文章摘要
楼毅云,傅萍.从《黄帝内经》“二阳之病发心脾”论治“女子不月”[J].浙江中医药大学学报,2022,46(3):276-279.
从《黄帝内经》“二阳之病发心脾”论治“女子不月”
Exploration of the Theory of “Disorder of Two Yang May be Affected by Disorders of the Heart or Spleen” of Inner Canon of Yellow Emperor for the Treatment of “Women Failing to Menstruate”
DOI:10.16466/j.issn1005-5509.2022.03.008
中文关键词: 二阳之病发心脾  隐曲  黄帝内经  月经  闭经  病机  治法
英文关键词: disorder of two Yang may be affected by disorders of the heart or spleen  depression  Inner Canon of Yellow Emperor  menstruation  amenorrhea  pathogenesis  treatment
基金项目:国家自然科学基金青年项目(81801475);浙江省中医药科技计划项目(2019ZA078、2020ZA074);杭州市科技计划项目(20180533B51);浙江省医坛新秀培养项目(浙卫办[2020]18号)
作者单位
楼毅云 杭州市中医院 杭州 310007 
傅萍 杭州市中医院 杭州 310007 
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中文摘要:
      [目的] 探析《黄帝内经》“二阳之病发心脾,有不得隐曲”对“女子不月”临床辨治的意义。[方法] 以“二阳之病发心脾,有不得隐曲”的论点出发,通过分析“二阳之病”和“发心脾”的各家注释以及其临证意义,阐述月经的正常生理过程和“女子不月”的病因病机,从而提出闭经、月经后期等疾病的辨证论治。[结果] 《黄帝内经》认为病心脾可及阳明胃肠,而病阳明亦可影响心脾,阳明亏虚、津伤燥热、心气不通是胞脉闭阻、血海不充、经断不月等“女子不月”病证的主要病因病机;主张对闭经从阳明、从心论治,以通利心气为主,多遣增津益液、调气养血、养阴润燥、利气解郁之品,辅以思想开导,帮助患者纾解情绪。[结论] 以“二阳之病发心脾”之论为基础,《黄帝内经》主张对“女子不月”的辨证当从阳明、从心论治出发,以调理脾胃为主,佐以通心气、和血脉、疏郁结,方能效如桴鼓。
英文摘要:
      [Objective] To explore the clinical significance of “disorder of two Yang may be affected by disorders of the heart or spleen, and the emotions should not be depressed” of Inner Canon of Yellow Emperor in the treatment of “women failing to menstruate”. [Methods] Based on the argument that “disorder of two Yang may be affected by disorders of the heart or spleen, and the emotions should not be depressed”, this paper analyzed the commentaries and clinical significance of “the disease of two Yang” and “affected by disorders of the heart or spleen”, then expounded the normal physiological process of menstruation and the etiology and pathogenesis of “women failing to menstruate”, and proposed the syndrome differentiation and treatment of amenorrhea and late menstruation. [Results] The Inner Canon of Yellow Emperor believed that the disorders of the heart and spleen can affect the Yangming stomach and intestines, and Yangming disease can also affect the heart and spleen. Yangming deficiency, loss of body fluid due to heat and dryness, impassability of Qi of the heart are the main etiology and pathogenesis of the “women failing to menstruate” disease syndrome, such as occlusion of vessels of the uterus, insufficient blood sea, menstrual dysfunction. It advocated the treatment of amenorrhea from the perspective of Yangming and heart, and the treatment should focus on dredging heart Qi. It tends to use the herbs of increasing body fluid, regulating Qi and nourishing blood, nourishing Yin and moistening dryness, promoting Qi and relieving depression. At the same time, psychological counselling for adjusting mood could assist treatment. [Conclusion] Based on the theory of “disorder of two Yang may be affected by disorders of the heart or spleen”, the Inner Canon of Yellow Emperor advocated the differentiation and treatment of “women failing to menstruate” syndrome from Yangming and heart. It proposed regulating the spleen and stomach, combined with channeling the heart Qi, harmonizing the blood and channels, dredging depression, in order to have good results.
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