基于证候分布探讨不同年龄段女性不孕症的病因病机
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摘要
目的基于中医证候隐含着病因病机,通过总结女性不孕症患者的临床证候分布规律探讨其病因病机特点及与年龄的关系。方法收集2016年7—12月到河南省中医院生殖科就诊的200例由副主任医师及主任医师诊断的女性不孕症患者的临床证候资料,总结证候分布情况,结合年龄段,以单一证候为证候统计基础,采用描述性分析方法总结女性不孕症的证候分布规律,探讨其病因病机特点,并阐明各个证候的病因病理机制。结果200例患者共出现296个频次的单一证候,其中肾阳虚证、肝郁证、湿热证、血瘀证为女性不孕症最常见的证候,分别占31. 42%、23. 65%、21. 62%、14. 86%,四证总计占91. 55%。证候与年龄密切相关,不同年龄段的主要证候各不相同,20～29岁的主要证候为湿热证、肾阳虚证、肝郁证、血瘀证,30～39岁的主要证候为肾阳虚证、肝郁证、湿热证、血瘀证,40～49岁主要证候为肾阳虚证、肝郁证、肾阴虚证。结论肾阳虚衰、肝气郁滞、湿热蕴结、瘀血阻滞是女性不孕症的主要病机,各个年龄段有其不同的病因病机要点,20～29岁女性不孕症的病机要点是湿热蕴结,30～39岁的病机要点是肾虚肝郁,40～49岁的病机要点是肾阳虚衰。
Objective To explore the etiology and pathology of female infertility and the relationship with age based on syndrome distribution and according to Traditional Chinese Medicine syndromes implying the etiology and pathology.Methods Clinical data of 200 cases of female infertility from the reproductive department of Henan Traditional Chinese Medicine Hospital that diagnosed by deputy chief physician and chief physician were collected during the period from July2016 to December 2016. The distribution of syndromes on the basis of single syndrome as evidence was summed up,the distribution rules of syndromes of female infertility were summarized by descriptive analysis,the etiology and pathology were to explored,and the change of each syndrome in different age groups was clarified. Results There were 296 single syndromes in 200 patients. Kidney yang deficiency syndrome,liver depression syndrome,damp heat syndrome and blood stasis syndrome were the most common syndromes of female infertility,accounting for 31. 42%,23. 65%,21. 62% and14. 86% respectively. They accounted for 91. 55% of the total. The syndrome was closely related to age and the main syndromes of different ages were different. The main syndromes of 20-29 years old were dampness heat syndrome,kidney yang deficiency syndrome,liver depression syndrome and blood stasis syndrome. The main syndromes of 30-39 years old were kidney yang deficiency syndrome,liver depression syndrome,damp heat syndrome and blood stasis syndrome. The main syndromes of 40-49 years old were kidney yang deficiency syndrome,liver depression syndrome and kidney yin deficiency syndrome. Conclusion Kidney yang deficiency,liver qi stagnation,damp heat accumulation and stagnation of blood stasis are the main pathogenesis of female infertility. Each age group has its different characteristic of etiology and pathology. The pathology characteristic is damp heat accumulation in 20-29 years old,kidney deficiency and stagnation of liver in 30-39 years old and deficiency of kidney yang in 40-49 years old.
Objective To explore the etiology and pathology of female infertility and the relationship with age based on syndrome distribution and according to Traditional Chinese Medicine syndromes implying the etiology and pathology.Methods Clinical data of 200 cases of female infertility from the reproductive department of Henan Traditional Chinese Medicine Hospital that diagnosed by deputy chief physician and chief physician were collected during the period from July2016 to December 2016. The distribution of syndromes on the basis of single syndrome as evidence was summed up,the distribution rules of syndromes of female infertility were summarized by descriptive analysis,the etiology and pathology were to explored,and the change of each syndrome in different age groups was clarified. Results There were 296 single syndromes in 200 patients. Kidney yang deficiency syndrome,liver depression syndrome,damp heat syndrome and blood stasis syndrome were the most common syndromes of female infertility,accounting for 31. 42%,23. 65%,21. 62% and14. 86% respectively. They accounted for 91. 55% of the total. The syndrome was closely related to age and the main syndromes of different ages were different. The main syndromes of 20-29 years old were dampness heat syndrome,kidney yang deficiency syndrome,liver depression syndrome and blood stasis syndrome. The main syndromes of 30-39 years old were kidney yang deficiency syndrome,liver depression syndrome,damp heat syndrome and blood stasis syndrome. The main syndromes of 40-49 years old were kidney yang deficiency syndrome,liver depression syndrome and kidney yin deficiency syndrome. Conclusion Kidney yang deficiency,liver qi stagnation,damp heat accumulation and stagnation of blood stasis are the main pathogenesis of female infertility. Each age group has its different characteristic of etiology and pathology. The pathology characteristic is damp heat accumulation in 20-29 years old,kidney deficiency and stagnation of liver in 30-39 years old and deficiency of kidney yang in 40-49 years old.
引文
[1]皇甫耀.输卵管性不孕症147例临床治疗探析[J].河南医学高等专科学校学报,2015,27(2):191-192.
[2]王海霞.宫腹腔镜联合下不孕症患者输卵管疏通术疗效观察[J].河南医学高等专科学校学报,2015,27(2):194-195.
[3]罗小琼,凌燕兰,罗小花,等. 1 834例女性不孕症病因分析[J].右江医学,2017,45(4):483-486.
[4]杜惠兰.中西医结合妇产科学[M]. 10版.北京:中国中医药出版社,2016:536-537.
[5]谈勇.中医妇科学[M]. 10版.北京:中国中医药出版社,2016:162-164.
[6]陈慧佳,胡丽娜.不孕症患者心理状态分析[J].现代医药卫生,2016,32(16):2524-2526.
[7]封宗成,骆书秀,吴显儒,等.农村育龄夫妇不孕症调查[J].现代医药卫生,2014,30(8):1163-1164.
[8]李文静,王艳华,杨晓葵.宫腔镜联合腹腔镜在女性不孕症中的应用价值研究[J].徐州医学院学报,2014,34(5):332-334.
[9]余小英,马科,胡卫华,等.复方玄驹胶囊联合小剂量雌激素治疗肾阳虚型薄型子宫内膜不孕症患者的临床疗效观察[J].生殖与避孕,2015,35(9):612-617.
[10]苗群英,王佩红,赵莉,等.汉中市不孕症患者病因调查分析[J].陕西医学杂志,2016,45(8):1094-1096.
[11]方舟,孔伟,张斌,等.不孕症的心理因素分析及心理干预[J].中国性科学,2014,23(10):89-92.
[12]杨晓梅,张君探.神经肌肉刺激联合中药红子汤灌肠治疗慢性盆腔炎性不孕症效果观察[J].山东医药,2017,57(14):91-93.
[13]于文朝,芦骏,朱月华,等.输卵管机械疏通联合臭氧注射在输卵管阻塞性不孕症治疗中的应用观察[J].山东医药,2017,57(3):53-55.
[14]苗群英,王佩红,赵莉,等.汉中市不孕症患者病因调查分析[J].陕西医学杂志,2016,45(8):1094-1096.
[15]韩冉,戴宁,林韵,等.妇科养坤丸与骨髓间充质干细胞移植修复薄型子宫内膜[J].中国组织工程研究,2016,20(1):65-69.
[16]王秋香,徐晓娟,姚莉娟,等.从“肾虚血瘀”论治子宫内膜异位症并发不孕[J].成都中医药大学学报,2015,38(2):105-108.
[17]梁秀文,季新梅.腹腔镜治疗子宫内膜异位症合并不孕症的疗效及影响术后妊娠的因素[J].医学临床研究,2017,34(4):711-714.
[18]李群,王立红,赵延坤,等.改进养膜方对肾虚血瘀型薄型子宫内膜不孕症患者妊娠结局的影响[J].实用临床医药杂志,2017,21(17):162-164.
[19]李群.养膜汤对不孕症薄型子宫内膜的影响[J].河北中医,2016,38(3):378-380.
[20]马景,张亚宁,万怡婷,等.齐聪治疗卵巢储备功能低下性不孕症经验[J].山东中医杂志,2017,36(8):690-693.
[2]王海霞.宫腹腔镜联合下不孕症患者输卵管疏通术疗效观察[J].河南医学高等专科学校学报,2015,27(2):194-195.
[3]罗小琼,凌燕兰,罗小花,等. 1 834例女性不孕症病因分析[J].右江医学,2017,45(4):483-486.
[4]杜惠兰.中西医结合妇产科学[M]. 10版.北京:中国中医药出版社,2016:536-537.
[5]谈勇.中医妇科学[M]. 10版.北京:中国中医药出版社,2016:162-164.
[6]陈慧佳,胡丽娜.不孕症患者心理状态分析[J].现代医药卫生,2016,32(16):2524-2526.
[7]封宗成,骆书秀,吴显儒,等.农村育龄夫妇不孕症调查[J].现代医药卫生,2014,30(8):1163-1164.
[8]李文静,王艳华,杨晓葵.宫腔镜联合腹腔镜在女性不孕症中的应用价值研究[J].徐州医学院学报,2014,34(5):332-334.
[9]余小英,马科,胡卫华,等.复方玄驹胶囊联合小剂量雌激素治疗肾阳虚型薄型子宫内膜不孕症患者的临床疗效观察[J].生殖与避孕,2015,35(9):612-617.
[10]苗群英,王佩红,赵莉,等.汉中市不孕症患者病因调查分析[J].陕西医学杂志,2016,45(8):1094-1096.
[11]方舟,孔伟,张斌,等.不孕症的心理因素分析及心理干预[J].中国性科学,2014,23(10):89-92.
[12]杨晓梅,张君探.神经肌肉刺激联合中药红子汤灌肠治疗慢性盆腔炎性不孕症效果观察[J].山东医药,2017,57(14):91-93.
[13]于文朝,芦骏,朱月华,等.输卵管机械疏通联合臭氧注射在输卵管阻塞性不孕症治疗中的应用观察[J].山东医药,2017,57(3):53-55.
[14]苗群英,王佩红,赵莉,等.汉中市不孕症患者病因调查分析[J].陕西医学杂志,2016,45(8):1094-1096.
[15]韩冉,戴宁,林韵,等.妇科养坤丸与骨髓间充质干细胞移植修复薄型子宫内膜[J].中国组织工程研究,2016,20(1):65-69.
[16]王秋香,徐晓娟,姚莉娟,等.从“肾虚血瘀”论治子宫内膜异位症并发不孕[J].成都中医药大学学报,2015,38(2):105-108.
[17]梁秀文,季新梅.腹腔镜治疗子宫内膜异位症合并不孕症的疗效及影响术后妊娠的因素[J].医学临床研究,2017,34(4):711-714.
[18]李群,王立红,赵延坤,等.改进养膜方对肾虚血瘀型薄型子宫内膜不孕症患者妊娠结局的影响[J].实用临床医药杂志,2017,21(17):162-164.
[19]李群.养膜汤对不孕症薄型子宫内膜的影响[J].河北中医,2016,38(3):378-380.
[20]马景,张亚宁,万怡婷,等.齐聪治疗卵巢储备功能低下性不孕症经验[J].山东中医杂志,2017,36(8):690-693.