经方治疗妇人慢性盆腔痛探讨
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摘要
慢性盆腔痛是女性的常见病、疑难病,可属中医"妇人腹痛"等范畴。经方加减在妇科慢性盆腔痛应用广泛且有较好疗效。本病病变复杂,其本为虚,其标与水、湿、瘀等病理产物相关。疾病初期病位多在三阳,以太阳膀胱蓄水、太阳与阳明蓄血,阳明胃肠腑热、湿热,少阳疏泄失调为主,常用方有桃核承气汤、抵挡汤、抵挡丸、柴胡汤类方。病久转入三阴,可三阴病并见,以太阴脾、少阴肾亏虚,厥阴肝寒为主,常用方有太阴理中类、建中汤类,少阴四逆辈;厥阴病可选用当归四逆汤、乌梅丸等;此外,张仲景治疗妇人腹痛,以当归芍药散养血柔肝、健脾利湿、行气止痛;温经汤调太阴、少阴、厥阴,温经散寒,养血祛瘀。经方为妇科疑难疾病慢性盆腔痛的中医诊治提供新思路。
Chronic pelvic pain(CCP) is a common stubborn disease in women,which belongs to the category of woman abdominal pain in traditional Chinese medicine. Modified classical prescriptions were applied in chronic pelvic pain widely and efficiently. The pathogenesis of CCP is complicated, the essence of which is deficiency and is closely related with pathological products such as fluid, dampness and static blood. The early stage is mainly involving three yang channels, to be specific, taiyang stagnated fluid, taiyang and yangming stagnated blood, yangming damp-heat, and shaoyang disturbance of conveyance and dispersion, Taohe Chengqi Decoction, Didang Decoction, Didang Pill, Xiaochaihu Decoction, etc. were commonly used. With the progression of disease, three yin channels were affected, spleen and kidney deficiency, and jueyin with cold damage were main pathogenesis, Lizhong Decotion, Jianzhong Decoction, Sini Decoction, Danggui Sini Decoction, Wumei Pill, etc. were commonly used. In the same time, ZHANG Zhong-jing commonly used Danggui Shaoyao Power to nourishing blood and live, invigorating spleen for eliminating dampness and regulating qi-flowing for relieving pain, while used Wenjing Decoction to adjust three yin channels, warming channel for dispelling cold and nourishing blood and dispelling stasis when treating woman abdominal pain.The use of classical prescriptions has provided a new idea in treatingchronic pelvic pain by traditional Chinese medicine.
Chronic pelvic pain(CCP) is a common stubborn disease in women,which belongs to the category of woman abdominal pain in traditional Chinese medicine. Modified classical prescriptions were applied in chronic pelvic pain widely and efficiently. The pathogenesis of CCP is complicated, the essence of which is deficiency and is closely related with pathological products such as fluid, dampness and static blood. The early stage is mainly involving three yang channels, to be specific, taiyang stagnated fluid, taiyang and yangming stagnated blood, yangming damp-heat, and shaoyang disturbance of conveyance and dispersion, Taohe Chengqi Decoction, Didang Decoction, Didang Pill, Xiaochaihu Decoction, etc. were commonly used. With the progression of disease, three yin channels were affected, spleen and kidney deficiency, and jueyin with cold damage were main pathogenesis, Lizhong Decotion, Jianzhong Decoction, Sini Decoction, Danggui Sini Decoction, Wumei Pill, etc. were commonly used. In the same time, ZHANG Zhong-jing commonly used Danggui Shaoyao Power to nourishing blood and live, invigorating spleen for eliminating dampness and regulating qi-flowing for relieving pain, while used Wenjing Decoction to adjust three yin channels, warming channel for dispelling cold and nourishing blood and dispelling stasis when treating woman abdominal pain.The use of classical prescriptions has provided a new idea in treatingchronic pelvic pain by traditional Chinese medicine.
引文
[1]曹泽毅.中华妇产科学.北京:人民卫生出版社,2014:1322-2329
[2]冷金花.重视慢性盆腔痛的诊治.中国实用妇科与产科杂志,2013,29(3):161-163
[3]汉·张仲景.金匮要略.北京:人民卫生出版社,2008:75-87
[4]陈聪,陆启滨.《伤寒论》热入血室与妇科疾病的关系浅析.上海中医药杂志,2016,50(7):35-36
[5]张雅冬,张英,李云波.四逆汤与通脉四逆汤治疗月经病临床举隅.辽宁中医杂志,2015,42(4):867-868
[6]李际强,杨荣源.试论四逆散证之病机为少阴阳郁.时珍国医国药,2007,18(6):1424-1425
[7]刘颖.运用刘云鹏经验治疗子宫内膜异位症痛经.中华中医药杂志,2013,28(10):2961-2963
[8]闫军堂,刘晓倩.论仲景对妇人腹痛的临床辨治.广州中医药大学报,2011,28(3):311-313,316
[9]郑佳,赵宏利.《金匮要略》温经汤中的圆运动及临床运用.江西中医药大学学报,2016,28(5):33-34,48
[10]马大正.论经方在妇科领域的拓展应用.中华中医药杂志,2015,30(10):3463-3465
[2]冷金花.重视慢性盆腔痛的诊治.中国实用妇科与产科杂志,2013,29(3):161-163
[3]汉·张仲景.金匮要略.北京:人民卫生出版社,2008:75-87
[4]陈聪,陆启滨.《伤寒论》热入血室与妇科疾病的关系浅析.上海中医药杂志,2016,50(7):35-36
[5]张雅冬,张英,李云波.四逆汤与通脉四逆汤治疗月经病临床举隅.辽宁中医杂志,2015,42(4):867-868
[6]李际强,杨荣源.试论四逆散证之病机为少阴阳郁.时珍国医国药,2007,18(6):1424-1425
[7]刘颖.运用刘云鹏经验治疗子宫内膜异位症痛经.中华中医药杂志,2013,28(10):2961-2963
[8]闫军堂,刘晓倩.论仲景对妇人腹痛的临床辨治.广州中医药大学报,2011,28(3):311-313,316
[9]郑佳,赵宏利.《金匮要略》温经汤中的圆运动及临床运用.江西中医药大学学报,2016,28(5):33-34,48
[10]马大正.论经方在妇科领域的拓展应用.中华中医药杂志,2015,30(10):3463-3465
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