先兆性流産的中西醫治療

早期妊娠（懷孕20週以前）約有五分之一會發生陰道出血現象，稱為先兆性流產，它是婦女懷孕時最常發生的併發症之一，也常被認為是產生胚胎不良的危險徵兆，在中醫屬於「胎動不安」或「胎漏」的範圍。早期妊娠發生陰道出血現象約有一半是不正常的妊娠造成。一般而言，31至40歲的孕婦若有先兆性流產現象，發生流產的比率(27.1%)和16到20歲(18.2%)以及21至30歲相同情形的孕婦(7.1%)相比較起來明顯較高。曾經生產的次數、是否曾流產過及陰道出血量和次數則似乎並不影響流產的比率。倒是發生的時間會有影響，在第一孕期(first trimester)(15%)會比第二孕期(5.6%)後才發生陰道出血現象，更容易發生流產，尤其發生在六週以前發生率高達29%。中醫則認為本病病因有母體和胎元兩方面，造成衝任氣血不調，胎元不固，導致發病。先兆性流產西醫並無特效療法，黃體素和休息是兩個治療重點。中醫則依臨床表現約可分四個證型：腎虛型、氣血虛弱型、血熱型、跌倒傷胎一來辨證論治。

關鍵字

先兆性流產；陰道流血；胎動不安；胎漏

並列摘要

Vaginal bleeding before 20 gestational weeks, which is called threatened miscarriage, is the most common complication in early pregnancy, occurring in about a fifth of cases. It also implies that abnormal pregnancy is a significant contributory factor to miscarriage. Half of all reasons for vaginal bleeding in early pregnancy are attributed to abnormal pregnancy. General speaking, older women 31-40 years old had a significantly higher rate of miscarriage 27.1% compared to 18.2% in the group of 16-20 years of age and 7.1% in the group of 21-30 years of age. Parity, previous miscarriage, the amount and number of episodes of vaginal bleeding seem to have no influence in the rate of miscarriage. Bleeding in the first trimester carries a higher rate of miscarriage (15%) than bleeding in the second trimester (5.6%) and bleeding before 6 weeks gestation in particular has the higher rate of miscarriage (29%). In the Traditional Chinese medicine theory, the etiology of this disease can be attributed to two aspects: maternal and fetal. The imbalance of qi and blood of meridians and unhealthy fetus are considered the main factors. In the modern medicine, doctors often prescribe bed rest and progesterone for women with symptoms of threatened miscarriage. In Traditional Chinese medicine, treatments mainly depend on four types of symptoms: kidney deficiency, insufficiency of qi and blood, blood heat and trauma.

並列關鍵字

threatened miscarriage ； threatened abortion ； vaginal bleeding

國際替代計量

先兆性流産的中西醫治療

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