国医大师夏桂成治疗不孕症学术思想探析

An Analysis of Academic Thoughts of Xia Guicheng on the Treatment of Infertility

国医大师夏桂成教授从“肾主生殖”理论出发,认为不孕症总体病机为肾气不足,冲任气血失调,故治法多主张补肾调冲任。排卵障碍性不孕症、多囊卵巢综合征型不孕症、卵巢功能不全性不孕症、黄体功能不全性不孕症、高催乳素血症不孕症、输卵管性不孕症、免疫性不孕症等发病机理主要在于肾阴亏虚,气血阴阳失调。夏老根据多年的临床经验以及妇科病生理特点总结出月经周期节律调节法,将女性月经周期分成7个阶段,分别是行经期、经后初期、经后中期、经后末期、经间期、经前前半期和经前后半期,根据不同时期的生理特点确定治则及方药,还独创心-肾-子宫生殖轴理论,注重调节肝脾气机、疏畅月经来潮。另外,夏老认为,精神因素不仅直接影响排卵,还会导致免疫力下降,临床治疗中重视阴阳相合,提倡男女双方同治同调。

Professor Xia Guicheng,a master of TCM,based on the theory of"kidney⁃dominant reproduction",believes that the overall pathogenesis of infertility is kidney qi deficiency and qi⁃blood imbalance in thorough vessel(TV)and conception vessel(CV),so the treatment focuses on tonifying the kidney and regulating TV and CV.The pathogenesis of ovulatory infertility,polycystic ovary syndrome infertility,ovarian insufficiency infertility,luteal insufficiency infertility,hyperprolactinemia infertility,tubal infertility,immune infertil⁃ity,etc.mainly lies in kidney yin deficiency and qi⁃blood imbalance between yin and yang.Based on many years of clinical experience and physiological characteristics of gynecology,Professor Xia has drawn the rhythm regulation method of menstrual cycle,which divides the menstrual cycle into 7 stages,namely,menstrual phase,early postmenstrual phase,middle postmenstrual phase,late postmenstrual phase,intermenstrual phase,the first half of pre⁃menstrual phase and the last half of pre⁃menstrual phase.According to the physiological characteristics of different periods,the treatment principles and formulas are determined.What′s more,he has established heart⁃kidney⁃uterus reproductive axis,which focuses on regulating liver⁃spleen qi movement and facilitating menstrual flow.In addition,Professor Xia believes that mental factors not only directly affect ovulation,but also lead to the decline of immunity.In clinical treatment,he pays more attention to yin⁃yang combination,and advocates treating and regulating both men and women simultaneously.