齐聪—内异症不孕的中医治疗概述⑴

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1、内异症不孕的中医治疗概述齐聪钱海墨李久现(屮国上海屮医约大学附属曙光医院，201204)[摘要]子宫内膜异位症由于病机复杂，病变广泛，具有浸润、转移和易复发的恶性生物学行为，由此所引发的不孕，更是当前妇科领域中研究的重耍课题。中医通过内服、外治以及综合疗法等整体调治，在调经助孕方面具有一定的特色与优势。[关键词]子宫内膜异位症不孕小医治疗综述子宫内膜异位症(cndometriosis,EM)是育龄期妇女口趋增多的常见疑难病,约5%-15%育龄妇女受累，其中80%的患者合并痛经，50%合并不孕。经腹腔镜检查证实不孕患者中了宫内膜界位症的发生率为32%,不孕伴慢性盆腔疼痛的妇女屮，子宫内膜

2、异位症的发生率高达40%-60%巴子宫内膜异位症已成为不孕的常见原因。目前，腹腔镜手术、药物治疗等，80%—90%的妇女可减轻内异症的症状，但并不提高妊娠结果⑵，因为手术与药物并不能改善卵子质量利盆腔黏连，其至可能加重卵巢的损伤。中医药治疗月经失调、不孕症注重整体调理，尤其是采用补厅活血以及内外兼治等综合手段，不仅取得了可喜的疗效，而且更具临床优势，有必要进一步深入研究。ChinesemedicineconditioningofrefractoryinfertilityQicongshuguangaffiliatedhospitalofShanghaiTCMuniversityFtef

3、ractoryinfertilityisthecouplewithfiveyearsmarriageandhavereceivedspecialtreatmentmorethantwoyears,withoutcontraceptionbutstilldonotbepregnancy[1].Amongthefactorsthefemaleaccountfor60%,themaleaccountfor30%,bothofthemaleandthefemaleaccountfor10%.After30yearsdevelopmentofAssistedFteproductiveTechno

4、logy(AFfT),ithasbecomeanimportantmeansforthetreatmentofinfertilityatpresent.Studieshaveshownthatclinicalpregnancyrateofsingle-cycleIVF-ETtechnologyhasbeenashighas60%[2].However,theoverallpregnancyrateisstillhoveringaround30%~40%⑶.Thereasonismainlytheresponseofovariandysfunction,poorendometrialre

5、ceptivity,repeatedembryoimplantationfailure.Howtobreakthroughthesebottlenecks,ithasbecomeanimportenttopicbeconcernedandstudiedbymanyscholars・ThetraditionalChinesemedicinerecordedtherelevantreasonsofinfertilityearlyin《YellowEmperor'sInternalOassic》for:Mthedumeridianoftheillness,thewomaninfertilit

6、y?《NvKeZhengZongeGuangSZongLun》for:"menwithstrongesseneeandwomenwithnormalmenstruation,thisistheconditionofhavingachild."Thusthebasicrequirementsofbecomingpregnantinvolvebothmenandwomenwithstrongkidneyqi,Tianguiarriving,therenmeridianunobstructedandchongmetidianstrong,sothewomenhavenormalmenstru

7、ationandthemenhavesufficientesseneetooverflow,themaleandfemalecopulationinduetime,thenspermandeggcancombinetobepregnant.Therefore,themaincauseofinfertilityisthedeficiencyofkidneyqi,thechongmeridianandrenmeridianaswellasqiand