叶敦敏二分法周期性治疗输卵管性不孕经验

Ye Dunmin′s Experience in Dichotomous Periodic Treatment of Tubal Infertility

输卵管性不孕病机之根在于血瘀,气滞、痰凝、邪毒与血瘀互为因果,加重疾病的发生,使疾病呈现一派虚实夹杂、寒热并存之征。针对输卵管性不孕,叶敦敏教授提出辨病论治与辨证论治的二分法人工周期治疗方案。首先,根据输卵管梗阻部位进行二分法,对输卵管梗阻患者,若为近端梗阻,建议行辅助生殖助孕,若为伞端积水且卵巢储备功能正常,建议先行腹腔镜下输卵管伞端造口术,其后口服中药试孕;对卵巢储备功能正常的输卵管通而不畅患者,可考虑中药内服并积极试孕。口服中药治疗坚持辨病论治与辨证论治相结合,将女性的月经周期分为着床前期和着床后期,进行二分法周期性治疗。着床前期,即月经第5天至基础体温升温7 d以内,辨病论治,针对主要病因,采用化瘀解毒、祛痰理气之法,使瘀血除而内毒清。着床后期,即基础体温升温7 d至下次月经来潮,根据此期女性的生理特点,子宫藏而不泄,阴盛阳生渐至重阳,辨证论治,重在补虚,采用扶正补虚,阴中求阳,温肾暖宫之法,使正气足而肾气盛,故胎孕可成。

The pathogenesis root of tubal infertility lies in blood stasis.Qi stagnation,phlegm coagulation.The cause-and-effect relation of pathogenic toxin and blood stasis exacerbate the disease′s occurrence,causing it to show signs of intermingled deficiency and excess and the coexistence of cold and heat.However,Professor Ye Dunmin,aiming at tubal infertility,proposed a dichotomous artificial periodic treatment plan based on disease and syndrome differentiation treatment.First,the dichotomy is based on the location of the fallopian tube obstruction.For patients with tubal obstruction,if the obstruction is proximal,it is recommended to perform assisted reproductive assistance.If the fimbriae are effusion and the ovarian reserve function is normal,it is recommended to perform a laparoscopic fimbriae ostomy,and then take Chinese medicine to try pregnancy.For patients with a normal ovarian reserve and poor fallopian tube patency,consider taking Chinese medicine orally and actively try pregnancy.During oral Chinese medicine treatment,the combination of disease differentiation and syndrome differentiation is necessary.As well as divide women′s menstrual cycle into pre-implantation and post-implantation,and perform dichotomy periodic treatment.In the pre-implantation period,from the 5 th day of menstruation to the basal body temperature rises within 7 days,aiming at the main cause of the disease,based on disease differentiation treatment,the methods of removing Blood stasis and detoxification,expelling phlegm,and regulating Qi can be used to remove blood stasis and clear internal toxicity.In The post-implantation,that is,the basal body temperature rises for 7 days until the next menstrual cramp.According to the female physiological characteristics in this period:the uterus is storing without leaking,Yin and Yang′s hyperactivity reaches the superposed yang.And the treatment is based on syndrome differentiation,which mainly focuses on replenishing deficiency.Thus,the method of strengthening the body to nourish the deficiency,seeking Yang from the Yin,warming the Kidney,and warming the uterus is adopted.And eventually,the healthy Qi is sufficient and the Kidney Qi is full,and pregnancy can be achieved.