基于证候分布探讨不同年龄段女性不孕症的病因病机

Explore the etiology and pathology of female infertility in different age groups based on syndrome distribution

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.