桂枝汤调节IVF-ET过程子宫内膜容受性的理论探讨
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摘要
在体外受精-胚胎移植过程中,子宫内膜容受性是影响其成功率的关键,而到目前为止,却仍无确切的改善方法和药物。中医传统辨治思路基于肾主生殖理论,多以补肾活血法干预治疗。笔者认为,子宫内膜容受性问题当属表证范畴,可用桂枝汤调和营卫祛表邪。而桂枝汤体现的诸多治法,如调和阴阳法、发汗法、解肌法、调节血流法、逐水气法等亦能针对子宫内膜容受性差的诸多病因病机加以干预。
Endometrial receptivity(ER) is the key to the success rate of in vitro fertilization and embryo transfer(IVF-ET), but so far, there is no exact methods and drugs to solve this problem. The traditional Chinese medicine differentiation and treatment ideas are based on the theory of Renal Reproductive, and most of them are treated with Bushen Huoxue method. The author believes that the problem of ER is a form of certificate, so Guizhi Decoction can be used to reconcile Ying and Wei, also to dispel evil. Many principle of Guizhi Decoction, such as reconciling Yin and Yang, sweating, soothing muscle, regulating blood flow, expelling the steam etc. can also intervene in many pathogenesis of poor ER.
Endometrial receptivity(ER) is the key to the success rate of in vitro fertilization and embryo transfer(IVF-ET), but so far, there is no exact methods and drugs to solve this problem. The traditional Chinese medicine differentiation and treatment ideas are based on the theory of Renal Reproductive, and most of them are treated with Bushen Huoxue method. The author believes that the problem of ER is a form of certificate, so Guizhi Decoction can be used to reconcile Ying and Wei, also to dispel evil. Many principle of Guizhi Decoction, such as reconciling Yin and Yang, sweating, soothing muscle, regulating blood flow, expelling the steam etc. can also intervene in many pathogenesis of poor ER.
引文
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[2] 岳在文,周丽萍,郜惠萍.《金匮要略》安胎十法[J].中医函授通讯,1994,9(3):7.
[3] 彭鑫,傅延龄.仲景著作中“膀胱”一词名实析辨[J].吉林中医药,2007,27(4):1.
[4] 李耀清.桂枝汤妇科临床应用举隅[J].山东中医杂志,2016,35(5):468.
[5] 刘卉.体外受精-胚胎移植降调节后的中医证候特点及与子宫内膜容受性的相关性研究[D].山东中医药大学博士学位论文,2007.
[6] 江媚,刘雁峰,黄羚.子宫内膜容受性低中医证型特点初探[J].中华中医药杂志,2015,30(11):3836.
[7] 高星,杜惠兰.辅助生殖技术中子宫内膜容受性治疗的研究进展[J].中华中医药杂志,2016,31(2):591.
[8] 魏丽坤,张雷,王蔼明.子宫内膜容受性的评价及其改善措施[J].生殖与避孕,2008,28(5):298.
[9] 杨学舟.围排卵期子宫收缩机制研究[D].湖北:华中科技大学博士学位论文,2013.
[10] 修丽梅,福岛峰子,吉崎克明,等.芍药甘草汤及其组成成分对子宫收缩抑制作用的研究[J].国外医学(中医中药分册),1997,19(3):53.
[11] 施瑾.输卵管积水对体外受精-胚胎移植(IVF-ET)的影响[J].生殖与避孕,1998,18(2):71.
[12] 袁世清,张琦,高燕.桂枝汤用药规律文献研究[J].中医杂志,2015,56(21):1880.
[13] 陈慧,姜美娇.子宫内膜容受性的超声评估和研究认识[J].诊断学理论与实践,2017,16(3):250.