脱花煎合平胃散加味治疗胎死腹中验案1则

One Proven Case of Tuohua Decoction and Powder of Stomach Regulation Treating Retention of Dead Fetus

[目的]分析胎死腹中验案1则,以期寻求能促使腹中死胎速下的相关有效中药。[方法]列举1则关于运用脱花煎合平胃散加味成功治愈早期胎死不下的医案,分析并总结其中的临床诊断思路及用药特点。[结果]胎死腹中责之于气血失调,冲任损伤,胎元失养,终致胎堕且排出障碍。临床上多以气滞血瘀标实为主。本着"急则治其标"的原则,明确诊断后当以下胎益母为大法,以行气导滞、活血化瘀促使胎下论治。运用脱花煎合平胃散加味治疗病患,临床疗效显著,成功促进死胎排出,而阴道出血量少,不全流产率低,不影响生育。胎下后需调理善后。[结论]通过对胎死腹中的诊断、病因、病机、治则分析,可为早期胎死腹中的临床诊疗提供经验,脱花煎合平胃散可作为一个经验方在临床上推广使用。

[Objective] To explore effective traditional Chinese medicine promoting excretion of dead fetus. [Method] I list one medical case which Tuohua Decoction and Powder of Stomach Regulation sucessfully treat early stage retention of dead fetus. Now, I analyze and sum up some of clinical diagnosis of ideas and characteristics of medication. [Result] Disorder of qi and biood impairment of chong and ren channels bring about retention of dead fetus and obstacle discharging. Syndrome differentiation is Qi- stagnation and blood stasis repletion of Biao. Based on the principles of treatment of relieving the secondary symptoms in an urgent case. Once diagnosed retention of dead fetus, we should promote excretion of dead fetus as soon as possible which is conducive to mother. Invigorating the circulation of Qi- blood and promoting excretion of dead fetus is the main therapy. We cure a number of patients with Tuohua Decoction and Powder of Stomach Regulation. It brings about a striking effect,exhausting dead fetus successfully, less vaginal bleeding, lower incomplete abortion rate and no fertility influence. After excretion of dead fetus,she needs to coordinate and aftercare. [Conclusion] To analyze retention of dead fetus from following aspects ： diagnosis, etiology, pathogenesis and therapeutic principles, it can provide the experiences of clincal diagnosis and treatment for early stage of dead fetus. Tuohua Decoction and Powder of Stomach Regulation are worth popularizing in clinic as empirical formula.