| 引用本文: |
郭利, 朱建平, 谢京红, 王梦雨, 关煜.基于“主客交-膜原”理论辨治输卵管阻塞性不孕症[J].湖南中医药大学学报,2026,46(6):1179-1186[点击复制] |
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| 基于“主客交-膜原”理论辨治输卵管阻塞性不孕症 |
| 郭利,朱建平,谢京红,王梦雨,关煜 |
| (中国中医科学院西苑医院, 北京 100091;普洱市中医医院风湿科, 云南 普洱 665099) |
| 摘要: |
| 输卵管阻塞性不孕症（TOI）是生殖医学领域的疑难病症，临床治疗手段有限，疗效欠佳。本文基于“主客交-膜原”理论，提出TOI以主气亏虚、膜原不荣为发病之本，客邪停滞、膜原闭塞为发病之标，主客胶结、膜原不通为病机关键。根据TOI的不同类型，提出分型论治：肾虚血瘀证以补肾化瘀为法，予桃红四物汤合寿胎丸加减；脾虚肝郁证以肝脾同调为要，予当归芍药散化裁；脾虚痰瘀证着重健脾化痰祛瘀，予完带汤加减；阳虚寒瘀证治以温阳化瘀，予少腹逐瘀汤加减；同时联合中药外敷、中药保留灌肠、针灸等中医外治法，增强疗效。上述分型论治及内外合治方案，体现了“主客交-膜原”理论在TOI辨治中的指导价值，为拓展中医药干预TOI的临床路径提供了参考。 |
| 关键词: 输卵管阻塞性不孕症 主客交 膜原 辨证论治 扶正祛邪 内外合治 |
| DOI：10.3969/j.issn.1674-070X.2026.06.012 |
| 投稿时间：2026-02-02 |
| 基金项目:北京市自然科学基金面上项目（7252269）；医疗机构制剂和中药新药研发与转化面上项目（XYZX0303-14）。 |
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| Differentiation and treatment of tubal obstructive infertility based on the theory of “host and guest interaction-membrane source” |
| GUO Li, ZHU Jianping, XIE Jinghong, WANG Mengyu, GUAN Yu |
| (Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China;Department of Rheumatology, Pu'er Municipal Hospital of Traditional Chinese Medicine, Pu'er, Yunnan 665099, China) |
| Abstract: |
| Tubal obstructive infertility (TOI) is a refractory disease in reproductive medicine with limited clinical treatments and unsatisfactory efficacy. Based on the theory of "host and guest interaction-membrane source", this study proposes the following pathogenesis for TOI: the root cause is deficiency of host qi and malnourishment of the membrane source; the manifestations are stagnation of guest pathogenic factors and obstruction of the membrane source; the key pathogenesis lies in the intwined adhesion of host qi and guest factors at the membrane source, leading to its blockage. According to the different pattern types of TOI, the pattern differentiation treatment is proposed: for the pattern of kidney deficiency and blood stasis, the principle is tonifying kidney and resolving stasis, with modified Taohong Siwu Decoction combined with Shoutai Pills; for the pattern of spleen deficiency and liver stagnation, the key is to harmonize the liver and spleen, with modified Danggui Shaoyao Powder; for the pattern of spleen deficiency complicated with phlegm and blood stasis, the focus is on invigorating spleen, resolving phlegm, and removing blood stasis, with modified Wandai Decoction; for the pattern of yang deficiency, cold stagnation, and blood stasis, the treatment focuses on warming yang and removing stasis, with modified Shaofu Zhuyu Decoction. Meanwhile, external TCM therapies such as herbal external application, herbal retention enema, and acupuncture are combined to enhance the therapeutic efficacy. The above pattern differentiation and treatment as well as the integrated internal-external therapy regimen reflect the guiding value of the theory of "host and guest interaction-membrane source" in the treatment of TOI, and provide a reference for expanding the TCM clinical pathway for TOI. |
| Key words: tubal obstructive infertility host and guest interaction membrane source pattern differentiation and treatment reinforcing healthy qi to eliminate pathogenic factors integrated internal and external treatments |
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