| 曹泽宁,袁慧慧,肖扬,等.张景岳辨治崩漏的学术思想探析[J].浙江中医药大学学报,2022,46(4):421-423, 432. |
| 张景岳辨治崩漏的学术思想探析 |
| Exploration and Analysis of ZHANG Jingyue's Academic Thoughts on Diagnosis and Treatment of Uterine Bleeding |
| DOI：10.16466/j.issn1005-5509.2022.04.012 |
| 中文关键词: 景岳全书 张景岳 崩漏 阴虚阳搏 温补脾胃 情志致病 |
| 英文关键词: Complete Works of ZHANG Jingyue ZHANG Jingyue uterine bleeding Yin deficiency and Yang excess warming the spleen and stomach emotional disease |
| 基金项目:浙江省医药卫生科技计划项目(2019RC134) |
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| 中文摘要: |
| [目的] 探析张景岳对崩漏的辨治思路及方药应用。[方法] 通过研读《景岳全书》中有关崩漏的论述内容，分析张景岳论治崩漏的病因病机认识，总结其治疗本病的治则治法、遣方用药，并以验案加以佐证。[结果] 张景岳以阴阳为总纲，认为本病基本病机为“阴虚阳搏”“先损脾胃，次及冲任”，以阴虚为主，辨治过程中需明辨五脏虚实、气血，以治血为要；重视温补脾胃，不忘寒凉又不妄投寒凉；强调情志致病，应调情志、疏肝郁；治疗时还应考虑年龄，异期异治，顺应天时。遣方用药体现“有是证，用是方”的原则，如阴虚有火者常用保阴煎等滋阴清热止血，营气虚无火者择五福饮、四物、四君类益气凉血，血脱甚者予举元煎急以固脱等。所附医案以张景岳治疗崩漏思想为指导，采用其方保阴煎加减，以疏肝健脾、滋阴清热、凉血止血为法治疗崩漏淋漓不尽，临床疗效确切。[结论] 张景岳治疗崩漏不止理法方药完备，师古而不拘泥，对后世崩漏的辨治具有重要指导意义。 |
| 英文摘要: |
| [Objective] To explore ZHANG Jingyue's thoughts on differentiation and treatment of uterine bleeding and the application of prescriptions. [Methods] By studying the content of uterine bleeding in Complete Works of ZHANG Jingyue， this paper analyzed ZHANG Jingyue's understanding of the etiology and pathogenesis of uterine bleeding， and summarized the treatment methods and prescriptions for this disease， and corroborated them with empirical case. [Results] ZHANG Jingyue took Yin and Yang as the general outline， and believed that the basic pathogenesis of this disease was that“Yin deficiency and Yang excess”“damaged the spleen and stomach first， and then Chong-Ren”， and Yin deficiency was the main result. In the process of differential treatment， it was necessary to distinguish deficiency and excess of the five viscera， Qi and blood， and the important thing was to treat blood; attention should be paid to warming and tonifying the spleen and stomach， without forgetting cold drugs or using cold drugs arbitrarily; for emotion disease， it should adjuste motion and soothe the liver depression; treatment should also consider age， different treatments in different periods， adapt to the weather. Prescriptions and medications reflected the principle of “there is the syndrome，there is the prescription”. For example， for those with Yin deficiency and fire， Baoyin Decoction was often used to nourish Yin and clear heat to stop bleeding; for those who suffered from deficiency of Ying Qi without fire， Wufu Drink， Siwu， Sijun type should be chosen to benefit Qi and cool blood， and those with blood loss should be given Juyuan Decoction for urgentl solidification， and so on. The attached medical case was guided by ZHANG Jingyue's thoughts on treating uterine bleeding， modified Baoyin Decoction was used to soothe the liver and invigorate the spleen， nourish Yin and clear heat， cool blood and stop bleeding as the method to treat metrorrhagia and bleeding， and the clinical effect was accurate. [Conclusion] ZHANG Jingyue's prescription for the treatment of uterine bleeding is complete， which is of great significance to the differentiation and treatment of uterine bleeding in later generations. |
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