何成瑶运用温补法周期调治复发性流产合并亚临床甲状腺功能减退症经验  

HE Chengyao's Experience in Treating Recurrent Miscarriage Comorbid with Subclinical Hypothyroidism with the Method of Warming and Supplementing by Stages

作　　者：欧燕 张泰魏 华诏召 文晓敏 周意园 何成瑶(指导) OU Yan;ZHANG Taiwei;HUA Zhaozhao;WEN Xiaomin;ZHOU Yiyuan(Guizhou University of Traditional Chinese Medicine,Guiyang,550002;The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine;The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine)

机构地区：[1]贵州中医药大学,贵州省贵阳市550002 [2]贵州中医药大学第一附属医院 [3]贵州中医药大学第二附属医院

出　　处：《中医杂志》2024年第15期1544-1549,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82260950,82060881);贵州省卫生健康委员会科学技术基金项目(gzwkj2023-428);贵阳市科技计划项目(筑科合同[2022]-4-3号)。

摘　　要：总结何成瑶教授治疗复发性流产合并亚临床甲状腺功能减退症的临证经验。认为肾阳不足为发病之本,五脏功能减退、三焦枢机不畅为病机关键环节。临证遵《周易》阳数之分,主张以9个月为复发性流产合并亚临床甲状腺功能减退症的基本调治周期。孕前前半周期(前3个月)治宜温枢三焦,常用右归丸为基础方温补肾阳,并配伍活血化瘀、调畅气机之品;孕前后半周期(后3个月)治宜养精育胞,常用五子衍宗丸加减;孕后(一般调治3个月)治宜补肾固冲、益气养血为主,佐以温补心阳,常用自拟补肾安胎方(寿胎丸合温胞饮化裁而成)。同时配合生活、饮食调护以调和阴阳,改善体质。This paper summarized the clinical experience of Professor HE Chengyao in treating recurrent miscarriage complicated with subclinical hypothyroidism.It is believed that kidney yang insufficiency is the root of the disease,while the functional decline of the five zang(脏)organs and the obstruction of the sanjiao(三焦)pivot are the key links of the pathogenesis.In clinical practice,the division of yang numbers in the Book of Changes(《周易》)is followed,and 9 months is advocated as the basic treatment cycle for recurrent miscarriage complicated with subclinical hypothyroidism.During the first half of the period before pregnancy(the first 3 months),it is recommended to warm the pivot and sanjiao(三焦),and Yougui Pills(右归丸)is commonly used as the basic prescription to warm and supplement the kidney yang,together with the medicinals of invigorating blood and dissolving stasis,regulating and unblocking qi movement.During the second half of the period before pregnancy(the second 3 months),it is better to nourish essence and nature the embryo commonly with Wuzi Yanzong Pills(五子衍宗丸)in modification.After pregnancy(the third 3 months),it is suggested to supplement kidney and consolidate chong mai(冲),replenish qi and nourish blood mainly,supplemented by warming and nourishing heart yang,and self-made Bushen Antai Formula(补肾安胎方)which is modified based on the combination of Shoutai Pills(寿胎丸)and Wenbao Beverage(温胞饮)is commonly used.Additionally,it is recommended to adjust lifestyle and diet so as to balance yin and yang and improve the physical condition.

关 键 词：复发性流产 甲状腺功能减退症 温补法 名医经验 何成瑶 

分 类 号：R271.9[医药卫生—中西医结合] R259[医药卫生—中医妇科学] R249[医药卫生—中医学]