叶敦敏对复发性流产患者再次妊娠后的安胎思路探讨

Miscarriage-prevention Thoughts of YE Dun-Min for Re-pregnant Patients with Recurrent Spontaneous Abortion

总结叶敦敏教授对复发性流产患者再次妊娠后的安胎思路。叶敦敏教授结合现代女性的生理病理特点、所处的社会生活环境及心理状态,将复发性流产患者辨为脾肾两虚、心脾不足、肝郁气滞、瘀血内阻4个证型;中药治疗以寿胎丸合四君子汤为基础方进行辨证加减用药。同时提出治病与安胎并举,联合运用现代安胎药物人绒毛膜促性腺激素、黄体酮、低分子肝素、人免疫球蛋白等。治疗过程中主张个体化用药,遵循“因时、因地、因人、因病、因证”的治疗原则,针对兼症总结出阿胶-地榆-荆芥炭、灯心草-何首乌藤-乌豆衣、金樱子-杜仲等验之有效的药物组合,同时重视心理调护,中西药结合,优势互补,临床上疗效显著。

This article summarizes the miscarriage-prevention thoughts of Professor YE Dun-Min in treating repregnant patients with recurrent spontaneous abortion(RSA).Professor YE differentiates patients with RSA into four syndrome types of spleen and kidney deficiency,heart and spleen deficiency,liver depression and qi stagnation,and internal obstruction of blood stasis based on the analysis of the physio-pathological characteristics of modern women and their social life status and psychological state.For the treatment with Chinese medicine,Professor YE recommends the modified application of Shoutai Pill plus Sijunzi Decoction based on traditional Chinese medicine(TCM)syndrome differentiation.Meanwhile,Professor YE advocates the combined application of the modern miscarriage-prevention drugs such as human chorionic gonadotropin,progesterone,low-molecular weight heparin and human immunoglobulin based on the principle of simultaneous treatment of disease and prevention of miscarriage.During the treatment,Professor YE emphasizes the individualized medication following the principle of medication according to climate,environment,individuality,disease and syndrome,and has come up with effective herbal combinations of Colla Corii Asini-Radix Sanguisorbae-carbonized Herba Schizonepetae,Medulla Junci-Caulis Polygoni Multiflori-Testa Glycinis(black soya bean testa),and Fructus Rosae Laevigatae-Cortex Eucommiae.Professor YE also addresses the importance of psychological care and the integration of Chinese and western medicines,which results into remarkable clinical efficacy.