中药分期治疗在体外受精-胚胎移植控制性超促排卵方案中的应用

Staged Treatment with Chinese Herbal Medicine in a Controlled Ovarian Hyperstimulation of In Vitro Fertilization-Embryo Transfer Programme

认为不孕症采用体外受精-胚胎移植(IVF-ET)控制性超促排卵方案的患者以肾虚为根本病机,以肝郁脾虚、冲任失调为关键病机。提出以补肾为主、肝脾同治为治疗大法,运用中药辅助IVF-ET控制性超促排卵方案进行分期论治。降调期治以补肾填精、健脾养肝,方以六味地黄丸加减;促排期治以温肾助阳、祛瘀养血,方以温经汤加减;移植前内膜准备期治以健脾益气、活血化瘀,方以参苓白术散加减;移植后治以健脾补肾、益气养血,方以寿胎丸或胎元饮加减。

It is believed that kidney deficiency is the fundamental pathogenesis while liver constraint and spleen deficiency,and disharmony of chong(thorough vessel,冲脉)and ren(conception vessel,任脉)is the key pathogenesis of infertility patients who adopted controlled ovarian hyperstimulation of in vitro fertilization-embryo transfer(IVF-ET)programme.Therefore,the method of tonifying the kidneys dominantly and treating the liver and spleen simultaneously is proposed,and Chinese herbal medicine is suggested to be used in adjuvant treatment of staged IVF-ET controlled ovrian hyperstimulation.In the regulation stage,modified Liuwei Dihuang Pill(六味地黄丸)can be used to tonify kidney and supplement essence,fortify spleen and nourish liver;in the ovulation promotion stage,modified Wenjing Decoction(温经汤)should be used to warm kidney and assist yang,dispel stasis and nourish blood;in the pre-transplantation endothelial preparation stage,modified Shenling Baizhu Powder(参苓白术散)is suggested to fortify spleen and replenish qi,invigorate blood and resolve stasis;after the transplantation stage,modified Shoutai Pill(寿胎丸)or Taiyuan Decoction(胎元饮)can be taken to fortify spleen and tonify kidney,benefit qi and nourish blood.