中医药临床优势病种探讨——先兆流产  

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine:Threatened Abortion

作　　者：杨新春 王树玉[2] 杜惠兰[3] 罗颂平[4] 金哲[5] 李蓉[6] 阮祥燕[2] 章勤[7] 冯晓玲[8] 陈世财[9] 贺丰杰 魏绍斌[11] 鹿群 王艳琴[13] 刘阳[14] 孟庆伟[15] 郝增平[16] 李颖 莫美 张霄潇[19] 赵瑞华[1] YANG Xinchun;WANG Shuyu;DU Huilan;LUO Songping;JIN Zhe;LI Rong;RUAN Xiangyan;ZHANG Qin;FENG Xiaoling;CHEN Shicai;HE Fengjie;WEI Shaobin;LU Qun;WANG Yanqin;LIU Yang;MENG Qingwei;HAO Zengping;LI Ying;MO Mei;ZHANG Xiaoxiao;ZHAO Ruihua(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Hebei University of Chinese Medicine,Shijiazhuang 050091,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Dongfang Hospital Beijing University of Chinese Medicine,Beijing 100078,China;Peking University Third Hospital,Beijing 100191,China;Hangzhou Hospital of Traditional Chinese Medicine(TCM),Hangzhou 310007,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China;Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China;Hospital of Chengdu University of TCM,Chengdu 610075,China;Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China;Tsinghua University Yuquan Hospital,Beijing 100040,China;Beijing Chuiyangliu Hospital,Beijing 100022,China;Beijing Hospital,Beijing 100730,China;Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Henan Second Provincial People's Hospital,Xinzheng 451191,China;State Key Laboratory of Critical Technology in Innovative Chinese Medicine,Tianjin 300410,China;China Association of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]首都医科大学附属北京妇产医院,北京100026 [3]河北中医学院,石家庄050091 [4]广州中医药大学第一附属医院,广州510405 [5]北京中医药大学东方医院,北京100078 [6]北京大学第三医院,北京100191 [7]杭州市中医院,杭州310007 [8]黑龙江中医药大学附属第一医院,哈尔滨150040 [9]首都医科大学附属北京潞河医院,北京101149 [10]陕西中医药大学附属医院,陕西咸阳712000 [11]成都中医药大学附属医院,成都610075 [12]首都医科大学附属朝阳医院,北京100020 [13]清华大学玉泉医院,北京100040 [14]北京市垂杨柳医院,北京100022 [15]北京医院,北京100730 [16]首都医科大学附属友谊医院,北京100050 [17]河南省第二人民医院,河南新郑451191 [18]创新中药关键技术国家重点实验室,天津300410 [19]中华中医药学会,北京100029

出　　处：《中国实验方剂学杂志》2024年第7期241-246,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者资助项目(国中医药人教函[2018]284号)。

摘　　要：先兆流产是常见的妇产科疾病,也是中医药治疗的优势病种之一。中华中医药学会组织中医妇产科、西医妇产科及药学领域专家,深入探讨先兆流产的中医、中西医结合治疗优势及用药方案。与会专家讨论后认为,染色体、内分泌、免疫异常是先兆流产发病的关键因素,冲任气血失调是核心病机;中医药治疗先兆流产在保胎、改善临床症状及中医证候、缓解焦虑状态、调节生殖内分泌及免疫异常、个体化、多样化治疗、增效减毒、未病先防等方面具有优势;中西医诊疗难点在于明确母体因素导致流产的预测指标和易栓症的治疗,在辨证的指导下,谨慎使用活血化瘀药;复发性流产是中西医结合治疗的切入点,未来亟需开展高质量循证医学研究,推进先兆流产的中医药现代化诊疗水平。Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine(TCM).The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology,Western medicine obstetrics and gynecology,and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion.After discussion,the experts concluded that chromosome,endocrine,and immune abnormalities were the key factors for the occurrence of threatened abortion,and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis.In the treatment of threatened abortion,TCM has advantages in preventing miscarriages,alleviating clinical symptoms and TCM syndromes,relieving anxiety,regulating reproductive endocrine and immune abnormalities,personalized and diversified treatment,enhancing efficiency and reducing toxicity,and preventing the disease before occurrence.The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia.Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine.It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

关 键 词：先兆流产 优势病种 中西医结合 专家指导建议 

分 类 号：R242[医药卫生—中医临床基础] R2-0[医药卫生—中医学] R2-031R714.21R271.9