogon japonicus 12 g, Polygonatum sibiricum 15 g, Polygonatum odoratum 15 g, and Acorus tatarinowii 15 g. Take it in water, twice a day.,Western medicine treatment, from the 6th day of menstruation, ethinyl estradiol 0.0375 mg was taken orally, once a day for 20 days.,Lifestyle intervention, inform the patient of the disease, conduct scientific education, guide diet and exercise, and order regular life.,Clinical outcomes, After treatment with the above method, the patient had a natural pregnancy, followed up with normal fetal development and full-term delivery.
子宫内膜异位症治疗策略俞瑾
EndometriosisTreatment strategyYu Jin
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