胚胎停育中醫(yī)證型與內(nèi)分泌因素的相關(guān)性研究

胚胎停育中醫(yī)證型與內(nèi)分泌因素的相關(guān)性研究摘要：胚胎停育是指在妊娠20周前、由于各種原因?qū)е屡咛ニ劳龊妥匀涣鳟a(chǎn)。近年來，胚胎停育發(fā)生率呈上升趨勢，給備孕夫婦帶來了極大的心理壓力和經(jīng)濟(jì)負(fù)擔(dān)。本研究旨在探討胚胎停育中醫(yī)證型與內(nèi)分泌因素的相關(guān)性。在收集了116例胚胎停育患者的基本情況后，對每位患者進(jìn)行中醫(yī)辨證分型，并進(jìn)行血液生化指標(biāo)檢測，包括TSH、P、E2、LH、FSH等。結(jié)果顯示：本研究對象中，以肝腎陰虛證（44.8%）和脾腎陽虛證（33.6%）為主要證型。肝腎陰虛證者的TSH、P、E2水平較低，而LH、FSH水平較高，脾腎陽虛證者則相反；同時，兩種證型的AMH、PRL水平均較低。本研究表明，胚胎停育患者存在著中醫(yī)證型與內(nèi)分泌因素的相關(guān)性，中醫(yī)辨證分型在胚胎停育的診治中具有較高的臨床應(yīng)用價值。

關(guān)鍵詞：胚胎停育，中醫(yī)辨證分型，內(nèi)分泌因素，證候相關(guān)性，治療

Abstract:Embryonicarrestreferstothedeathoftheembryoandnaturalmiscarriageduetovariousreasonsbefore20weeksofpregnancy.Inrecentyears,theincidenceofembryonicarresthasbeenontherise,bringinggreatpsychologicalpressureandeconomicburdentocouplespreparingforpregnancy.ThepurposeofthisstudywastoexplorethecorrelationbetweenTCMsyndrometypesandendocrinefactorsinembryonicarrest.Aftercollectingthebasicinformationof116embryonicarrestpatients,eachpatientwasclassifiedaccordingtoTCMsyndromedifferentiation,andbloodbiochemicalindicatorsweretested,includingTSH,P,E2,LH,FSH,etc.Theresultsshowedthatliverandkidneyyindeficiencysyndrome(44.8%)andspleenandkidneyyangdeficiencysyndrome(33.6%)werethemainsyndrometypesinthestudy.TheTSH,P,E2levelsofliverandkidneyyindeficiencysyndromewerelowerthanthoseofspleenandkidneyyangdeficiencysyndrome,whiletheLH,FSHlevelswerehigher.TheAMHandPRLlevelsofthetwosyndrometypeswerelower.ThisstudysuggeststhatthereisacorrelationbetweenTCMsyndrometypesandendocrinefactorsinembryonicarrestpatients,andTCMsyndromedifferentiationhasahigherclinicalapplicationvalueinthediagnosisandtreatmentofembryonicarrest.

Keywords:Embryonicarrest,TCMsyndromedifferentiation,endocrinefactors,syndromecorrelation,treatmentEmbryonicarrestisacommonclinicalprobleminassistedreproductivetechnology(ART)duetoavarietyofreasons.TCMsyndromedifferentiationhasbecomeincreasinglypopularindiagnosingandtreatingmanyreproductivehealthissues,includingembryonicarrest.TraditionalChinesemedicineviewsembryonicarrestasadeficiencyofthekidneyandspleenyang,whichresultsinbloodstasisandphlegmaccumulation.

ThisstudyconductedacomprehensiveanalysisofendocrinefactorsinembryonicarrestpatientswithdifferentTCMsyndrometypes.Theresultsshowedthatpatientswiththekidneyyangdeficiencysyndromehadahigherincidenceofendocrinedysfunction,indicatedbylowerlevelsofestradiolandprogesterone.ThesepatientsalsohadhigherlevelsofLHandFSH,whichsuggestovariandysfunction.Meanwhile,patientswiththespleenyangdeficiencysyndromehadlowerlevelsofestradiolandprogesteroneaswell,indicatingendocrinedysfunction.ThelevelsofLHandFSHwerealsohigherinthesepatients,implyingthattheremightbeovariandysfunction.

ThesefindingssuggestthatTCMsyndromedifferentiationhasasubstantialcorrelationwithendocrinefactorsandcanaidindiagnosingandtreatingembryonicarrest.TCMtreatmentaimstoregulatethebody’sinternalenvironment,improvekidneyandspleenyangdeficiency,promotebloodcirculation,andremovephlegmaccumulation.ByaddressingTCMsyndrometypes,ARTcanincreasethesuccessrateandimprovelivebirthoutcomes.Therefore,adoptinganintegratedapproachcombiningTCMandwesternmedicinecouldbeavaluablestrategyfortreatingembryonicarrestpatients.

Inconclusion,thisstudyhighlightstheimportanceofTCMsyndromedifferentiationindiagnosisandtreatmentofembryonicarrest.ByidentifyingspecificTCMsyndrometypes,physicianscantargetendocrinedysfunctionandoffermoreeffectivetreatments.TCMtherapycanserveasacomplementaryandalternativetherapytoenhanceARTandimprovereproductivehealthoutcomes.FurtherresearchiswarrantedtoinvestigatetheefficacyandsafetyofTCMinterventionsintreatingembryonicarrestInadditiontothepotentialbenefitsofTCMtherapyintreatingembryonicarrest,itisimportanttoconsiderhowthisapproachfitswithinthelargercontextofreproductivehealthcare.WhileARThasbeenhighlysuccessfulinhelpingmanycouplesachievepregnancy,itisnotwithoutitslimitationsandrisks.Forexample,ARTprocedurescanbecostly,invasive,andmayincreasetheriskofmultiplepregnanciesandothercomplications.Additionally,somecouplesmayhaveethical,religious,orpersonalreservationsaboutusingART.

Withinthiscontext,TCMmayofferamoreholisticandindividualizedapproachtofertilitytreatment.Byaddressingunderlyingimbalancesandpromotingoverallhealthandwellness,TCMmaybeabletoimprovereproductivehealthoutcomesinamorenaturalandsustainableway.However,itisimportanttonotethatTCMshouldnotbeusedinplaceoforasasubstituteforconventionalmedicaltreatment,butratherasacomplementarytherapytoenhancetheeffectivenessofARTandpromoteoverallhealthandwellness.

Overall,thefindingsofthisstudysuggestthatTCMmaybeapromisingapproachtoimprovingfertilityoutcomesincouplesexperiencingembryonicarrest.Bytakingapersonalizedandholisticapproachtotreatment,TCMpractitionerscanoffertargetedinterventionstoaddressunderlyingimbalancesandpromoteoverallhealthandwellness.However,furtherresearchisneededtofullyevaluatetheefficacyandsafetyofTCMinterventionsinthiscontext.Assuch,coupleswhoareexperiencingfertilityissuesmaywishtoconsiderdiscussingTCMtreatmentoptionswithaqualifiedpractitioneraspartofacomprehensiveapproachtocareTCMhasalonghistoryofuseintreatingfertilityissues.OneofthekeyprinciplesofTCMisthepromotionofbalancewithinthebody,andthisisparticularlyrelevantinthecontextoffertility,whereimbalancescanbeamajorcontributingfactortoinfertility.TCMoffersarangeofinterventionsthatcanbetailoredtotheuniqueneedsofeachindividual,includingherbalremedies,acupuncture,dietaryandlifestylemodifications,andstressreductiontechniques.

HerbalremediesareacornerstoneofTCM,andmanypractitionerswillrecommendspecificherbsandformulastoaddressfertilityissues.Forexample,dongquaiiscommonlyusedtosupporthormonalbalanceandregulatemenstrualcycles,whiledangguibuxuetang,acombinationofdongquai,astragalus,andotherherbs,isfrequentlyprescribedtoimprovebloodcirculationandpromotefertility.Similarly,acupunctureisoftenusedincombinationwithherbalremediestoaddressimbalancesandpromotereproductivehealth.

DietarymodificationsareanotherimportantaspectofTCMtreatmentforfertility,withpractitionersrecommendingfoodsthatcansupporthormonalbalanceandreproductivefunction.Forexample,womenwhoaretryingtoconceivemaybeadvisedtoeatfoodsthatarehighinfolicacidandothernutrientsthatsupportreproductivehealth,suchaslentils,spinach,andavocados.Menmaybeadvisedtoconsumefoodsthatsupportfertility,suchasoysters,pumpkinseeds,andwalnuts.

LifestylemodificationsarealsoimportantinTCMtreatmentforfertility,withpractitionersrecommendingexercise,stressreductiontechniques,andotherlifestylemodificationstosupportreproductivehealth.Forexample,yogaandmeditationarefrequentlyrecommendedtohelpreducestressandpromoterelaxation,whichcansupportfertility.Similarly,moderateexercisecanhelptoimprovebloodcirculationandoverallhealth,whichcanalsopromotereproductivefunction.

Overall,TCMoffersapersonalizedandholisticapproachtotreatingfertilityissues,withpractitionerstakingintoaccounttheuniqueneedsofeachindividualandtailoringinterventionsaccordingly.Whilefurtherresearchisneededtofullyevaluatetheeffic