辅助生育技术IVF-ET与妇科卵巢肿瘤发病关系及中医药干预的地位和意义探讨  

The Relationship between Assisted Reproductive Technology IVF-ET and the Incidence of Gynecological Ovarian Tumors and the Position and Significance of the Intervention of Traditional Chinese Medicine

作　　者：欧韵怡 俞瑾 朱南孙[3,6] 董丽 潘芳[5] 杨优州 赵佳 孟炜 

机构地区：[1]香港大学中医药学院,香港 [2]香港大学中医药学院,中西医结合妇科教研基地(香港分中心),俞瑾名中医传承工作站,香港 [3]香港大学中医药学院,海派朱氏妇科流派基地香港分中心,朱南孙国医大师传承工作站,香港 [4]上海复旦大学妇产科医院中西医结合科,上海 [5]上海泰坤堂中医院妇科,上海 [6]上海中医药大学附属岳阳中西结合医院妇科,上海

出　　处：《中医学》2023年第9期2679-2692,共14页Traditional Chinese Medicine

摘　　要：近年来不孕症的发病率升高,不孕夫妇使用辅助生殖技术也相应增加,而体外受精–胚胎移植(IVF-ET)是其中一个最常见及有效的辅助生殖技术,惟在IVF过程中所应用的大剂量卵巢刺激药物及穿刺取卵在理论上均有诱发恶性肿瘤的风险,但相关研究数据一直存有争议。即使如此,IVF与卵巢肿瘤的风险仍然不容忽视。目前就文献统计,IVF-ET最有效解决不孕的排行榜依次为:1) 男性因素;2) 女性因素(两侧输卵管闭塞);3) 最差的是原因不明的不孕。经研究发现中医药能有效地改善这些因素,还能改善子宫内膜厚度及胚胎质素,从而提高临床妊娠率。「种子必先调经」,中医的调周疗法除了可应用在治疗月经病外,亦可应用在辅助治疗中,可增加受孕的成功率及预防流产。近年来认为辅助生殖技术与卵巢肿瘤发病风险有一定相关性的文献研究在数量上相对较多,但相关结论仍有待更多的研究数据和分析方能确定。虽然如此,IVF-ET所使用的卵巢刺激药物,确实会导致高于一般生理水平的激素量,及令卵巢细胞过度增殖,这些是形成肿瘤的重要因素。姑且勿论IVF-ET是否直接引致卵巢肿瘤发病,使用中医药进行干预,以提升IVF-ET促孕的成功率,无疑能减少接受IVF的次数,并减少副作用。而中医药不仅能有助不孕夫妇成功妊娠,在结合西药治疗后,更能减少使用有增加卵巢肿瘤发病风险嫌疑的药物取得良好疗效,故此推荐在IVF-ET同时,辅助中医药治疗有益。The incidence rate of infertility has been increasing in recent years. The use of assisted reproductive technology became more popular, and In-vitro Fertilization-Embryo Transfer (IVF-ET) is one of the most common and effective assisted reproductive technology. However, the safety of IVF-ET has not been clearly ascertained in medical industry. Theoretically, high-dose of ovarian stimulation drugs and oocyte retrieval in IVF associated with the risk of inducing malignant tumors, yet the research data on this aspect has been controversial. That being said, the correlation between IVF and ovarian tumors cannot be ignored. According to the literature statistics, the most effective solution of infertility by IVF-ET is: 1) Male factor;2) female factor (bilateral fallopian tube occlusion);3) the worst is unknown infertility. Studies have found that traditional Chinese medicine can effectively improve these factors, as well as improve endometrial thickness and embryo quality, thereby increasing the clinical pregnancy rate. “Seeds must first regulate menstruation.” In addition to the treatment of menstrual disorders, traditional Chinese medicine’s cycle-regulating therapy can also be used in adjuvant therapy, which can increase the success rate of pregnancy and prevent miscarriage. In recent years, there are relatively more results of literature research concluded that there is a certain correlation between assisted reproductive technology and the risk of ovarian tumor. Research data and analysis are still required to reach a conclusion. Yet, the stimulation drugs used in IVF-ET will inevitable result in high hormone level, and cause excessive hyperblastosis of ovarian cells, in which these are important factors for the formation of tumors. Regardless of whether IVF-ET will cause ovarian tumors, the use of traditional Chinese medicine can increase the success rate of IVF-ET will undoubtedly reduce the number of time for conducting IVF and reduce the potential side effects. Traditional Chinese medicine can not only h

关 键 词：辅助生殖 体外受精–胚胎移植 不孕症 

分 类 号：R71[医药卫生—妇产科学]