黄欲晓教授论治子宫内膜异位症合并卵巢功能减退性不孕的经验

Huang Yuxiao′s Experience in Treating Endometriosis Complicated with Ovarian Dysfunction Infertility

子宫内膜异位症(Endometriosis,EMs)是指子宫内膜组织在子宫体腔外的部位生长,是妇科常见慢性病之一,近半数患者合并不孕。临床上子宫内膜异位症损伤卵巢功能,如造成卵巢储备功能减退,进一步加重生育障碍,是当前生殖医学的难点之一。黄欲晓教授临证经验丰富,认为本病病位在胞宫,病机繁杂、虚实交错,血瘀是基本病机,肾精亏虚是关键致病因素,气血失调是疾病发展的重要环节。黄欲晓教授运用“扶正祛邪”理论,重视气血关系,认为治疗EMs当益气补肾以扶正,化瘀消癥以祛邪,同时结合胞宫藏泻理论分期治疗,关注身心同调,注重孕后补肾益气、固冲安胎,在改善内异症患者卵巢储备功能、提高妊娠率方面取得较好疗效。

Endometriosis(EMs)refers to the growth of endometrial tissue outside the uterine cavity.It is a common chronic gynecological disease,with nearly half of the patients experiencing infertility.Clinically,EMs can impair ovarian function,leading to diminished ovarian reserve and exacerbating fertility issues,presenting a challenging aspect in the field of reproductive medicine.Professor Huang Yuxiao,with extensive clinical experience in this area,believes that the primary pathological location of this disease is within the uterus.The disease pathogenesis is intricate,involving a combination of deficiencies and excesses,with blood stasis as the fundamental pathological factor and kidney essence deficiency as a crucial pathogenic element.Moreover,the imbalance of qi and blood plays a significant role in disease progression.Applying the “tonifying healthy qi and dispelling pathogenic factors” theory,Professor Huang emphasizes the relationship between qi and blood and suggests that treating EMs involves reinforcing qi and supplementing the kidneys to strengthen the healthy qi,dispersing blood stasis and resolving mass to eliminate pathogenic qi,and concurrently employing a staged treatment approach based on the concept of uterine storage and discharge.This treatment approach considers the harmony of both physical and mental aspects,placing particular importance on post-pregnancy kidney reinforcement and qi enhancement,as well as securing thoroughfare to prevent miscarriage.Through these methods,Professor Huang has achieved positive therapeutic effects in improving ovarian reserve and enhancing pregnancy rates for patients with EMs.