| 引用本文: |
张紫娟, 杨瑞恩, 游卉, 尤昭玲.输卵管性不孕辅助生殖中西医结合全程干预的临床策略[J].湖南中医药大学学报,2025,45(9):1607-1612[点击复制] |
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| 输卵管性不孕辅助生殖中西医结合全程干预的临床策略 |
| 张紫娟,杨瑞恩,游卉,尤昭玲 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 输卵管性不孕是临床的常见病、多发病，影响女性生殖健康与生育安全。本文基于“以胞宫为中心的五脏一体观”中医生殖理论，系统探讨输卵管性不孕的辅助生殖中西医融合全过程助孕管理模式。尤昭玲教授认为，本病核心病机为胞宫（两歧）络伤脉滞，并提出A、B、C、D四段诊治-管理方案的“四段四期”论治体系：A方案（中医药助孕前调治方案）以理气宣络、破滞通脉为法，选用尤氏妇炎方加减；B方案（辅助生殖助孕方案）因病制宜选择合适取卵方案，并通过经阴道三维彩色超声技术确定移植时间；C方案（手术方案）治以攻补兼施，采用内外合治之法，缩短治疗周期；D方案（中医药妊娠后安胎方案）以宣络养胎为基本治法，方选尤氏养胎方加减。通过辨析输卵管性不孕的中医发病机制，采用分阶段、闭环式的中西医融合诊疗思路指导临床遣方用药，内外合治，分期论治，从而改善输卵管微环境，提高妊娠成功率。 |
| 关键词: 输卵管性不孕 “四段四期”论治体系 辅助生殖技术 全过程管理 尤昭玲 |
| DOI：10.3969/j.issn.1674-070X.2025.09.003 |
| 投稿时间：2025-06-16 |
| 基金项目:国家中医药管理局全国名中医传承工作室建设项目(国中医药办人教函[2022]5号); 湖南省自然科学基金项目(2025JJ80972); 湖南创新型省份建设专项重点研发计划(2023SK2050); 湖南省创新型省份建设专项重点研发项目(2025JK2111)。 |
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| Clinical strategy for whole-course intervention with integrated Chinese and Western medicine in assisted reproductive technology for tubal infertility |
| ZHANG Zijuan, YANG Rui'en, YOU Hui, YOU Zhaoling |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Tubal infertility is a common and frequently occurring disease that significantly impacts female reproductive health and safety. Based on the reproductive theory of "uterus-centered five zang organs integration view" in Chinese medicine（CM）, this paper systematically explores a whole-course intervention with integrated Chinese and Western medicine in assisted reproductive technology for tubal infertility. Professor YOU Zhaoling proposes that the core pathogenesis is the impairment of the collaterals and obstruction of the meridians in the uterus（fallopian tubes）, and has established the comprehensive "four-stage and four-phase" treatment system that integrates and refines the four-stage diagnosis-treatment-management protocol（Protocols A, B, C,and D）. Protocol A（CM Preconception Regulation and Treatment Protocol）: Guided by the therapeutic principles of "regulating qi to dredge collaterals, resolving stagnation to unblock meridians," it adopts a modified YOU’s Fuyan Formula. Protocol B（Fertility Assistance Protocol）: An appropriate oocyte retrieval protocol is selected based on the specific condition of the disease, and the embryo transfer timing is determined using three-dimensional transvaginal ultrasonography. Protocol C（Surgical Protocol）: The treatment principle is to integrate elimination and tonification, combining internal and external therapeutic approaches to shorten the treatment course. Protocol D（CM Protocol for Antenatal Care After Conception）: It focuses on dredging collaterals and nurturing the fetus as the basic therapeutic method with a modified YOU’s Fetal Nourishing Formula. By analyzing the CM pathogenesis of tubal infertility, a phased and closed-loop diagnosis and treatment approach integrating Chinese and Western medicine is adopted to guide clinical prescription and medication. Through integrated internal and external treatment and phased management, the fallopian tube microenvironment is improved, and the pregnancy success rate is enhanced. |
| Key words: tubal infertility “four-stage and four-phase” treatment system assisted reproductive technology whole-course management YOU Zhaoling |
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