子宫内膜异位症性不孕中医病机治法探析

An exploration on the TCM pathogenesis and treatment of endometriosis with infertility

子宫内膜异位症归属于中医“痛经、不孕、癥瘕”范畴,子宫内膜异位症以肾虚为本,血瘀为标,气滞、寒凝、血瘀、湿热不仅可以阻滞胞宫经络,致使“不通则痛”;亦可损伤冲任、胞脉导致不孕。临证时应随证变法,如气滞血瘀,行气活血,调经助孕;寒凝血瘀,温经散寒,暖宫助孕;湿热瘀结,分消走泄,化湿助孕;肾虚血瘀,补肾调周,祛瘀助孕;注重分析二者之间病机联系,切中症结再行论治。

Endometriosis belongs to the category of“dysmenorrhea,infertility,and abdominal mass”in traditional Chinese medicine.The disease is characterized by kidney deficiency as its root cause and blood stasis as manifestation.Qi stagnation,cold coagulation,blood stasis and damp-heat could not only block the uterine meridians,causing“obstruction and pain”,but also damage the thoroughfare and conception channels,uterine vessels,resulting in infertility.In its clinical treatment,proper methods should be determined according to the varying syndromes.For instance,for a syndrome of qi stagnation and blood stasis,methods should be chosen for promoting qi movement and blood circulation to assist conception by regulating menstruation;for a syndrome of cold coagulation and blood stasis,measures should be taken for warming channels and dispelling cold to assist pregnancy by warming the uterus;for a syndrome of damp-heat and binding of static blood,methods should be opted for eliminating pathogens through purgation and diuresis to help conception by eliminating dampness;while for a syndrome of kidney deficiency and blood stasis,methods should be adopted for invigorating the kidney and regulating menstruation to assist pregnancy by dispelling blood stasis.In conclusion,attention should be given to the analysis of their pathogenesis relationship between the syndrome patterns and varying treatment methods of the disease,and proper treatment can only be conducted on the basis of the precise identification of the specific syndrome.