摘要
中医学理论认为肾虚血瘀是免疫复发性流产(recurrent spontaneous abortion,RSA)的基本病机,补肾活血应贯穿治疗的始终。补肾活血药治疗免疫RSA的可能机制包括:调节下丘脑-垂体-卵巢轴的功能,促进雌孕激素和人绒毛膜促性腺激素的分泌,提高子宫内膜容受性;调节免疫细胞和细胞因子的分泌,增强母胎界面的免疫耐受状态;改善子宫和胎盘微循环、抗血栓形成。同时,对于免疫RSA患者需重视用药时机的选择,孕前重视预培其损,通过补肾活血调经,调节免疫失衡状态,纠正生殖抗体异常;孕后益肾养血,活血止血,积极安胎。然而,目前对于免疫RSA的具体发病机制及诊治标准尚无定论,补肾活血中药对于免疫RSA的作用机制和靶点还有待进一步探讨;研究停留在大量临床研究和经验总结的阶段,尚需多样本、大规模的研究数据以证实补肾活血中药是否可以通过上游调控干预RSA的病理进展。今后的研究还需进一步探讨补肾活血中药治疗免疫RSA的作用靶点和分子生物学机制。
Traditional Chinese medicine theory believes that kidney deficiency and blood stasis is the basic pathogenesis of recurrent spontaneous abortion(RSA).Possible mechanisms of Bushen Huoxue medicine in the treatment of immune RSA include:regulation of hypothalamic-pituitary-ovarian axis function,promotion of secretion of estrogen and progesterone and human chorionic gonadotropin,improvement of endometrial receptivity;regulation of immune cells and cytokines Secretion,enhance the immune tolerance status of the maternal-fetal interface;improve uterus and placental microcirculation,anti-thrombosis.At the same time,for patients with immune RSA,it is necessary to pay attention to the timing of medication,pre-pregnancy damage,pre-pregnancy damage,through the Kidney and blood circulation,regulate immune imbalance,correct reproductive antibody abnormalities;after pregnancy,kidney and nourishing blood,blood circulation to stop bleeding,active fetus.However,the specific pathogenesis and diagnosis and treatment criteria of immune RSA are still inconclusive.The mechanism and target of Bushen Huoxue medicine for immune RSA remains to be further explored.The study remains at the stage of a large number of clinical studies and experience,and many samples are needed.Large-scale research data to confirm whether the Chinese medicine for tonifying Kidney and promoting blood circulation can interfere with the pathological progress of RSA through upstream regulation.Future research needs to further explore the therapeutic targets and molecular biological mechanisms of Bushen Huoxue medicine for the treatment of immune RSA.
作者
曹天澈
陆启滨
陈聪
CAO Tianche;LU Qibin;CHEN Cong(The Affiliated Hospital to Nanjing University of Chinese Medicine,Nanjing Jiangsu China 210023)
出处
《中医学报》
CAS
2019年第12期2554-2557,共4页
Acta Chinese Medicine
基金
江苏省卫生厅科研基金项目(F201667)
江苏省自然科学基金青年基金课题(BK20161084)
关键词
免疫
复发性流产
补肾活血中药
研究进展
immunization
recurrent abortion
Bushen Huoxue medicine
research progress
作者简介
曹天澈(1994-),女,江苏南通人,硕士研究生,研究方向:复发性流产、更年期综合征等疾病临床研究。通信作者:陆启滨(1959-),女,江苏启东人,教授,博士研究生导师,主要从事复发性流产、更年期综合征研究工作。Email:Wenwd@nuaa.edu.cn。
