赵宏利治疗产科抗磷脂综合征验案一则
A Case of ZHAO Hongli Treating Obstetric Antiphospholipid Syndrome
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1.浙江中医药大学附属杭州市中医院妇二科,杭州 310007
2.浙江中医药大学第三临床医学院,杭州 310053
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丁心逸, 杨汉铭, 赵宏利. 赵宏利治疗产科抗磷脂综合征验案一则[DB/OL].(2023-06-20)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=38875488&Fpath=home&index=0
Ding Xinyi, Yang Hanming, Zhao Hongli. A Case of ZHAO Hongli Treating Obstetric Antiphospholipid Syndrome[DB/OL].(2023-06-20)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=38875488&Fpath=home&index=0
丁心逸, 杨汉铭, 赵宏利. 赵宏利治疗产科抗磷脂综合征验案一则[DB/OL].(2023-06-20)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=38875488&Fpath=home&index=0 DOI:
Ding Xinyi, Yang Hanming, Zhao Hongli. A Case of ZHAO Hongli Treating Obstetric Antiphospholipid Syndrome[DB/OL].(2023-06-20)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=38875488&Fpath=home&index=0 DOI:
病史摘要,2,患者,女,32岁,因“发现人绒毛膜促性腺激素(HCG)升高14 d,腰酸7 d”就诊。既往发现子宫粘连史,2012年、2017年曾行宫腔镜下子宫粘连电切术。(足月产子1次,流产2次1-0-2-1):2007年因计划外妊娠行清宫术,2011年足月顺产1健康女婴,2016年孕10周左右因胎停行清宫术。2018年1月19日抗,β,2,糖蛋白I(,β,2,GPI)免疫球蛋白G(IgG)23.6 CU,2018年2月2日、2018年3月21日复查,β,2,GPI抗体均阳性,NK细胞水平波动在29%~35.7%,早孕期子宫动脉阻力舒张期反向。患者平素不耐寒热,眠差,腰酸、乳房胀痛、口咽干,中药治以补肾活血安胎,未用西药及其他疗法。后期患者以产后调理再就诊,诉于2018年足月顺产1健康男婴。中医诊断 胎动不安;肾虚血瘀,兼肝郁脾弱证。西医诊断 先兆流产;非典型产科抗磷脂综合征。干预措施 治以补肾活血、疏肝健脾,中药用方:党参15 g、黄芩15 g、菟丝子20 g、川续断15 g、桑寄生20 g、当归10 g、炒白芍10 g、川芎10 g、穿山龙10 g、砂仁5 g、北柴胡3 g、羌活3 g、桑叶15 g、龙骨15 g、牡蛎15 g、生姜6 g、大枣15 g,后期用药均随此方随症加减。患者孕14~15周因阴道出血每日加用白及粉3 g,血止停服。疗效转归 后期患者以产后调理再就诊,诉于2018年足月顺产1健康男婴。
Summary of case history, The patient, female, 32 years old, presented to the doctor because of "found human chorionic gonadotropin (HCG) elevation for 14 days and backache for 7 days". A history of uterine adhesions was found in the past, and hysteroscopic resection of uterine adhesions was performed in 2012 and 2017. On (1 full-term birth, 2 miscarriages 1-0-2-1): in 2007, she underwent uterine evacuation due to an unplanned pregnancy. In 2011, she gave birth to a healthy baby girl at full term. In 2016, she underwent uterine evacuation due to inevitable miscarriage. Anti-β,2, glycoprotein I (β,2, GPI)IgG 23.6CU on January 19, 2018, and β,2, GPI antibody was retested positive on February 2, 2018 and March 21, 2018, and the level of NK cells fluctuated between 29% and 35.7%, and the uterine artery resistance during early pregnancy was reversed during diastolic period. The patient usually suffers from cold and heat intolerance, poor sleep, backache, breast tenderness, and dry mouth and throat. Traditional Chinese medicine is used to invigorate the kidney and promote blood circulation, and no western medicine or other treatments were used.Patient gave birth to a healthy baby boy at full term in 2018.,TCM diagnosis, The fetus is restless; Kidney deficiency and blood stasis, and liver depression and spleen weakness.,Western medicine diagnosis, Threatened miscarriage; non-criteria obstetric antiphospholipid antibody syndrome.,Therapeutic methods, Treatment to tonify the kidneys and activate the blood, thin the liver and strengthen the spleen. Prescription: Codonopsis Radix 15 g, Scutellariae Radix 15 g, Semen Cuscutae 20 g, Dipsaci Radix 15 g, Taxilli Herba 20 g, Angelicae Sinensis Radix 10 g, Paeoniae Radix Alba 10 g, Rhizoma Chuanxiong 10 g, Dioscoreae Nipponicae Rhizoma 10 g, Amomi Fructus 5 g, Bupleuri Radix 3 g, Notopterygii Rhizoma Et Radix 3 g, Mori Folium 15 g, Longgu 15 g, Ostreae Concha 15 g, Zingiberis Rhizoma Recens 6 g, Fructus Jujubae 15 g. Later prescriptions were added or subtracted with this prescription. After, because of vaginal bleeding, adding Bletillae Rhizoma 3 g /d, stop taking blood.,Clinical outcomes, Patient gave birth to a healthy baby boy at full term in 2018.
产科抗磷脂综合征活血安胎先兆流产
non-criteria obstetric antiphospholipid antibody syndromeactivate blood and safe fetusthreatened miscarriage
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