基于“精血俱耗致衰”探讨高龄复发性流产的证治思路

Pattern identification and treatment of recurrent spontaneous abortion in advanced age based on senescence due to dual consumption of essence and blood

复发性流产是临床常见的妊娠并发症,近年来伴随高龄孕产妇人数的增加,复发性流产发病率逐渐增加。从“精血俱耗致衰”的角度切入,通过探讨其理论内涵,提出高龄复发性流产的发生与精血虚衰关系密切;进一步总结高龄复发性流产患者病机以肾虚为本,以精血虚耗为主,同时可兼具血瘀、寒凝、气滞等病理因素,与心、肝、脾等多脏相关。治疗以益精养血为主,妊娠前补肾调肝、交通心肾,妊娠期健脾益肾、固摄胎元,从而减少复发性流产的发生。

Recurrent spontaneous abortion(RSA)is a common pregnancy complication in clinic.In recent years,the incidence of RSA has grown gradually with increasing number of pregnant women in advanced age.From the perspective of"senescence due to dual consumption of essence and blood",by discussing its theoretical connotation,this paper has proposed the close relationship between the occurrence of RSA in advanced age and the deficiency of essence and blood,and has further concluded that the pathogenesis of recurrent spontaneous abortion in patients of advanced age is rooted in kidney deficiency,mainly based on consumption of dual essence and blood,accompanied by pathological factors including blood stasis,cold retention,and qi stagnation,and related to the heart,liver,spleen and other zang organs.The treatment focuses on tonifying essence and nourishing blood.Specifically,it involves tonifying the kidney,regulating the liver,and coordinating the heart and kidney prior to pregnancy,and strengthening the spleen,benefiting the kidney,and securing the fetus during pregnancy,thereby reducing the occurrence of RSA.