甲状腺功能减退症与先兆流产的相关性及治疗

近年来的研究发现甲减与先兆流产的关联性主要与下丘脑—垂体—卵巢轴调节、甲状腺素与卵泡刺激素的协同作用、自身免疫失衡、甲状腺相关抗体等因素有关,而中医方面认为两者主要病机都为脾肾阳虚,故甲减可致胞宫失养,系胎无力,最终发为"胎漏""胎动不安"。在临床过程中,防治甲状腺功能减退症已成为控制先兆流产发生率的必要措施之一,除西医的常规治疗方法外,中医根据其发病机制,主要以益气健脾、补肾温阳之法调整体内气血平衡,从而改善机体内分泌代谢状态,降低血清TSH水平,最终达到减少流产的目的。目前临床中主要有单纯中药疗法、中西医结合疗法及针刺疗法,而中西医疗法因其突出的疗效而被临床广泛应用。

The correlation between hypothyroidism and threatened abortion and its treatment of Chinese and Western Medicine

Recent studies have found that the relevance of hypothyroidism and threatened abortion mainly concerns the regulation of hypothalamus-hypophysis-ovarian axis、synergistic effect of thyroid hormone and follicle stimulating hormone、autoimmune imbalance、thyroid related antibodies and other factors. However,their main pathogenesis is Yang deficiency of spleen and kidney according to TCM. Therefore,hypothyroidism can cause failure of nourishment of uterus and fetal weakness,which finally causes ＂fetal leakage＂、＂threatened abortion＂. The prevention and treatment of hypothyroidism has become one of the necessary measures to control the incidence of threatened abortion in clinic. In addition to the conventional treatment of Western medicine,Chinese medicine treatment methods of replenishing Qi to invigorate the spleen、tonifying kidney and warming yang can adjust the balance between Qi and blood based on its pathogenesis so as to improve the endocrine metabolic state and lower the level of serum TSH to achieve final purpose to reduce the abortion. At present the main therapies in clinic are pure TCM therapy、combined therapy of Chinese and Western medicine and acupuncture therapy. The combined therapy of Chinese and Western medicine has been widely used in clinic for its prominent curative effect.