中医药辅助高龄女性生育临证经验采撷  

Clinical experience of Traditional Chinese Medicine in assisting fertility for women of advanced age

作　　者：闫菲 刘雁峰 赵琦 刘星童 李影 舒畅 李晶晶 YAN Fei;LIU Yanfeng;ZHAO Qi;LIU Xingtong;LI Ying;SHU Chang;LI Jingjing(Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029;Dongzhimen Hospital,Beijing University of Chinese Medicine)

机构地区：[1]南京中医药大学附属医院/江苏省中医院,南京210029 [2]北京中医药大学东直门医院

出　　处：《现代中医临床》2025年第2期74-78,共5页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金面上项目(No.82074480,No.82274567);北京市自然科学基金资助项目(No.7222280)。

摘　　要：高龄女性生育比例逐年增加,其生育问题也受到越来越广泛的关注,中医药在女性调经助孕安胎方面疗效显著。难孕和既孕难系是影响高龄女性生育的两大问题,难孕表现为:精衰血少、天癸乏源则卵子生长发育障碍,精血失充、胞脉失畅则胞宫摄纳胞胎无权,既孕难系则表现为:胎元薄弱、禀赋不健,气血失养、胎堕难留。临证以补血填精益气为治疗大法,注重顺期而治,包括:预培其损,养卵培胞;衷中参西,顺期而治,降调阶段滋养肝肾、收敛固涩,促排阶段温肾疏肝、理气活血,移植阶段温肾暖脾、清心解郁;补气养血,固肾安胎。并结合临床验案对中医药辅助高龄女性生育的临证经验进行阐述。The fertility needs of senior women are increasing year by year, and their fertility issues are receiving more and more attention. Traditional Chinese Medicine(TCM) has shown significant efficacy in regulating menstruation, facilitating impregnation, and preventing abortion. The two primary challenges affecting fertility in elderly women are difficulty in conceiving and difficulty in maintaining pregnancy. Difficulty in conceiving is manifested as the deficiency of essence and blood, and insufficient Tiangui, resulting in impaired oocyte development. Difficulty in maintaining pregnancy is characterized a weak fetal constitution, insufficient of qi and blood, and eventually leads to miscarriage. The clinical approach focuses on the principle of tonifying blood, replenishing essence and benefiting qi, with attention to adapting treatment to different stages. TCM treatment strategies include nourishing the oocyte and uterus during the recuperation stage, integrating Traditional Chinese and Western medicine at all stages of assisted reproduction, including nourishing the liver and kidney at the stage of downregulation;in the stage of promoting ovulation, warming kidney and soothing liver, regulating qi and activating blood;in the embryo transfer stage, warming the kidney and spleen, clearing heart fire and relieving restraint. During pregnancy, the key is to reinforce kidney tonify qi and nourish blood. This paper also expounds the clinical experience of using TCM to assist elderly women with fertility, supported by clinical cases.

关 键 词：中医药 高龄女性 助孕 补血填精益气 临证经验 

分 类 号：R271.14[医药卫生—中医妇科学] R271.9[医药卫生—中医学]