| 时珍,刘佳俐.子宫内膜异位症从蓄血证论治[J].浙江中医药大学学报,2020,44(2):170-172, 206. |
| 子宫内膜异位症从蓄血证论治 |
| Treatment of Endometriosis from Syndrome of Blood Accumulation |
| DOI：10.16466/j.issn1005-5509.2020.02.012 |
| 中文关键词: 伤寒论 蓄血证 瘀热互结 子宫内膜异位症 医案 临证经验 |
| 英文关键词: “Treatise on Febrile Diseases” syndrome of blood accumulation accumulation of blood stasis mixed with heat endometriosis medical cases clinical experience |
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| 中文摘要: |
| [目的]探讨以《伤寒论》蓄血证理论治疗子宫内膜异位症的可行性。[方法]通过跟师学习，结合《伤寒论》中蓄血证相关理论，从病机、证候、治疗几方面阐述子宫内膜异位症与蓄血证之间的相互关系，并列举验案加以分析佐证。[结果] 从临床角度看，蓄血证与子宫内膜异位症有相似之处，离经之血瘀滞，瘀热互结下焦是其病因病机，以少腹硬满胀痛、血下则缓为主要临床表现。破结逐瘀是其治疗大法，以抵当汤为治疗主方。临证施治时，根据月经周期、患者体质，在破结逐瘀泻热基础上，佐以补肾、健脾、温经、解痉，并配合针灸治疗。文中所附子宫内膜异位症病案，皆为瘀热互结下焦，从蓄血证论治，以水蛭、地鳖虫祛瘀消散离经之血，以大黄、猫爪草等泻热解毒，并防止病灶的异常出血，取得较好疗效。 [结论]以《伤寒论》蓄血证理论治疗下焦瘀热互结的一类疾病，如子宫内膜异位症等，疗效良好，值得临床推广应用。 |
| 英文摘要: |
| [Objective] To explore the feasibility of treating endometriosis from the theory of syndrome of blood accumulation of “Treatise on Febrile Diseases”.[Methods] Through learning from the teacher and combining with the theory of syndrome of blood accumulation of “Treatise on Febrile Diseases”, the relationship between endometriosis and syndrome of blood accumulafion was analyzed and expounded from the pathogenesis, syndrome and treatment, and two cases were presented as proof.[Results]From the clinical point of view, there are similarities between syndrome of blood accumulation and endometriosis. The cause and pathogenesis of syndrome of blood accumulation and endometriosis are both stagnation of leaving blood of meridians and accumulation of blood stasis mixed with heat in lower Jiao. The main clinical manifestations includes that the lower abdomen stiff fullness and distending pain, and the symptoms should be relieved after blood excretion. The main therapeutic method is resolving masses and dispersing blood stasis, and the main prescriptions are Didang decoction. During the clinical treatment, according to the menstrual cycle and the patient's constitution, on the basis of resolving masses and dispersing blood stasis and releasing heat, the treatment of tonifying the kidney, strengthening the spleen, warming the meridians, and relieving spasm should be adopted, combined with acupuncture and moxibustion. The cases of endometriosis attached in this paper were all caused by accumulation of blood stasis mixed with heat in lower Jiao, which can be treated from the syndrome of blood accumulation. Whitmania pigra Whitman and Eupolyphaga were used to remove blood stasis and dissipate the leaving blood of meridians, Rheum palmatum L. and Ranunculus ternatus Thunb. were used to release heat and toxin, and to prevent abnormal bleeding of the lesions, and good results were achieved.[Conclusion]It is effective to treat diseases of accumulation of blood stasis mixed with heat in lower Jiao from the theory of syndrome of blood accumulation of “Treatise on Febrile Diseases”, such as endometriosis, and is worthy popularization and application. |
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