習慣性流產的中西醫觀點文獻探討

Viewpoints of Recurrent Pregnancy Loss in Traditional Chinese Medicine and Western Medicine

習慣性流產對於懷孕的婦女與家庭而言對身心都造成極大的影響，本文嘗試藉由文獻搜尋來探討中西醫學習慣性流產的病因病機與治療方式，以期未來利用中西醫結合治療習慣性流產的問題。從各大電子期刊資料庫搜尋的文獻顯示習慣性流產的危險因子及可能原因如孕婦年齡、子宮體異常、基因染色體異常、前次流產次數、內分泌系統疾患、免疫疾患如抗磷脂抗體症候群、凝血功能異常等等，但超過一半以上的習慣性流產患者沒有確定診斷。胎孕的形成在於先天之腎氣、母體後天之脾胃化生的氣血所育養。若腎氣虧虛，衝任不固，則胎失所繫；脾胃失調，生化乏源，則胎失所養，造成衝任損傷、胎元不固以致滑胎。現今臨床上發現子宮肌瘤、子宮內膜異位、與免疫相關的疾患、人工流產日漸增多，易形成瘀血內阻胞宮，胎失血養。在補腎健脾、益氣養血的安胎基本原則之下，活血化瘀亦是安胎的重要一環。

Recurrent pregnancy loss can cause great frustration to pregnant women and their families on both physical and mental sides. This article attempts to research the etiology, pathogenesis and treatments of recurrent pregnancy loss in traditional Chinese medicine and Western medicine, with a view to integrate traditional Chinese medicine and Western medicine to treat recurrent pregnancy loss in the future. Through literature searching from major journal databases, the risk factors and possible causes of recurrent pregnancy loss, such as the age of pregnant women, uterine abnormalities, genetic chromosomal abnormalities, the number of previous abortions, endocrine disorders, immune disorders such as antiphospholipid antibody syndrome, blood coagulation dysfunction, etc. However, more than half of patients with recurrent pregnancy loss have no confirmed diagnosis. In traditional Chinese medicine theory, the formation of fetal pregnancy is nourished by innate kidney qi and acquired spleen qi from mother. Insufficiency of kidney qi and spleen qi would lead to poor nutrition to fetus, which may cause miscarriage. Nowadays, uterine myoma, endometriosis, immune-related diseases, and artificial abortion cases increase in clinical practice. These gynecological and obstetrical problems make women become easily forming blood stasis in the uterus causing miscarriage. The basic principles of miscarriage prevention in traditional Chinese medicine are supplementing kidney and fortifying spleen, boosting qi and nourishing blood. Last but not least, enhancing blood circulation and removing blood stasis is also an important part of miscarriage prevention.