异位妊娠从瘀论治再认识

Re-understanding of the Treatment of Ectopic Pregnancy from Blood Stasis

[目的]探讨从瘀论治异位妊娠的理论渊源、临床应用方法、效果和现实意义。[方法]通过探析各种文献,溯本求源,分析异位妊娠病位、病机。同时,分期论治异位妊娠,采用活血化瘀、益气养血以化瘀等方法杀胚,化瘀破血、消癥等方法,以期合理选用各种活血化瘀药物治疗本病。[结果]异位妊娠病位在少腹,与冲任、胞脉、胞络相关。其病因虽各不同,其病机则均有血瘀,血瘀既是异位妊娠的重要的致病因素,又是异位妊娠的病理产物,也是其迁延难愈的主要原因。从瘀论治异位妊娠,既可加快血β-HCG转阴,又可加速异位妊娠包块的吸收,临床疗效显著,最大程度保护患侧输卵管的完整性,改善血运,恢复输卵管功能,增加治疗后的受孕机会。[结论]气滞血瘀及气虚血瘀是异位妊娠的基本病机,少腹血瘀实证是其病机本质。血瘀存在于异位妊娠的各型及疾病发展的整个过程,在本病的发生、发展中占有重要的地位,活血化瘀是治疗本病的基本治法,应融合于临床辨证施治的全过程。

[Objeetive] To explore the theoretical origin, clinical application method, effect and practical significance of the treatment of ectopic pregnant with blood stasis. [Method] From blood stasis on the treatment by promoting blood circulation to remove blood stasis, Yiqi Yangxue Huayu Shapei, expellir blood circulation, method to eliminate the disease, stage of treatment, a reasonable choice of promoting blood circulation and removing blood stasis drugs i the treatment of ectopic pregnancy. [Results] From blood stasis on the treatment of ectopic pregnancy, it can accelerate the beta HCG negative, and speed u the ectopic pregnancy mass absorption, clinical curative effect significantly, the greatest degree of protection of fallopian tube integrity, improve bloc circulation, and tubal function recovery, increase after treatment the chances of conception. [Conclusion] Qi stagnation, blood stasis and Qi deficiency at blood stasis are ectopic pregnancy basic pathogenesis, less empirical abdominal blood stasis is the essence of its pathogenesis. The existence of blood stas in ectopic pregnancy of each type and disease development of the whole process, in the occurrence of the disease, and occupies an important position in t] development, promoting blood circulation and removing blood stasis is the basic treatment, should be in clinical dialectical treatment of the whole process fusion.