非妊娠期不明原因复发性流产患者中医证候分布规律探究

Study on distribution rule of traditional chinese medicine syndromes in non-pregnancy unexplained recurrent spontaneous abortion patients

目的探究非妊娠期不明原因复发性流产患者中医证候分布规律。方法收集并分析2020年6月1日至2021年12月31日于浙江省中西医结合医院生殖医学科首诊的164例非妊娠期不明原因复发性流产患者医案中的四诊信息,进行频数统计、证素分析及系统聚类分析。结果本研究共涉及患者症状与体征66种、舌象16种、脉象10种。非妊娠期不明原因复发性流产的病位证素主要为胞宫、肝、肾、脾、心神、心,病性证素主要为气虚、阴虚、阳虚、血虚、气滞、血瘀。聚类分析将本病常见中医证型归纳为肝肾阴虚证、肝郁血瘀证、气血两虚证、脾肾两虚证和脾虚痰湿证。结论非妊娠期不明原因复发性流产中医证候以虚证为主,部分可呈虚实夹杂,虚证主要包括肝脾肾脏腑不足,阴阳偏失,精气血虚损,实证主要涉及气血不畅,痰湿内阻,寒热偏盛等。此外,心(心神)病机需得到更多关注。

Objective To explore the distribution rule of traditional Chinese medicine(TCM)syndromes in patients with unexplained recurrent spontaneous abortion(URSA)during non–pregnancy period.Methods The first–time medical records of 164 non–pregnant patients with URSA who were treated in department of reproductive medicine of Zhejiang Hospital of Integrated Traditional and Western Medicine from June 1,2020 to December 31,2021 were collected and analyzed,and frequency statistics,syndrome factor analysis and systematic cluster analysis were performed.Results This subject involved 66 clinical symptoms and signs,16 tongue properties and 10 pulse conditions.The syndrome factors of disease location mainly involved uterus,liver,kidney,spleen,mind,heart while the main syndrome factors of disease property were qi depression,yin deficiency,yang deficiency,blood deficiency,qi stagnation and blood stasis.Systematic cluster analysis classified the common TCM syndromes of this disease into liver and kidney yin deficiency syndrome,liver stagnation and blood stasis syndrome,qi and blood deficiency syndrome,spleen and kidney deficiency syndrome,spleen deficiency and dampness syndrome.Conclusion The TCM syndrome types of non–pregnancy URSA patients are mainly deficiency syndromes,and some of which can be mixed with excess syndromes.Deficiency syndromes mainly include deficiency of liver,spleen and kidney,yin and yang deviation as well as deficiency of essence,qi and blood.Excess syndromes mainly involve qi and blood obstruction,internal resistance of phlegm and dampness,and excessive cold or heat.Moreover,the pathogenesis of heart(mind)requires more attention.