1.首都医科大学附属北京中医医院 北京 100010
2.北京中医药大学
张董晓,女,博士,主任医师,博士生导师
#刘秀茹,女,主任医师,E-mail:bjzyyyrxk@163.com
纸质出版日期:2022-09-30,
收稿日期:2021-11-06,
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张董晓, 谭玉培, 赵文洁, 等. 从肝脾辨治乳头溢液经验总结[J]. 现代中医临床, 2022,29(5):68-71.
ZHANG Dongxiao, TAN Yupei, ZHAO Wenjie, et al. Syndrome differentiation and treatment of nipple discharge from the perspective of the liver and spleen[J]. Modern Chinese Clinical Medicine, 2022,29(5):68-71.
张董晓, 谭玉培, 赵文洁, 等. 从肝脾辨治乳头溢液经验总结[J]. 现代中医临床, 2022,29(5):68-71. DOI: 10.3969/j.issn.2095-6606.2022.05.016.
ZHANG Dongxiao, TAN Yupei, ZHAO Wenjie, et al. Syndrome differentiation and treatment of nipple discharge from the perspective of the liver and spleen[J]. Modern Chinese Clinical Medicine, 2022,29(5):68-71. DOI: 10.3969/j.issn.2095-6606.2022.05.016.
乳头溢液属中医“乳泣”“乳汁自出”范畴,血性溢液属“乳衄”范畴。房家外科在乳腺等各类外科疾病诊疗方面经验丰富,本文总结房家外科从肝脾辨治乳头溢液的经验。临床以辨病为先。病机上,病责肝脾,认为乳头溢液和肝郁化火及脾虚失统关系密切;治疗上,针对肝郁化火、血热妄行和脾虚失统、痰凝血瘀两类证候,分别予疏肝清热、凉血止血及健脾行气、活血化痰之法;同药异治,根据同一味中药炮制方法、采摘时机、入药部位等不同而辨证使用;在乳头溢液治疗中擅用玄参和仙鹤草两味中药。
Nipple discharge belongs to the category of
rǔ qì
(nipple dripping) and
rǔ zhī zì chū
(spontaneous secretion of milk) in traditional Chinese medicine
while bloody discharge is referred to as
rǔ nǜ
(thelorrhagia). The Fang’s School of Surgery has rich experience in the diagnosis and treatment of various surgical diseases such as breast diseases. This paper summarizes the experience of the Fang’s School of Surgery in treating nipple discharge from the perspective of the liver and spleen. Syndrome differentiation is the priority in the clinical diagnosis and treatment of the disease. The pathogenesis is believed to lie in the liver and spleen
and it is suggested that nipple discharge is closely related to liver constraint transforming into fire and spleen deficiency causing it to lose control of the blood. In terms of treatment
the method of soothing liver and clearing heat
cooling blood and stanching bleeding is adopted for liver constraint transforming into fire and frenetic flow of the blood caused by blood heat
and in the case of spleen deficiency and the result ant loss of its function to control the blood
phlegm coagulation
and blood stasis
it is needed to invigorate the spleen and promote the flow of qi
invigorate blood and dissolve phlegm. The Fang’s school believes that one herb can have different medical efficacy based on how it is processed
when it is picked
and which part of the plant is used
etc. In the treatment of nipple discharge
Radix Scrophulariae and Herba Agrimoniae are the key ingredients.
肝脾辨治乳头溢液房家外科
syndrome differentiation and treatment from the perspective of the liver and spleennipple dischargeFang’s School of Surgery
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