现代名老中医治疗先兆流产经验的文献研究

Literature research on the experience of modern famous TCM doctors in the treatment of threatened abortion

目的:总结现代名老中医治疗先兆流产的临床经验。方法:以“先兆流产”“胎漏”“胎动不安”“妊娠腹痛”等为关键词,检索万方数据库、中国期刊全文数据库、维普中文科技期刊等中医治疗先兆流产的经验总结,文献发表时间范围为1999年12月1日-2019年12月1日。提取纳入研究文献中的中医证候分型、惯用经方、常用药物建立数据库,采用Excel软件进行统计,并进行整理、分析。结果:共纳入文献105篇。在先兆流产的临床辨证分型中,脾肾亏虚型最常见,约占56.60%,其次为血热型,约占20.20%,气血虚弱型占8.50%,湿热型占7.90%,血瘀型占3.40%,其他类型占3.40%。常用处方中以寿胎丸为主,约占37.41%。此外,还有许多医家根据自己的临床经验自拟经验方,临床疗效显著。常用药物类型出现频次前3位的依次为固肾安胎药、健脾安胎药、养血安胎药。结论:现代名老中医在先兆流产临床辨证上以脾肾亏虚型最常见,治疗上以益肾健脾、养血安胎为主,多以寿胎丸为基本方进行治疗。名老中医们经过长时间的临床实践,在临床治疗先兆流产方面造诣深厚,各有所长,通过学习这些宝贵的临床经验,让后继医务人员能够更加准确地辨证论治、组方用药,更加有效地提高临床保胎成功率。

Objective:To summarize the clinical experience of modern famous doctors of traditional Chinese medicine in the treatment of threatened abortion.Methods:With"threatened abortion""fetal leakage""fetal disturbance""pregnancy abdominal pain"as key words,the author searched the experience of Wanfang Database(万方数据库),Chinese journal full-text database,Weipu(维普)Chinese science and technology journal and other traditional Chinese medicine treatment of threatened abortion.The literature was published from December 1,1999 to December 1,2019.A database of traditional Chinese medicine(TCM)syndrome typing,traditional Chinese medicine prescription and commonly used drugs was extracted from the included literature,and Excel software was used for statistics,sorting and analysis.Results:A total of 105 references were included.In the clinical syndrome classification of threatened abortion,spleen-kidney deficiency type is the most common,accounting for 56.60%,which was followed by blood-heat type,accounting for 20.20%,Qi and blood weakness accounted for 8.50%,humidity and heat accounted for 7.90%,blood stasis accounted for 3.40%,and other types accounted for 3.40%.Among the commonly used prescriptions,Shoutai pill(寿胎丸)was mainly used,accounting for 37.41%.In addition,there were many doctors draw up the experience prescription according to their own clinical experience,of which the clinical efficacy was significant.The top three commonly used drug types in the frequency of occurrence were:kidney-strengthening and consolidating fetus drugs,spleen-strengthening and consolidating fetus drugs,and blood-nourishing and consolidating fetus drugs.Conclusion:The deficiency of spleen and kidney is the most common type in the clinical syndrome differentiation of threatened abortion by modern famous old doctors of Chinese medicine.After a long time of clinical practice,famous traditional Chinese medicine practitioners have profound atone in the clinical treatment of threatened abortion,and each has its own advantages.By learning these valuable clinical experience,the subsequent medical staff can differentiate the treatment,prescription medication more accurately,and improve the success rate of clinical pregnancy preservation more effectively.