中西医结合治疗原发性闭经致不孕验案1例
One Case of Primary Amenorrhea-Induced Infertility Cured by Therapy of Combining Traditional Chinese and Western Medicine
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1.南京中医药大学附属苏州市中医医院妇二科,江苏苏州 215009
2.南京中医药大学,江苏南京 210000
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王静, 陈新悦, 许小凤. 中西医结合治疗原发性闭经致不孕验案1例[DB/OL].(2023-10-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41959925&Fpath=home&index=0
WANG Jing, CHEN Xin-Yue, XU Xiao-Feng. One Case of Primary Amenorrhea-Induced Infertility Cured by Therapy of Combining Traditional Chinese and Western Medicine[DB/OL].(2023-10-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41959925&Fpath=home&index=0
王静, 陈新悦, 许小凤. 中西医结合治疗原发性闭经致不孕验案1例[DB/OL].(2023-10-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41959925&Fpath=home&index=0 DOI:
WANG Jing, CHEN Xin-Yue, XU Xiao-Feng. One Case of Primary Amenorrhea-Induced Infertility Cured by Therapy of Combining Traditional Chinese and Western Medicine[DB/OL].(2023-10-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41959925&Fpath=home&index=0 DOI:
病史摘要,2,患者33岁结婚,婚后于2018年4月至复旦大学附属妇产医院就诊,超声提示:幼稚子宫,未探及双侧卵巢。给予芬吗通序贯治疗后月经来潮,量少,初潮时年龄33岁。此后一直间断使用雌孕激素序贯治疗,用药来潮,5天净,量少,色黯红,无血块,无痛经,停药则闭经。末次月经2021年6月14日(芬吗通治疗后)。2020年10月外院行HSG提示:双侧输卵管粘连(报告未见),遂行“宫腔镜下双侧输卵管COOK导丝疏通及插管通液术”,术中提示双侧输卵管通畅(具体不详)。刻下:患者形体清瘦,易感畏寒肢冷,腰酸乏力,带下量少,纳食尚可,夜寐多梦,大便质软,舌淡,苔白微腻,脉沉细弱。中医诊断 不孕症(肾气亏虚证)西医诊断 原发性不孕(低促性腺激素性原发闭经)干预措施 中药调经助孕,以“补肾填精,调理冲任”贯穿全程,结合国医大师夏桂成教授补肾调周理论、吴门名医叶天士奇经八脉辨证立法,以期治本调经;西医主要以雌孕激素序贯联合诱发排卵治疗为主。疗效转归 中西医结合调经治疗两个月经周期后予中西医结合诱发排卵治疗,一个周期后成功妊娠,妊娠后予安胎合剂、芬吗通及黄体酮保胎治疗,目前患者已孕三月产科建卡。
Abstract of case history, The patient married when she was 33 years old. After marriage, she came to the maternity hospital affiliated to Fudan University and found that she has infantile uterus and bilateral ovaries are not detected by ultrasound. The patient had menstrual periods with a little menstrual flow after Femoston sequential therapy, whose menarche is 33 years old. Then she received estrogen and progesterone sequential treatment discontinuously, and she had menstrual periods after drug treatment, which last 5 days. Menstruation is along with scant menstrual flow of black red color, no clotted blood and no dysmenorrhea. Once she stopped drug treatment, amenorrhea occurred. The last menstrual period is 2021.06.14 (after curing by Femoston). The hysterosalpingography (HSG) checked at 2020.10 in other hospital, and showed that double-sided tubal adhesion (the report was not shown). So she had an operation using COOK guided wire to unlock double-sided tubal and check hydrotubation under hysteroscope. During this operation, double-sided tubal was found unobstructed (details unknown). At present, patient is slim, susceptible, fear of cold, tired and sluggish, along with less leucorrhea, acceptable appetite, more dreams, soft stool, pale tongue, whitish and greasy fur, deep-thin-weak pulse.,TCM diagnosis ,infertility (syndrome of kidney deficiency),Western medicine diagnosis ,primary infertility (low gonadotropin primary amenorrhea),Therapeutic methods ,In order to achieve a permanent cure, the use of traditional Chinese medicine regulated the menstrual function to assist pregnancy with the treatment of traditional Chinese medicine, treated by the rule of "Bushen Tianjing, Tiaoli Chongren", based on "Bushen Tiaozhou" theory of Professor Xia Guicheng, master of traditional Chinese Medicine, and "Qijing Bamai" theory of Ye Tianshi, famous doctor of Wumen. Western medicine treatment was mainly dominated by sequential therapy of estrogen and progesterone and induction of ovulation..,Clinical outcomes ,After regulating two menstrual periods with traditional Chinese medicine combining western medicine, the method of combining traditional Chinese medicine and western medicine was carried out to induce ovulation. After one ovulation induction cycle, she got pregnant successfully, and then was treated by Chinese medicine, Femoston, progesterone to prevent miscarriages. Now the patient has established files in Obstetrics Department.
不孕症低促性腺激素性原发闭经补肾调周雌孕激素序贯治疗促排卵
infertilitylow gonadotropin primary amenorrheabushen tiaozhousequential therapy with the use of estrogen and progesteroneinduction of ovulation
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