子宫内膜异位症不孕的中医临床研究思路与方法ClinicalstudyApproac.ppt

子宫内膜异位症不孕的中医临床研究思路与方法 Clinical study Approaches on TCM of Endometriosis-related Infertility 广州中医药大学妇科 欧阳惠卿 Ouyang Huiqing Gynecological Department, Guangzhou University of TCM March.22.2009 New York . USA 子宫内膜异位症不孕Endometriosis-related Infertility 子宫内膜异位症（内异症）是指有生长功能的子宫内膜组织在子宫腔以外的组织和器官生长，并因异位内膜病灶的存在引发一系列临床症状和体征的疾病。 Endometriosis is a disorder in which abnormal growths of tissue, histologically resembling the endometrium, are present in locations other than the uterine lining. 子宫内膜异位症不孕Endometriosis-related Infertility 结婚2年，同居、性生活正常，未避孕而不孕者称之为不孕症 A couple is said to be infertile if pregnancy does not result after 1 year of normal sexual activity without contraceptives. 子宫内膜异位症不孕Endometriosis-related Infertility 与内异症共存的不孕症称为内异症不孕. It has been suggested that endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon; for this reason it is preferable to speak of endometriosis-related infertility in such cases. 子宫内膜异位症不孕 患内异症的妇女中合并不孕的约有30－50％，不孕症患者约有30－58％同时患有内异症。 According to medical statistics it is estimated that 30-40% of women with endometriosis are also infertile. 30-58% of infertile women are found to have endometriosis. 内异症不孕发病机理 (一) Pathogenesis Ⅰ 1、盆腔器官解剖结构改变 1.The implication of endometrial adhesions 内异症的盆腔存在程度不同的粘连 ，使输卵管的拾卵以及在输卵管内的输送障碍 ； 内膜异位病灶，直接影响受孕 ； If the Endometriosis related adhesions obstruct or close off the fallopian tube, they could obstruct the pathway of the egg and sperm and thus prevent conception; 内异症不孕发病机理 (一) Pathogenesis Ⅰ 卵巢周围粘连影响排卵； 盆腔腹膜的痛性结节造成的性交痛，可使性交频率减少甚至拒绝性交，从而减少了受孕机会 ； 子宫后倾固定，宫颈向前变位难以接触精液池，影响了精子的输入 ； Adhesions around the ovary could influence ovulation; Endometriosis also leads to dyspareunia due to some tender nodules in the posterior vaginal fornix; Sperm motility may also be influenced by the cul-de-sac adhesions of the uterus. 内异症不孕发病机理 (二) Pathogenesis Ⅱ 2、盆腔局部免疫环境的改变 2.Endometriosis causes reduced immune function in the Pelvic Cavity 盆腔内异位