摘要
近年来,以中药联合保守性手术、联合西药以及中医综合疗法配合西医辅助生殖技术等中西医结合方法治疗子宫内膜异位症均可有效缓解患者临床症状,降低其复发率。但目前对于子宫内膜异位症的发病机制尚不明确,该病临床表现复杂多变,从源头阻止其发病困难重重。同时,研究存在以下问题:中医辨证灵活多变,中药组方复杂,对其药理作用机制尚不明确;临床研究各自为营,结果多为个案报道,难以重复,缺乏系统性、多中心、大样本的随机实验;西医药物治疗存在激素依赖性的不良反应。因此,今后对于子宫内膜异位症的治疗应以行气活血祛瘀为根本大法,根据有关证型的基础方药及临证加减形成标准化方案,做到“未病先防,既病防变”,结合病情进展及早干预,并配合西医精准治疗,积极改善患者情况。同时,加大中西医结合治疗子宫内膜异位症的推广应用,进一步开展大样本、多中心的临床验证。
In recent years,Chinese medicine combined with conservative surgery,western medicine and assisted reproductive technology can effectively reduce the clinical symptoms and recurrence rate of patients with endometriosis(EMS).But at present,the pathogenesis of EMS is not clear,the clinical manifestations are complex and changeable,so it is difficult to prevent the onset of EMS from the source.At the same time,the research has the following problems:The syndrome differentiation of traditional Chinese medicine is flexible and complex,and its pharmacological mechanism is still unclear;the results of clinical research are mostly case reports,hard to repeat,lack of systematic,multicenter,large sample randomized trials;there are side effects of hormone dependence in western medicine.In the future,the treatment of EMS should be based on the fundamental method of promoting qi,promoting blood circulation and removing blood stasis.According to the basic formula of relevant syndrome types and the standardized scheme of clinical syndrome addition and subtraction,we should achieve the effect of"prevention before disease,prevention of change after disease",intervene as soon as possible in combination with the progress of the disease,and cooperate with the precise treatment of western medicine to actively improve the situation of patients.In addition,the promotion and application of integrated Chinese and western medicine in the treatment of EMS should be increased,and the clinical verification of large sample and multi center should be further carried out.
作者
范新雨
卫爱武
FAN Xinyu;WEI Aiwu(The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)
出处
《中医学报》
CAS
2020年第5期989-993,共5页
Acta Chinese Medicine
基金
国家自然科学基金项目(81673735)。
关键词
子宫内膜异位症
中西医结合
辅助生殖技术
endommetriosis
integration of Chinese and western medicine
assisted reproductive technology
