摘要
药物流产因操作简便且创伤小等诸多优点,常作为早期妊娠终止方式之一在临床广泛使用,但药物不全流产并发症严重影响了女性对药物流产的接受度,尤其当部分残留蜕膜组织滞留宫腔日久,且组织物较多或机化需要清宫处理时,更是对女性身心再次造成巨创。文章基于对药物流产过程及产后生理特点分析,认为流产时失血伤津、元气受损,发生不全流产的根本原因为冲任受损,血不收摄;瘀行不尽,停留胞宫;或因虚致瘀,瘀血内阻既是病理产物,又成为新的致病因素,呈现虚中兼瘀,虚实夹杂的特点。综上可知,药物不全流产的病机为产后虚损,瘀阻冲任。鉴于此,文章提出药物不全流产的治疗应以补虚化瘀为根本原则,主要治法:①补虚固本、补气养血,使冲任得固,同时补气兼行滞,以防因虚致瘀;②活血化瘀行滞,但不宜峻攻,也不可过早止血;③攻补兼施,补虚祛瘀,以补虚不留瘀为原则,通过补气养血,祛瘀生新,使旧血不滞,新血得宁。总之,结合药物不全流产病因病机特点,给予补虚化瘀治疗可促进残留妊娠组织排出及子宫复旧,减少不全流产的发生,兼顾保护女性生殖及身心健康、保护生育力方面,发挥了中医的独特优势。
Due to advantages such as simple operation and small trauma,drug abortion is one of the methods widely used in clinical practice for early pregnancy termination.However,its complications have seriously affected women’s acceptance of drug abortion.Furthermore,in cases when fairly big amounts of residual tissues are long left in the uterus,it is necessary to take curettage,which means extra mental and physical harm to women.This paper analyzes both the process and the postpartum features of drug abortion,noticing that during the process of incomplete abortion,there are blood and vitality losses,the reason might be Chong and Ren(冲任)Channels damages,which causes blood flow,if blood stasis can not be handled in time,it will stay at uterus.Or blood stasis is caused by weakness,blood stasis is not only a pathological product,but also a new pathogenic factor,presenting the characteristics of mixed deficiency and blockage.To sum up,the pathogenesis of incomplete drug abortion is the weakness and blood stasis after giving birth to a child.Based on such findings,a key principle of supplementing deficiency and removing stasis is put forward for the treatment of incomplete drug abortion,and the proposed methods include:①Supplementing deficiencies and invigorating Qi(气),and nourishing blood strengthen Chong and Ren Channels,and at the same time,invigorating Qi to prevent stagnation and blood stasis caused by deficiency.②Improving health,removing the blood stasis and getting rid of stagnations,but violent attack and too early bleeding stopping should be avoided.③Combining tonification and purgation.The principle of tonifying deficiency and removing blood stasis is to replenish deficiency without leaving blood stasis.The paper also believes that replenishing Qi and nourishing blood,eliminating blood stasis and promoting blood regenerating can stop the original blood from getting stagnated,and generate new blood.In short,combined with the characteristics of etiology and pathogenesis of drug incomplete abortion,the treatment of tonifying deficiency and removing blood stasis is given,so residual tissues can be expelled,which is helpful to the recovery of the uterus.This therapy takes into account the reduction of the incidence of incomplete abortion,the protection of female reproduction and physical and mental health,and the protection of fertility,manifesting the unique advantages of traditional Chinese medicine.
作者
吕秀花
李辉
王丽娟
LV Xiuhua;LI Hui;WANG Lijuan
出处
《中医临床研究》
2024年第15期116-118,共3页
Clinical Journal Of Chinese Medicine
基金
兰州市科技计划项目(2022-ZD-35)。
关键词
虚瘀
药物流产不全
补虚化瘀
Deficiency and blood stasis
Incomplete drug abortion
Supplementing deficiency and removing stasis
作者简介
吕秀花(1975-),女,硕士研究生,副主任医师,甘肃省生殖内分泌专业委员会委员,兰州市微无创专业委员会委员,研究方向为生殖内分泌疾病(月经失调、经前期紧张综合征、围绝经期综合征、多囊卵巢综合征、异常子宫出血)、不孕症、盆腔炎症、孕产相关疾病(不全流产、宫外孕保守治疗、先兆流产、妊娠剧吐)及产后相关疾病等;通讯作者:李辉,女,副主任医师,研究方向为妇产科常见病。
