从肝论治原发性痛经的思考和体会
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摘要
原发性痛经(primary dysmenorrhea,PD)是一种在青年女性中高发的病证。在月经期前、期间或期后出现小腹疼痛,甚至可向大腿内侧、会阴部等部位放射,严重者可出现恶心呕吐、冷汗淋漓、手足厥冷甚至昏厥等情况。现代医学对PD的病因尚不明确,尚缺有效药物。笔者通过总结文献,认为痛经与肝气有密切关系,病位在肝经,由肝气失常所致。因此,痛经当从肝论治。根据临床,将痛经分为虚实之证,分别采用养血柔肝,调补冲任,缓急止痛和疏肝理气,调理冲任,活血止痛的治则进行治疗,同时还可以采取针灸疗法进行治疗。
Primary Dysmenorrhea(PD) is a high-risk syndrome in young women.Abdominal pain occurs before,during or after the menstrual period,and even to the inside of the thigh,the perineum and other parts of the thigh,severe cases may occur nausea and vomiting,cold sweat dripping,cold hands and feet and even fainting.The etiology of PD in modern medicine is still unclear,and there is still no effective drug.By summarizing the literature,the author believes that dysmenorrhea is closely related to Liver Qi,and the disease is located in the Liver,which is caused by Liver dysfunction.Therefore,dysmenorrhea should be treated from perspective of the function of Liver.According to the clinical observation,the dysmenorrhea syndromes can be divided into the deficiency syndrome and the excessive syndrome.By using nourishing Blood to nourish Liver,adjusting the Chong and Ren meridian,relieving the spasm and pain,soothing the Liver Qi,promoting Blood to relieve pain as well as taking acupuncture and moxibustion therapy,the diseased can be treated properly.
Primary Dysmenorrhea(PD) is a high-risk syndrome in young women.Abdominal pain occurs before,during or after the menstrual period,and even to the inside of the thigh,the perineum and other parts of the thigh,severe cases may occur nausea and vomiting,cold sweat dripping,cold hands and feet and even fainting.The etiology of PD in modern medicine is still unclear,and there is still no effective drug.By summarizing the literature,the author believes that dysmenorrhea is closely related to Liver Qi,and the disease is located in the Liver,which is caused by Liver dysfunction.Therefore,dysmenorrhea should be treated from perspective of the function of Liver.According to the clinical observation,the dysmenorrhea syndromes can be divided into the deficiency syndrome and the excessive syndrome.By using nourishing Blood to nourish Liver,adjusting the Chong and Ren meridian,relieving the spasm and pain,soothing the Liver Qi,promoting Blood to relieve pain as well as taking acupuncture and moxibustion therapy,the diseased can be treated properly.
引文
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[2]华永庆,谢海棠,段金廒,等.当归芍药散治疗痛经的方药量效关系研究[J].中国临床药理学与治疗学,2009,14(5):557-563.
[3] 张仲景.金匮要略[M].上海:上海科学技术出版社,1985:227.
[4] 谭志洪,邓小英.陈国权教授治疗痛经临证经验举隅[J].时珍国医国药,2014,25(9):2272-2273.
[5]叶红.朱南孙治疗痛经用药经验[J].四川中医,1998,16(4):3-4.
[6]韩延华,王敏,张雪芝.从“肝主冲任”论治妇科杂病[J].中华中医药杂志,2013,28(11):3284-3286.
[7]韩延华,张雪芝,王敏.肝主冲任在月经病辨治中的应用[J].辽宁中医杂志,2013,40(5):833-834.
[8]张晓阳.耳针联合体针治疗原发性痛经100例[J].陕西中医,2008,29(11):1521-1522.
[9]刘杰.耳针治疗女兵痛经70例[J].人民军医,2010,53(2):117.
[10]丁玉梅,马晓勇.温针三阴交穴治疗原发性痛经[J].中国针灸,2009,29(11):883.
[11]何杰.中药穴位贴敷治疗原发性痛经32例[J].人民军医,2009,52(7):421.
[12]李素荷,杜淑佳.耳针治疗原发性痛经54例[J].中医外治杂志,2009,18(3):54-55.
[13]王爱玉.艾炷隔姜灸神阙穴治疗寒凝胞中型痛经60例疗效观察及护理[J].海南医学,2010,21(12):135-136.
[14]赵虹.针灸治疗痛经42例疗效分析[J].针灸临床杂志,2004,20(12):30.