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舒畅, 刘雁峰, 邓楠, 李晶晶, 金凡惠, 刘枳男, 张璇.从《医旨绪余》“种子之道”探讨卵巢储备功能减退合并复发性流产的证治思路[J].湖南中医药大学学报英文版,2025,45(4):742-747.[Click to copy
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| 从《医旨绪余》“种子之道”探讨卵巢储备功能减退合并复发性流产的证治思路 |
| 舒畅,刘雁峰,邓楠,李晶晶,金凡惠,刘枳男,张璇 |
| (北京中医药大学东直门医院, 北京 100700) |
| 摘要: |
| 卵巢储备功能减退（DOR）及复发性流产（RSA）作为妇科常见的生殖内分泌疾病，存在潜在的病理关联。DOR患者因卵母细胞质量下降导致胚胎非整倍体率增加，易出现RSA，而RSA患者反复妊娠丢失引发的应激反应加速卵巢功能衰退，二者对于女性的生殖及心理健康均产生不利影响。明代医家孙一奎在《医旨绪余·删定野山秘抄种子论》中将择地、养种、乘时、投虚4者称为“种子之道”，循此路径得以育麟。文章基于“种子之道”理论，提出DOR合并RSA的病机以肾虚为主，兼有脾虚、肝郁、血瘀等。治疗从改善宫腔环境、提升受精卵质量、促进规律排卵及保胎4方面着手，通过孕前、孕后序贯治疗，通补并施，男女同调以降低DOR合并RSA患者再孕后流产率，提高生育力。 |
| 关键词: 卵巢储备功能减退 种子之道 复发性流产 脏腑辨证 卵巢功能 |
| DOI：10.3969/j.issn.1674-070X.2025.04.024 |
| Received:November 26, 2024 |
| 基金项目:北京市自然科学基金面上项目（7222280）；北京中医药大学研究生自主科研课题（ZJKT2023024）。 |
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| Pattern differentiation and treatment of diminished ovarian reserve complicated with recurrent spontaneous abortion based on "Way of Seeding" in Yi Zhi Xu Yu (Remnants of Medical Decree) |
| SHU Chang, LIU Yanfeng, DENG Nan, LI Jingjing, JIN Fanhui, LIU Zhinan, ZHANG Xuan |
| (Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China) |
| Abstract: |
| Diminished ovarian reserve (DOR) and recurrent spontaneous abortion (RSA), as common gynecological reproductive endocrine disorders, exhibit potential pathological connections. In DOR patients, declining oocyte quality leads to an increased rate of embryonic aneuploidy, predisposing them to RSA. Conversely, the repeated pregnancy loss experienced by RSA patients induces stress responses that accelerate ovarian function decline. Both conditions adversely affect women's reproductive and mental health. The Ming Dynasty physician SUN Yikui, in the chapter of "Revised Traditional Folk Text on Fertility" of his medical treatise Yi Zhi Xu Yu (Remnants of Medical Decree), referred to the four principles of nourishing the uterus, nurturing sperms and ova, seizing the timing, and reinforcing deficiency as the "Way of Seeding", which is essential for successful conception. Guided by this theoretical framework, this paper holds that the pathogenesis of DOR complicated with RSA primarily involves kidney deficiency, accompanied by spleen deficiency, liver qi stagnation, and blood stasis. Therapeutic strategies focus on four aspects: optimizing the uterine environment, improving fertilized ovum quality, promoting regular ovulation, and implementing timely pregnancy maintenance. Through sequential pre-conception and post-conception interventions, integrating both tonifying and regulating therapies, and addressing the health of both men and women, this approach aims to reduce miscarriage rates and enhance fertility outcomes in DOR patients with RSA. |
| Key words: diminished ovarian reserve Way of Seeding recurrent spontaneous abortion pattern differentiation of zang-fu organs ovarian function |
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