文献类型：期刊文献

中文题名：胎元饮加减联合依诺肝素钠对气血亏虚型复发性流产诊疗思路

英文题名：Modified Taiyuanyin(胎元饮)Combined with Enoxaparin Sodium for Recurrent Abortion with Deficiency of Qi and Blood Clinical Thinking

作者：李春瑶[1];赵粉琴[1]

第一作者：李春瑶

机构：[1]甘肃中医药大学,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2021

卷号：48

期号：8

起止页码：26

中文期刊名：辽宁中医杂志

外文期刊名：Liaoning Journal of Traditional Chinese Medicine

收录：CSTPCD

基金：国家自然科学基金(81760806);甘肃省中医药管理局项目(GZK-2019-28);甘肃省高等学校创新能力提升项目(2019B-103)

语种：中文

中文关键词：气血亏虚型复发性流产;胎元饮;依诺肝素钠;诊疗思路

外文关键词：recurrent spontaneous abortion with deficiency of Qi and blood;Taiyuanyin(胎元饮);enoxaparin sodium;clinical thinking

摘要：复发性流产是目前妇产科临床常见的生殖疾病,发病率逐年升高,大多发生在怀孕早期,目前该病仍有50%左右发病原因不明,且机制现尚不完全清楚,当前研究表明其与血栓前状态息息相关,对患者及其家庭造成极大的负担和精神心理压力。追寻病史并经中医综合辨证发现本病多数患者存在气血亏虚的病机,不外母体冲任受损或胎元失固,治以益气养血、健脾固冲。血栓前状态导致复发性流产的证据等级为一级,首选抗凝治疗,依诺肝素钠作为常用的一类低分子肝素,分子量小于8 KD,皮下注射吸收好、半衰期长、生物利用度高,保胎作用明确,在妇产科临床使用已超过30年,应用广泛,但其亦存在出血、过敏、引起血小板减少等不良反应,且患者对单纯使用西药依从性较差。胎元饮为张景岳益气养血经典方,配伍得当,具有补气养血、固肾安胎之功效,联合依诺肝素钠治疗气血亏虚型复发性流产,疗效良好,且能有效降低西药不良反应,确保安全。
Recurrent abortion is a common reproductive disease in gynecology and obstetrics.The incidence is increasing year by year.Most of the cases occur in the early stage of pregnancy.At present,the causes of about 50%of the diseases are still unknown.The current research indicates that it is closely related to the prethrombotic state,bringing great burden and mental stress to patients and their families.After tracing the history and syndrome differentiation of traditional Chinese medicine,it is found that most of the patients have Qi and blood deficiency,either Chong and Ren damaged or the fetal Yuan being not solid.The treatment is to replenish Qi,nourish blood and strengthen spleen.The evidence level of recurrent abortion caused by prethrombotic state is grade I,and anticoagulant therapy is the first choice.Enoxaparin sodium,as a kind of commonly-used low molecular weight heparin,has good absorption,long half-life,high bioavailability,and clear fetal protection effect.It has been widely used in obstetrics and gynecology for more than 30 years,but it also has the problems of bleeding,allergy and so on.It can cause adverse reactions such as thrombocytopenia,and the compliance of patients with simple use of Western medicine is poor.Taiyuanyin(胎元饮)is ZHANG Jingyue′s classical prescription of replenishing Qi and nourishing blood.It has the effect of tonifying Qi and nourishing blood,strengthening kidney and stabilizing fetus.Combined with enoxaparin sodium,it has good curative effect in the treatment of recurrent abortion with deficiency of Qi and blood,and can effectively reduce the adverse reactions of Western medicine and ensure safety.