1.北京中医药大学中医学院 北京 100029
2.北京中医药大学护理学院
沈翊康,男,在读硕士生
#张保春,男,教授,硕士生导师,E-mail:zhangbaochun11@126.com
纸质出版日期:2022-09-30,
收稿日期:2021-11-25,
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沈翊康, 姜婧, 张钰欣, 等. 易水医家李东垣崩漏治法探究[J]. 现代中医临床, 2022,29(5):64-67.
SHEN Yikang, JIANG Jing, ZHANG Yuxin, et al. Study on the treatment of metrorrhagia and metrostaxis by Li Dongyuan of the Yishui School[J]. Modern Chinese Clinical Medicine, 2022,29(5):64-67.
沈翊康, 姜婧, 张钰欣, 等. 易水医家李东垣崩漏治法探究[J]. 现代中医临床, 2022,29(5):64-67. DOI: 10.3969/j.issn.2095-6606.2022.05.015.
SHEN Yikang, JIANG Jing, ZHANG Yuxin, et al. Study on the treatment of metrorrhagia and metrostaxis by Li Dongyuan of the Yishui School[J]. Modern Chinese Clinical Medicine, 2022,29(5):64-67. DOI: 10.3969/j.issn.2095-6606.2022.05.015.
崩漏,是指月经周期、经期、经量严重失常的病证。李东垣在《李东垣医学全书》妇人门“经漏不止有三”和“崩漏治验”篇中系统论述了对崩漏病的独特认识。在自身脾胃学说的基础上,李东垣认为脾胃气虚下陷,结合亢盛之阴火,形成湿热邪气是崩漏的主要病机。对于崩漏的临床辨证,李东垣认为最重要的是根据崩漏的病理产物判断寒热病性,并根据典型脉象对崩漏进行辨证。治疗应以补脾胃、泻阴火为根本大法,同时根据所兼夹的证候进行加减。脾胃虚损、心火乘脾治以调经升阳除湿汤,肾阴亏虚、相火妄动治以凉血地黄汤,心气不足、血虚寒盛治以丁香胶艾汤,血脱气陷、寒湿内盛治以自拟柴胡调经汤。此外,还有随时加减、外用灸法和情志疏导等治法特色。厘清李东垣的这些观点,对后世崩漏治法理论发展和临床应用研究具有指导意义。
Bēng Lòu
or metrorrhagia and metrostaxis
refers to the syndrome of serious abnormal menstrual cycle
duration and hypermenorrhea. Li Dongyuan systematically discussed his unique understanding of metrorrhagia and metrostaxis in two articles entitled
Three Types of Metrorrhagia and Metrostaxis
and
Treatments of Metrorrhagia and Metrostaxis
in his
Medical Encyclopedia of Li Dongyuan
. On the basis of his own theory of the spleen and stomach
Li believes that the main pathogenesis of metrorrhagia and metrostaxis is the deficiency and sinking of spleen and stomach qi
combined with exuberance of yin fire
creating damp-heat pathogenic qi. In the clinical syndrome differentiation of metrorrhagia and metrostaxis
Li believes that the most important thing is to determine the cold or heat nature of the disease using the pathological products
and conduct syndrome differentiation based on the typical pulse manifestations. For the treatment
the fundamental method is to tonify the spleen and stomach and purge yin fire
and make adjustments to the formulas according to the syndromes. Patients with spleen and stomach deficiency and heart fire attacking the spleen should be given Menstruation-Regulating
Yang-Rising and Dampness-Removing Decoction; those with kidney yin deficiency and frenetic stirring of ministerial fire should be treated with Blood-Cooling Rehmannia Decoction; in the case of heart qi deficiency and blood deficiency-cold
we should choose Clove
Donkey-Hide Gelatin and Mugwort Decoction; and if the pattern of blood collapse
sinking of qi
and excessive cold-dampness is present
Bupleurum Menstruation-Regulating Decoction
an original formula created by Li
can have desirable efficacy. These are also augmented with the principle of making modifications to the prescription at any time when needed
and the use of moxibustion and emotional counseling. Clarifying these philosophies of Li Dongyuan has guiding significance for the theoretical development and clinical research of metrorrhagia and metrostaxis treatment in later generations.
李东垣崩漏易水学派辨证论治
Li Dongyuanmetrorrhagia and metrostaxisYishui Schoolsyndrome differentiation and treatment
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