中医药治疗输卵管炎性不孕临床研究评述

Review on Clinical Research of TCM in Treating SI

本文就近年来中医药治疗输卵管炎性不孕(SI)的临床研究作一评述。SI指因输卵管阻塞、粘连等因素导致输卵管通畅异常所引起的不孕,占女性不孕症25%~35%。SI是中医妇科优势病种,归属中医“不孕”“癥瘕”“断绪”“妇人腹痛”等。中医药在SI治疗上理论基础深厚,辨治思路广泛。现代医家在承继古代医家的思想及治法的基础上,结合西医学的理化指标与自身临证经验,认为“瘀”为本病主要病因病机,其病位在胞络、两歧,临床多表现为虚实夹杂之候。临床研究主要分为单纯中药治疗,内外同治之针药联合、灌肠联合中药内服等以及中西医联合治疗。中药辨证治疗能够改善患者临床症状,提高输卵管复通率及受孕率,内外合治有标本同治之效,中西医联合治疗各展所长,优势互补。本文总结中医药治疗SI的临床研究现状,探索中医药治疗机制,构建适宜中医的临床循证方案,为凸显中医药优势提出建议。

This study reviewed the clinical studies on treatment of salpingitis infertility(SI)by TCM therapies in recent years.SI refers to infertility caused by fallopian tube obstruction,adhesion and other factors,which accounts for 25%-35%of female infertility.It is a kind of dominant gynecological disease in TCM,and belongs to the categories of‘infertility’,‘Zhengjia’,‘Duanxu’and‘female abdominal pain’.There is a profound theoretical foundation in SI treatment and a wide range of treatment ideas in TCM.Modern doctors,on the basis of inheriting treatment ideas and methods of ancient doctors,combined with physical and chemical indexes of modern medicine and their own clinical experience,believe that‘stasis’is the main pathogenic mechanism of this disease,and its disease location is in uterus and fallopian tube,and clinical manifestations are mostly featured in combination of deficiency and excess.Clinical studies are mainly divided into simple Chinese medication,acupuncture combined with Chinese medication,enema combined with Chinese medication and other integrated therapies of Chinese and Western medicine.Chinese medication based on syndrome differentiation can improve clinical symptoms,increase tubal recanalization rate and pregnancy rate.Internal and external combined treatment generally consists of acupuncture and Chinese medication,as well as enema and Chinese medication,which can achieve the result of treating the root and the manifestation.The integrated treatment of Chinese and Western medicine is generally composed of fluidectomy combined with Chinese medication,or Chinese medication combined with Western medication,uterine laparoscopic surgery combined with Chinese medication,or traditional Chinese mediation combined with Western medication,which can show their own strengths and complement each other.This study summarized the current clinical research status of TCM treatment for SI,and put forward the suggestions from three aspects,that is,exploring TCM treatment mechanism,constructing clinical evidence-based programs suitable for TCM,and highlighting the advantages of TCM,in order to promote clinical research on TCM treatment for SI.