从伏邪学说辨治宫腔粘连思路

Ideas of Syndrome Differentiation and Treatment of Intrauterine Adhesion fromTheory of Latent Pathogen

通过梳理伏邪学说的源流及发展,发现宫腔粘连的病因病机及发病特点与“伏邪致病”具有高度相似性。涉及的伏邪主要包括先天伏邪及伏瘀、伏痰、伏毒;病位在胞宫胞脉,主要责之脾肾等;正气亏虚为邪伏的前提条件,先天精毒及瘀痰毒等内伏邪气久滞不去为疾病缠绵难愈的主要原因。在此基础上,拟定扶正祛邪的治疗原则,具体以补肾健脾、扶助正气为主,然后结合内伏邪气的不同分别佐以祛瘀化痰解毒等治法。依托伏邪学说辨治宫腔粘连,其可行性及有效性仍需今后临床实践不断加以验证。

Through the analysis of the origin and development of the theory of latent pathogen,it is found that the intrauterine adhesion has high similarities with“disease caused by latent pathogen”in etiology,pathogenesis and clinical characteristics.The involved latent pathogens mainly include innate latent pathogen,latent stasis,latent phlegm and latent toxin.The disease is located in uterus and veins,mainly related to the spleen and kidney.Deficiency of healthy qi is the prerequisite for latent pathogen,and innate sperm toxin,blood stasis,phlegm,toxin and other latent pathogens are the main causes of lingering diseases.On the basis of this theory,the treatment principle of reinforcing healthy qi and eliminating pathogen is put forward.Concrete treatment methods should be based on tonifying kidney and invigorating spleen,supplementing healthy qi.Combined with the differences in the internal latent pathogen,they should be treated by resolving stasis and phlegm and removing toxin. Relying on latent pathogen as the theoretical hypothesis to treat intrauterine adhesions can innovate syndrome differentiation and treatment ideas,but its feasibility and effectiveness still need to be continuously verified in future clinical practice.