Ma Kun, Wang Kai-Li, Chen Yan-Xia
Xiyuan Hospital,China Academy of Chinese Medical Sciences Beijing 100091,China.
Zhongguo Zhong Yao Za Zhi. 2019 Mar;44(6):1099-1103. doi: 10.19540/j.cnki.cjcmm.20181225.004.
Infertility caused by salpingitis is one of the main causes of secondary infertility in women. In recent years,the incidence has been increasing year by year. Modern medicine believes that this disease is a complication due to incomplete or delayed treatment of acute and chronic salpingitis,with no satisfactory drug therapy at present. Clinical therapies mainly include surgical treatment,interventional treatment and assisted reproductive technology. After summarizing the experience of predecessors and the clinical practice of treating infertility for many years,the author considers that the disease location is the cell veins,and the nature is mostly mixed of deficiency and excess. Kidney deficiency and blood stasis are the main pathogenesis of infertility caused by salpingitis. Blood stasis is the pathological basis,while kidney deficiency is the fundamental pathogenesis. Long-term kidney deficiency will lead to blood stasis,and blood stasis will aggravate kidney deficiency. Both of them are cause and effect to each other. Infertility caused by salpingitis is difficult to cure. Based on the theory of kidney deficiency and blood stasis,the basic principles of clinical treatment are tonifying kidney and activating blood circulation,removing blood stasis and dredging collaterals. Oral administration with traditional Chinese medicine combined with external therapies,such as enema,external application,acupuncture and moxibustion,have been achieved a good efficacy in repairing fallopian tube function and improving pregnancy rate. Therefore,the treatment of infertility caused by salpingitis based on " kidney deficiency and blood stasis" is worthy of further discussion in both clinical and experimental aspects.
输卵管炎所致不孕症是女性继发性不孕的主要原因之一。近年来，其发病率逐年上升。现代医学认为，本病是急、慢性输卵管炎治疗不彻底或延误所致的并发症，目前尚无令人满意的药物治疗方法。临床治疗主要包括手术治疗、介入治疗和辅助生殖技术。笔者在总结前人经验及多年治疗不孕症临床实践的基础上，认为本病病位在胞脉，其性质多为本虚标实。肾虚血瘀是输卵管炎所致不孕症的主要病机，血瘀是病理基础，肾虚是根本病机。长期肾虚可导致血瘀，血瘀又会加重肾虚，二者相互因果。输卵管炎所致不孕症难以治愈。基于肾虚血瘀理论，临床治疗的基本原则是补肾活血、化瘀通络。口服中药配合灌肠、外敷、针灸等外治疗法，在修复输卵管功能、提高妊娠率方面取得了较好疗效。因此，基于“肾虚血瘀”论治输卵管炎所致不孕症，在临床及实验方面均值得进一步探讨。
