从络脉瘀阻探讨反复自然流产易栓症的病机及治疗思路

Discussion on pathogenesis and treatment of RSA with thrombophilia from the perspective of stagnant blockade of collaterals

易栓症所致的反复自然流产临床研究发现,患者中有血栓形成倾向的约占66%。目前肝素抗凝是最佳的治疗手段,然而在肝素防治反复自然流产的适应症、剂量、疗程、监测方面缺乏相应的规范。中医关于反复自然流产易栓症的认识随着近年来有关络脉理论、微循环系统等研究而不断深入,其病机主要在于胞宫胞络瘀阻。基于络脉瘀阻,治疗上以补肾活血为法,辅以调补脾肾、益气养血。

Recurrent spontaneous abortion(RSA)caused by thrombophilia is very common in clinic,and clinical studies have found that about 66%of patients have a tendency of thrombus.At present,heparin anticoagulation is the best treatment method for the disease.However,there are no corresponding norms for the indications,dosage,course of treatment and monitoring in the prevention and treatment of RSA.The understanding of RSA with the symptom of thrombophilia in traditional Chinese medicine has been deepened with the research on the theory of collaterals and the microcirculation system in recent years,holding that its pathogenesis mainly lies in the stagnant blockade of collaterals in uterus.Accordingly,it is maintained RSA with the symptom of thrombophilia should be treated by invigorating the kidney and promoting blood circulations,supplemented by regulating the spleen and kidney,replenishing qi and nourishing blood.