朱玲从“虚、郁、瘀”论治高龄复发性流产

ZHU Ling’s Experience in Treating Recurrent Spontaneous Abortion of Elderly Women from the Pathogenesis of Deficiency,Depression and Blood Stasis

高龄女性复发性流产发生率较高,朱玲教授认为其病机特点为“虚、郁、瘀”。“虚”指肾精不足,阳明脉衰;“郁”指情志不调,肝气郁结;“瘀”则缘于冲任损伤,瘀阻胞宫。高龄女性复发性流产的治疗以补肾填精、培元固本为基础,同时需重视疏肝解郁,调畅气机,强调活血化瘀,养血固冲。治疗过程中,中药汤剂、丸剂、膏剂可配合使用,持之有效,缓肾精之衰,强后天之本,疏肝气之郁,调气血之畅,养冲任之虚,以筑胎元之源;孕后需尽早安胎,补肾健脾,疏肝活血,则胎元自固,而无流产之虞。

High incidence of recurrent spontaneous abortion was seen in elderly women.Professor ZHU Ling believes that the pathogenesis of recurrent spontaneous abortion in elderly women can be characterized by deficiency,depression and blood stasis.“Deficiency”refers to the kidney essence insufficiency and the debilitation of the yangming meridian,“depression”refers to the emotional disorder and the stagnation of liver qi,and“blood stasis”developed from the damage to the thoroughfare vessel and conception vessel and the obstruction of static blood in the uterus.Professor ZHU Ling advocates that the treatment of recurrent spontaneous abortion in elderly women should be based on the methods of tonifying kidney and supplementing essence,cultivating the vital essence and consolidating vital base,and the therapies of soothing liver and relieving depression,activating the qi movement,activating blood and removing blood stasis,and nourishing blood to strengthen thoroughfare vessel were also emphasized.In the course of treatment,Chinese herbal decoction,pills and medicinal extract can be used together to maintain their effectiveness,slowing down the decline of the kidney essence,strengthening the foundation of acquired(postnatal)constitution,relieving the depression of the liver qi,promoting qi and blood,and nourishing the deficiency of thoroughfare vessel and conception vessels,thereby building the foundation of the fetal primordial qi.Professor ZHU Ling suggested that the methods of preventing miscarriage should be performed as soon as possible after pregnancy,and therapies of tonifying kidney and strengthening spleen,soothing liver and activating blood can be used for the consolidation of the fetal primordial qi and the prevention of abortion.