Ma Kun, Li Min
China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2021 Jun;46(11):2639-2643. doi: 10.19540/j.cnki.cjcmm.20210224.502.
Pelvic inflammatory disease(PID) has become one of the leading causes of female infertility, with an increasing incidence in recent years. Modern medicine believes that risk factors of PID will affect the formation of eggs and embryo implantation, especially on the encounter of gametes, fertilization, and transport of fertilized eggs to the uterine cavity. Therapies for infertility due to PID include medication, sonographic hydrotubation, surgery, and assisted reproductive technology. Professor Ma Kun believes that the disease is located in the uterus with appendages with the main pathogenesis of kidney deficiency and blood stasis. Blood stasis is the pathological basis, and kidney deficiency is the fundamental pathogenesis, which exhibits deficiency-excess in complexity. Kidney deficiency will cause blood stasis over time, while blood stasis will aggravate kidney deficiency in turn, making PID-induced infertility refractory. In clinical practice, basic therapies follow the principles of kidney-tonifying and blood-activating, removing blood stasis, dredging collaterals, and coordinating thoroughfare and conception vessels. The oral administration of Chinese medicine combined with enema, external application, and external washing displays better efficacy in improving the pelvic microenvironment and increasing the pregnancy rate and pregnancy success rate in the treatment of PID-induced infertility.
盆腔炎（PID）已成为女性不孕症的主要原因之一，近年来发病率呈上升趋势。现代医学认为，PID的危险因素会影响卵子的形成和胚胎着床，尤其是对配子的相遇、受精以及受精卵向宫腔的运输。PID所致不孕症的治疗方法包括药物治疗、超声输卵管通液、手术及辅助生殖技术。马坤教授认为，该病病位在子宫及附件，主要病机为肾虚血瘀。血瘀是病理基础，肾虚是根本病机，表现为虚实夹杂。肾虚日久会导致血瘀，而血瘀反过来又会加重肾虚，使PID所致不孕症难以治愈。在临床实践中，基本治法遵循补肾活血、化瘀通络、调理冲任的原则。中药口服联合灌肠、外敷、外洗在改善盆腔微环境、提高PID所致不孕症的妊娠率及妊娠成功率方面显示出较好的疗效。
