马堃教授以肾虚血瘀论治子宫发育不良所致不孕病案举隅

Professor MA Kun treats infertility caused by uterine dysplasia with kidney deficiency and blood stasis

子宫发育不良是子宫发育异常中一种常见类型,可导致不孕症。中医药治疗该病具有独特优势,该文主要介绍马堃教授应用补肾活血法治疗子宫发育不良所致不孕的验案,探讨其治疗子宫发育不良导致不孕的理论依据与组方原则。肾藏精,主生殖,肾虚是该病的发病基础,肾气不足、肾阴亏虚、肾阳不足均可导致气血运行不畅,久滞成瘀;瘀阻胞络,化精乏源又加重肾虚;两者相互影响,甚则形成肾虚-血瘀-肾虚的恶性循环,最终胞宫失于濡养,造成子宫发育不良,难以孕育,故马堃教授认为肾虚血瘀是子宫发育不良所致不孕的关键病机。在治疗上,主张以补肾活血为根本治疗原则,肾中精气充盛,瘀血去,新血生,阴阳气血调和,通达冲任,濡养胞宫,胞宫生理功能正常,方能有子;亦重视以益气养血为辅,调经种子并行,养气血与补肾精同用,顺应月经周期变化,以使肾中精气旺盛、气血充沛,滋养胞宫血络,促进子宫的发育及卵泡的成熟排出;亦注意中西医结合,标本兼治。马堃教授治疗该病临床疗效显著,供广大同仁参考。

Uterine dysplasia is a common cause of infertility.Traditional Chinese medicine has unique advantages in the treatment of this disease.This paper introduces a case of infertility caused by uterine dysplasia treated by Professor MA Kun who adopted the therapy of tonifying kidney and activating blood,aiming to summarize the theoretical foundation and formula principles of Professor MA Kun in the clinical treatment of this disease.The kidney stores essence and governs reproduction.Kidney deficiency is the root cause of infertility.The deficiencies in kidney Qi,Yin,and Yang can result in blood stasis to obstruct the uterus,leading to insufficient source for essence and aggravating kidney deficiency.Kidney deficiency and blood stasis affect each other and form a vicious cycle,resulting in uterine dysplasia due to insufficient nutrition and difficult pregnancy.Therefore,Professor MA Kun believes that kidney deficiency and blood stasis is the key pathogenesis of infertility caused by uterine dysplasia and proposes the treatment principle of tonifying kidney and activating blood.Sufficient essence and Qi in the kidney can resolve stasis and generate blood,thus harmonizing Yin and Yang, which can reach thoroughfare and conception vessels to nourish the uterus and recover the normal physiological functionof the uterus. In that case, normal pregnancy is possible. Professor MA Kun attaches importance to the therapeutic principle ofsupplementing Qi and nourishing blood. In addition, she advocates conforming to changes in the menstrual cycle to promote thedevelopment of the uterus and the implantation of fertilized eggs. She also integrates traditional Chinese medicine and western medicineto treat both symptoms and root causes. Professor MA Kun′s experience has demonstrated definite clinical effect on this disease and canbe taken as a reference.