首页|马堃教授以肾虚血瘀论治子宫肌瘤所致不孕病案举隅

马堃教授以肾虚血瘀论治子宫肌瘤所致不孕病案举隅

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子宫肌瘤是影响育龄期女性不孕的常见因素，通过整理马堃教授临床诊治子宫肌瘤所致不孕症的案例，探讨其治疗子宫肌瘤导致不孕症的理论依据及组方原则。肾藏精，主生殖，肾虚是导致不孕症的基本病机，无论是肾气、肾精不足或肾阴阳失调均可导致气血运行不畅，久滞成瘀，而血瘀是贯穿始终的重要因素，女子以血为用，气血之根在于肾，故马堃教授认为肾虚血瘀是子宫肌瘤所致不孕症的关键病机。马堃教授以补肾活血法为原则治疗子宫肌瘤所致不孕，根据月经周期气血变化规律和卵泡生长过程，辨证施治，行经期胞宫正开，正值经血下泄之时，以滋肾阴活血为主促进卵泡发育;经后期在此基础上化瘀消癥散结，攻补并行;经间期重阴则阳时，则以补肾活血为法，促进阴阳转化，卵子得以顺利排出;经前期以温肾阳为主，促进孕卵着床，兼以疏肝理气，行气消滞，补中有行，随症加减，临床效果显著，供广大同仁参考。
Examples of Professor MA Kun's treatment of infertility caused by uterine fibroids using method of tonifying kidney and activating blood
Uterine fibroids are a prevalent factor that impacts fertility in women of reproductive age.This study discusses the theoretical foundation and formula principles of Professor MA Kun's clinical treatment for infertility caused by uterine fibroids.The kidney stores essence and is responsible for reproduction,while blood serves as a vital material basis for women's physiological functions.Kidney deficiency is the fundamental pathogenesis of infertility,and imbalances in kidney Qi and essence or deficiencies in kidney Yin and Yang can result in blood stasis.Blood stasis plays a significant role throughout this condition by impeding the flow of blood,which is crucial for nourishing Qi.Therefore,both kidney deficiency and blood stasis are key factors contributing to infertility caused by uterine fibroids.Professor MA Kun treats infertility caused by uterine fibroids using an approach that involves tonifying the kidneys and activating blood circulation based on changes in Qi and blood during the menstrual cycle as well as follicular growth processes.By identifying stage-specific evidence,appropriate treatments can be applied accordingly.During menstruation when the uterus opens and menstrual blood flows out,promoting follicular development through nourishing kidney Yin and activating blood circulation becomes essential.In later stages of menstruation,additional measures are taken to remove blood stasis,alleviate symptoms,disperse knots,attack pathogens while simultaneously replenishing vital energy.During intermenstrual periods when Yin holds greater importance than Yang,tonifying the kidneys and activating blood circulation helps facilitate smooth discharge of eggs by promoting transformation between Yin and Yang energies.Premenstrual period to warm kidney Yang to promote pregnant egg implantation,and at the same time to dredge the liver and regulate Qi,Qi elimination stagnation,complementary in the line,with the symptoms of additional subtractions.Clinical effect is remarkable,for the reference of colleagues.

uterine fibroidsinfertilitykidney deficiency and blood stasistonifying kidney and activating blood

马堃、李佳妮、钟观兰、张涵、马林纳、孙立华

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中国中医科学院西苑医院,北京 100091

天津中医药大学,天津 301617

子宫肌瘤 不孕症 肾虚血瘀 补肾活血

中医药传承与创新"百千万"人才工程(岐黄工程)岐黄学者专项北京市科技计划"首都特色"重点项目北京市自然科学基金中国中医科学院科技创新工程项目北京市中医药"薪火传承3+3工程"项目

201826Z1711000010171047212193CI2021A024062017-SZ-B-36

2024

10.19540/j.cnki.cjcmm.20230914.501

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子：1.718
ISSN：1001-5302
年,卷(期)：2024.49(8)
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