剖宫产瘢痕妊娠（CSP）为异位妊娠的特殊类型，严重威胁女性生育健康。邓高丕教授为广东省名中医，对异位妊娠的 辨治颇有心得，认为异位妊娠的关键病机为瘀阻少腹、冲任不畅，核心在“瘀”，病位在胞宫。CSP为异位妊娠的特殊类型， 其病机与异位妊娠相似，CSP的发病缘于女性剖宫产后正气不足，气血津液运行受阻，痰浊瘀血凝滞冲任胞宫，出现血脉瘀 滞、络脉受损，致孕卵着床于瘢痕之上。治疗CSP从痰瘀互结、瘀结成癥的病机入手，以益气活血、化瘀消癥为主要治法， 选用化瘀消癥颗粒（由丹参、赤芍、桃仁、牛膝、牡丹皮、天花粉、紫草等组成）及理冲汤（由黄芪、党参、白术、山药、三 棱、莪术、知母、天花粉、鸡内金等组成）为基础方；依据“气旺生血，气行瘀去”的气血关系，重视气血辨治；兼顾地域 特色及个体化，善用岭南道地药材如布渣叶、广地龙等。在预防CSP及防治其并发症方面，邓高丕教授提倡健脾生肌，从源 头上祛除剖宫产操作所造成的子宫创面受损；而针对“瘀阻胞宫”造成的湿热蕴下焦所致的并发症，临床处方时可加强清 热祛湿活血。

Cesarean scar pregnancy （CSP） is a special type of ectopic pregnancy （EP） that poses a serious threat to women’s reproductive health. Professor Deng Gaopi，a renowned traditional Chinese medicine （TCM） expert of Guangdong Province， has extensive experience in the diagnosis and treatment of EP. He believes that the key pathogenesis of EP is due to the obstruction of blood stasis in the lower abdomen and the disharmony of chong-ren meridians，with the core pathogenic factor of blood stasis and with the disease location in the uterus. As a special type of EP， CSP shares the similar pathogenesis to that of EP. The occurrence of CSP is attributed to the obstruction of qi， blood and body fluids induced by insufficient healthy qi after cesarean delivery， and then phlegm-turbidity and blood stasis congealing in the chong-ren meridians and uterus， resulting in blood vessel stasis and collateral damage，which causes the fertilized egg to implant in the scar. The treatment of CSP should start from the pathogenesis of phlegm blended with blood stasis and stasis developing into masses，with the main therapeutic methods of supplementing qi， activating blood， resolving stasis， and removing masses. The foundational prescriptions include Huayu Xiaozheng Granules （composed of Salviae Miltiorrhizae Radix et Rhizoma，Paeoniae Radix Rubra，Persicae Semen，Achyranthis Bidentatae Radix，Moutan Cortex，Trichosanthis Radix， Arnebiae Radix，etc.） and Lichong Decoction （composed of Astragali Radix，Codonopsis Radix，Atractylodis Macrocephalae Rhizoma， Dioscoreae Rhizoma， Sparganii Rhizoma， Curcumae Rhizoma， Anemarrhenae Rhizoma，Trichosanthis Radix，Galli Gigerii Endothelium Corneum，etc.）. Based on the relationship between qi and blood，i.e.，the enrichment of qi promoting the generation of blood，and the movement of qi promoting the removal of stasis，he emphasizes the importance of treatment based on qi-blood differentiation. Additionally，he is skillful in using genuine Lingnan medicinal herbs such as Microctis Folium and Guangdong Pheretima based on regional characteristics and following the principle of individualization. In terms of preventing CSP and its complications，Professor Deng advocates for strengthening the spleen and promoting granulation to fundamentally eliminate to the endometrial damage caused by cesarean section. For complications caused by damp-heat accumulation in the lower energizer which results from the obstruction of blood stasis in the uterus，heat-clearing， dampness-removing，and blood-activating actions should be enhanced in the clinical prescriptions for treatment.

R271.41

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