尤昭玲教授治疗宫腔粘连不孕验案一则(1)
[摘要]宫腔粘连是子宫内膜的一种损伤性病变，是各种原因引起子宫内膜基底层损伤而导致子宫壁相互粘连的病理现象。尤昭玲教授认为宫腔粘连根据症状表现属中医“经少”“闭经”“不孕”的范畴，辨证以肾虚血瘀证为主，予以中西医结合治疗，临床效果显著。尤教授在诊病疗疾过程中，全面精准地分析其发生发展及预后，给予适当的建议及处理，给求助者带来希望，其诊疗思路及医之精诚，值得学习，本文通过介绍尤教授治疗宫腔粘连不孕患者验案一则，浅析其诊疗思路，以飨同道。
[关键词]宫腔粘连;不孕;三期序贯助孕法;尤昭玲
[中图分类号] R256.39 [文献标识码] A [文章编号] 1674-4721(2020)5(a)-0158-04
One case of professor You Zhao-ling in the treatment of infertility due to intrauterine adhesions
TANG Li1 TAN Zhen-Yu2▲ YOU Zhao-Ling2 QIU Le-Le1
1. School of Graduate， Hu′nan University of Chinese Medicine， Hu′nan Province， Changsha 410007， China; 2. Department of Obstetrics and Gynecology， the First Affiliated Hospital of Hu′nan University of Chinese Medicine， Hu′nan Province， Changsha 410007， China
[Abstract] Uterine adhesion is a kind of damaging lesion of the endometrium， which is a pathological phenomenon that the basal layer of the endometrium is damaged by various reasons and the uterine walls adhere to each other. Professor You Zhao-ling believes that intrauterine adhesion is in the category of "hypomenorrhea" "amenorrhea" and "infertility" of traditional Chinese Medicine according to the manifestations， the syndrome differentiation is mainly based on kidney deficiency and blood stasis syndrome， and the combination of traditional Chinese medicine and Western medicine has obvious clinical effect. In the process of diagnosis and treatment of the disease， professor You comprehensively and accurately analyzes its occurrence， development and prognosis， gives appropriate suggestion and treatment， and brings hope to the help seeker， whose ideas of diagnosis and treatment and sincerities of medicine are worth studying. This article introduces one case of professor You Zhao-ling in the treatment of infertility due to intrauterine adhesions， analyzes ideas of diagnosis and treatment to benefit the peer.
[Key words] Intrauterine adhesion; Infertility; Three-stage sequential assisted pregnancy; You Zhao-ling
宮腔粘连(intrauterine adhesion，IUA)是子宫内膜的一种损伤性病变，是各种原因引起子宫内膜基底层损伤而导致子宫壁相互粘连的病理现象。其临床主要表现与粘连的位置、程度、性质有关，具体表现为宫腔操作或流产后月经过少或闭经、周期性腹痛、继发性不孕或习惯性流产等[1]。近年来，随着无痛人工流产技术的开展，以及年轻女性对避孕和生殖保健知识的缺乏，人工流产、药物流产等宫腔操作增多，宫腔粘连作为人工流产远期并发症也逐年增加，严重影响妇女的生活质量及身心健康，文献报道，女性不孕症患者中宫腔粘连发生率高达13%[2]。目前宫腔镜下宫腔粘连分离术是IUA首选的西医治疗措施[3]。IUA治疗的主要目的是恢复正常月经模式，缓解痛经，提高生育率。
中医古籍中虽没有“宫腔粘连”一词，却有“经水量少”“经少”“经水涩少”的描述，根据其临床表现(月经过少、继发性闭经、继发不孕、复发性流产)及致病特点可将本病归于“不孕”“妇人腹痛”“经少”“闭经”等疾病的范畴[4]。本病病位在胞宫，病因病机可责之于瘀血阻滞、肾脏亏虚、肝肾不足、脾胃虚损、肾虚血瘀、冲任失调、邪瘀互结等[5]。临床治疗以调经助孕为主。, 百拇医药(唐丽 谈珍瑜 尤昭玲 邱乐乐)
[关键词]宫腔粘连;不孕;三期序贯助孕法;尤昭玲
[中图分类号] R256.39 [文献标识码] A [文章编号] 1674-4721(2020)5(a)-0158-04
One case of professor You Zhao-ling in the treatment of infertility due to intrauterine adhesions
TANG Li1 TAN Zhen-Yu2▲ YOU Zhao-Ling2 QIU Le-Le1
1. School of Graduate， Hu′nan University of Chinese Medicine， Hu′nan Province， Changsha 410007， China; 2. Department of Obstetrics and Gynecology， the First Affiliated Hospital of Hu′nan University of Chinese Medicine， Hu′nan Province， Changsha 410007， China
[Abstract] Uterine adhesion is a kind of damaging lesion of the endometrium， which is a pathological phenomenon that the basal layer of the endometrium is damaged by various reasons and the uterine walls adhere to each other. Professor You Zhao-ling believes that intrauterine adhesion is in the category of "hypomenorrhea" "amenorrhea" and "infertility" of traditional Chinese Medicine according to the manifestations， the syndrome differentiation is mainly based on kidney deficiency and blood stasis syndrome， and the combination of traditional Chinese medicine and Western medicine has obvious clinical effect. In the process of diagnosis and treatment of the disease， professor You comprehensively and accurately analyzes its occurrence， development and prognosis， gives appropriate suggestion and treatment， and brings hope to the help seeker， whose ideas of diagnosis and treatment and sincerities of medicine are worth studying. This article introduces one case of professor You Zhao-ling in the treatment of infertility due to intrauterine adhesions， analyzes ideas of diagnosis and treatment to benefit the peer.
[Key words] Intrauterine adhesion; Infertility; Three-stage sequential assisted pregnancy; You Zhao-ling
宮腔粘连(intrauterine adhesion，IUA)是子宫内膜的一种损伤性病变，是各种原因引起子宫内膜基底层损伤而导致子宫壁相互粘连的病理现象。其临床主要表现与粘连的位置、程度、性质有关，具体表现为宫腔操作或流产后月经过少或闭经、周期性腹痛、继发性不孕或习惯性流产等[1]。近年来，随着无痛人工流产技术的开展，以及年轻女性对避孕和生殖保健知识的缺乏，人工流产、药物流产等宫腔操作增多，宫腔粘连作为人工流产远期并发症也逐年增加，严重影响妇女的生活质量及身心健康，文献报道，女性不孕症患者中宫腔粘连发生率高达13%[2]。目前宫腔镜下宫腔粘连分离术是IUA首选的西医治疗措施[3]。IUA治疗的主要目的是恢复正常月经模式，缓解痛经，提高生育率。
中医古籍中虽没有“宫腔粘连”一词，却有“经水量少”“经少”“经水涩少”的描述，根据其临床表现(月经过少、继发性闭经、继发不孕、复发性流产)及致病特点可将本病归于“不孕”“妇人腹痛”“经少”“闭经”等疾病的范畴[4]。本病病位在胞宫，病因病机可责之于瘀血阻滞、肾脏亏虚、肝肾不足、脾胃虚损、肾虚血瘀、冲任失调、邪瘀互结等[5]。临床治疗以调经助孕为主。, 百拇医药(唐丽 谈珍瑜 尤昭玲 邱乐乐)