| 何美秀,谢秀超.从少阳论治宫内妊娠组织残留初探[J].浙江中医药大学学报,2022,46(7):800-804. |
| 从少阳论治宫内妊娠组织残留初探 |
| Preliminary Exploration of Treating Residual Intrauterine Pregnancy Tissue from Shaoyang |
| DOI：10.16466/j.issn1005-5509.2022.07.019 |
| 中文关键词: 少阳 宫内妊娠组织残留 和解少阳 行气祛瘀 通利冲任 小柴胡汤 三川汤 |
| 英文关键词: Shaoyang residual intrauterine pregnancy tissue harmonizing Shaoyang promoting Qi and removing blood stasis unblocking the Chongren Xiaochaihu Decoction Sanchuan Decoction |
| 基金项目:四川省中医药管理局面上项目(2021MS479) |
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| 中文摘要: |
| [目的] 探析从少阳论治宫内妊娠组织残留的理论依据及临证经验。 [方法] 通过查阅宫内妊娠组织残留的相关文献、整理医案并溯源古籍，从宫内妊娠组织残留的病因病机、经络理论基础、古籍溯源、用药经验等方面探析从少阳论治宫内妊娠组织残留的理论依据及临证经验，并附验案一则予以佐证。[结果] 笔者认为，“药物、金刃、产创损伤冲任、胞宫，血室正开而胞衣残留，余血未尽，产后胞宫、胞脉空虚，感受风寒邪毒，风寒邪毒与血相结，瘀阻冲任、胞宫”是宫内妊娠组织残留的基本病机。笔者从多方面探析从少阳论治宫内妊娠组织残留的理论依据，以“和解少阳、行气祛瘀、通利冲任”为基本大法，选用少阳证经方小柴胡汤治疗本病，考虑到宫内妊娠组织残留瘀血较之热入血室更加严重，故而合用三川汤。所举医案中，患者为顺产2 d后，产创损伤冲任、胞宫，血室正开而胞衣残留，起病急骤，正气未虚，诊断为宫内妊娠组织残留热入血室(瘀血证)，治以和解少阳、行气祛瘀、通利冲任，以小柴胡汤合三川汤化裁排出宫内残留的妊娠组织，依据舌脉及兼症，随症加减，方证相应，故收全功。[结论] 从少阳论治宫内妊娠组织残留，选用小柴胡汤合三川汤加减治疗本病，以达到“和解少阳、行气祛瘀、通利冲任”之效，临床疗效显著，值得推广应用。 |
| 英文摘要: |
| [Objective] To explore the theoretical basis and empirical experience of treating residual intrauterine pregnancy tissue from Shaoyang. [Methods] Through consulting the documents of residual intrauterine pregnancy tissue and medical cases， tracing ancient books， from the etiology and pathogenesis of residual intrauterine pregnancy tissue， meridian theory， ancient traceability， medication experience， the theoretical basis and proof experience of treating the residual intrauterine pregnancy tissue from Shaoyang were investigated， and one case was attached. [Results] The author believes that “Chongren and uterine damage due to drugs， knives， trauma during childbirth， blood chamber is open with membrane residue， the remaining blood is not exhausted， the postpartum uterus and blood vessels are empty， affected with the wind-cold evil， and the wind-cold evil poison is combined with the blood， leading to the blood stasis in the Chongren and the uterus” which are the basic pathogenesis of residual intrauterine pregnancy tissue. The author explores the theoretical basis for the treatment of residual intrauterine pregnancy tissue from Shaoyang from many aspects. The basic method is “harmonizing Shaoyang， promoting Qi and removing blood stasis， and unblocking the Chongren”. Considering that the residual blood stasis in intrauterine pregnancy tissue is more serious than the heat entering the blood chamber， Sanchuan Decoction should be used in combination. In the medical case cited， the patient had a vaginal delivery 2 days later， trauma during childbirth leading to sputum and uterine damage， blood chamber was open with placenta and fetal membranes residue. The onset of illness was sudden， the righteousness was not empty， the patient was diagnosed as residual intrauterine pregnancy tissue-heat entering the blood chamber(blood stasis syndrome)， and the treatment was to harmonize Shaoyang， promote Qi and remove blood stasis， and unblock the Chongren. Xiaochaihu Decoction and Sanchuan Decoction were used to eliminate residual intrauterine pregnancy tissue， according to the tongue pulse and concurrent symptoms， added or subtracted according to the symptoms， the prescription and syndrome were corresponding， so the good results were achieved. [Conclusion] In order to achieve the effect of “harmonizing Shaoyang， promoting Qi and removing blood stasis， and unblocking the Chongren”， Xiaochaihu Decoction and Sanchuan Decoction are adopted to treat residual intrauterine pregnancy tissue from Shaoyang. The clinical curative effect is significant and it is worthwhile to promote applications. |
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