试论先兆流产的中医证型分布规律

目的:寻求先兆流产的中医证型分布规律与孕妇年龄、孕龄及既往流产次数的关系。方法:通过对485例确诊为先兆流产的患者进行回顾性分析,根据四诊八纲分型,按统计学方法,探讨证型分布规律。结果:发现本病好发年龄为24～35岁,其证型分布由大到小依次为肾虚型>脾肾两虚型>血热型>肾虚血瘀型>气血虚弱型>外伤型,以虚证为主。肾虚是本病的基本环节,随着疾病发展,更伤及脾(脾肾两虚),甚至久病入络为瘀(肾虚血瘀),致虚实夹杂之证。结论:孕妇年龄、孕龄和流产史与再次妊娠发生先兆流产中医证型分布有内在联系,尤其与肾虚证候出现密切相关。

The Exploration of the Distribution of TCM Syndromes in the Threatened Abortion

Objective:To explore the relation between the distribution of TCM syndromes in threatened abortion and the relative factors of the pregnant age, the gestational age and previous abortive times. Methods:Through the review of 485 cases of diagnostic threatened abortion with retrospective analysis, based on four diagnostic methods and syndrome differentiation with eight principles, to investigate the distribution by means of statistical methods. Results:Our finding shows that the threatened abortion is frequent among the age from 24 to 35. The distribution of the syndromes is as follows (in descending order of frequency):deficiency of the kidney, deficiency of both the spleen and the kidney, blood heat, deficiency of the kidney with blood stagnation, deficiency of both qi and blood, trauma. The deficiency syndromes are the major ones with the kidney deficiency as the basic link. And with the development of the disease, the spleen will be affected (that is deficiency of both the spleen and the kidney). In addition, the blood stagnation may arise because of the lasting disease (namely deficiency of the kidney with blood stagnation). Finally, a complicated syndrome of deficiency and excess come into being. Conclusion:The pregnant age, the gestational age and the history of abortion are associated closely with the distribution of TCM syndromes in threatened abortion, especially with he kidney deficiency.