谢萍论治崩漏经验
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摘要
谢萍教授认为崩漏的病机总属脾肾不足,冲任失固,多生热夹瘀,其中尤以瘀阻之轻重程度难辨。谢老师认为,子宫内膜退化脱落的部位、深度及范围不同步,导致修复困难,是出血时间延长的关键所在,子宫内膜厚度是无排卵型功能失调性子宫出血发展变化的外在表现。谢老师根据正常子宫内膜周期性变化,结合临床实践,将出血期子宫内膜厚度分为厚型(单层> 8 mm)、常规型(单层=5～8 mm)、薄型(单层<5 mm),辅以其他常用检测手段,辨证论治,灵活运用塞流之法。谢老师认为应顺应胞宫生理藏泻,在补肾健脾固冲的基础上,灵活运用逐瘀止崩、化瘀止崩、收涩止崩三法。
Professor Xie Ping thinks that the pathogenesis of metrorrhagia is generally insufficient spleen and kidney,dysfunction of TV and CV,which leads to heat combined with blood stasis. Especially the degree of blood stasis is difficult to distinguish. Professor Xie believes that the location,depth and extent of endometrial degeneration and exfoliation are not synchronized,leading to difficult repair,which is the key to prolonging bleeding time. Endometrial thickness is the external manifestation of the development and change of anovulatory dysfunctional uterine bleeding. According to the periodic changes of normal endometrium and combined with clinical practice,Professor Xie has divided the thickness of endometrium in bleeding period into thick type( single layer > 8 mm),conventional type( single layer = 5-8 mm),thin type( single layer < 5 mm),supplemented by other commonly used detection methods,syndrome differentiation and treatment,and flexible use of unblocking method. On the basis of nourishing the kidney and invigorating the spleen and strengthening TV,Professor Xie flexibly applies the following three methods: removing stasis to stop metrorrhagia,dissolving stasis to stop metrorrhagia,and astringing to stop metrorrhagia.
Professor Xie Ping thinks that the pathogenesis of metrorrhagia is generally insufficient spleen and kidney,dysfunction of TV and CV,which leads to heat combined with blood stasis. Especially the degree of blood stasis is difficult to distinguish. Professor Xie believes that the location,depth and extent of endometrial degeneration and exfoliation are not synchronized,leading to difficult repair,which is the key to prolonging bleeding time. Endometrial thickness is the external manifestation of the development and change of anovulatory dysfunctional uterine bleeding. According to the periodic changes of normal endometrium and combined with clinical practice,Professor Xie has divided the thickness of endometrium in bleeding period into thick type( single layer > 8 mm),conventional type( single layer = 5-8 mm),thin type( single layer < 5 mm),supplemented by other commonly used detection methods,syndrome differentiation and treatment,and flexible use of unblocking method. On the basis of nourishing the kidney and invigorating the spleen and strengthening TV,Professor Xie flexibly applies the following three methods: removing stasis to stop metrorrhagia,dissolving stasis to stop metrorrhagia,and astringing to stop metrorrhagia.
引文
[1]罗颂平,谈勇.中医妇科学[M].北京:人民卫生出版社,2013:78.
[2]谢幸,苟文丽.妇产科学[M].北京:人民卫生出版社,2013:344.
[3]巢元方.诸病源候论[M].北京:人民卫生出版社,1955:205.
[4]傅山.傅青主女科[M].北京:人民卫生出版社,2006:11-13.
[5]刘亮亮,隋峰,闫美娟,等.大黄炮制品各组分泻下作用的比较研究[J].中国实验方剂学杂志,2012,18(17):161-165.
[6]赵玲,胡昌江,耿媛媛,等.生、熟大黄及其在下瘀血汤中对热结血瘀模型大鼠血液流变学的影响[J].药物评价研究,2014,37(2):113-116.
[7]赵玲,胡昌江,潘新,等.下瘀血汤中大黄生熟互换对热结血瘀模型大鼠血管内皮功能及微循环的影响[J].药物评价研究,2014,37(5):413-416.
[8]郭慧玲,许茜茜,胡志方,等.四制香附对大鼠离体子宫平滑肌收缩的影响及作用机制研究[J].江西中医药大学学报,2014,26(5):76-78.
[9]张文富,戴铭,张璐砾,等.国医大师班秀文运用鸡血藤治疗妇科病拾遗[J].环球中医药,2018,11(5):784-786.
[10]许云飞,吴昀,李文春.益母草碱对大鼠肠系膜动脉的力学效应及其机制探讨[J].中国临床解剖学杂志,2017,35(5):548-553.
[11]陈自明.妇人大全良方[M].北京:人民卫生出版社,1985:23,461,578-579,636.
[12]边智伟,吴承玉.“女子以血为本”理论源流探析[J].中医药导报,2010,16(12):8-10.
[13]郑红.海螵蛸对胃黏膜损伤保护及其凝血、止血功效之研究[D].福州:福建农林大学,2015.
[14]杨艳芳.中原门氏家传方乌茜断丝散治疗崩漏经验[J].中医学报,2018,33(5):774-777.
[15] WANG W D,ZHANG N N,CHANDA W,et al. Antibacterial and anti-biofilm activity of the lipid extract from Mantidis ootheca on Pseudomonas aeruginosa[J]. Journal of Zhejiang UniversitySCIENCE B,2018,19(5):364-371.
[16]何燕飞,周祺,陈华,等.中药炭药的临床应用及作用机理研究[J].氨基酸和生物资源,2015,37(3):1-6.
[17]石丽,宋莹莹,陈云侠.中药炮制对中药微量元素的影响研究[J].河北医药,2011,33(18):2854-2855.
[2]谢幸,苟文丽.妇产科学[M].北京:人民卫生出版社,2013:344.
[3]巢元方.诸病源候论[M].北京:人民卫生出版社,1955:205.
[4]傅山.傅青主女科[M].北京:人民卫生出版社,2006:11-13.
[5]刘亮亮,隋峰,闫美娟,等.大黄炮制品各组分泻下作用的比较研究[J].中国实验方剂学杂志,2012,18(17):161-165.
[6]赵玲,胡昌江,耿媛媛,等.生、熟大黄及其在下瘀血汤中对热结血瘀模型大鼠血液流变学的影响[J].药物评价研究,2014,37(2):113-116.
[7]赵玲,胡昌江,潘新,等.下瘀血汤中大黄生熟互换对热结血瘀模型大鼠血管内皮功能及微循环的影响[J].药物评价研究,2014,37(5):413-416.
[8]郭慧玲,许茜茜,胡志方,等.四制香附对大鼠离体子宫平滑肌收缩的影响及作用机制研究[J].江西中医药大学学报,2014,26(5):76-78.
[9]张文富,戴铭,张璐砾,等.国医大师班秀文运用鸡血藤治疗妇科病拾遗[J].环球中医药,2018,11(5):784-786.
[10]许云飞,吴昀,李文春.益母草碱对大鼠肠系膜动脉的力学效应及其机制探讨[J].中国临床解剖学杂志,2017,35(5):548-553.
[11]陈自明.妇人大全良方[M].北京:人民卫生出版社,1985:23,461,578-579,636.
[12]边智伟,吴承玉.“女子以血为本”理论源流探析[J].中医药导报,2010,16(12):8-10.
[13]郑红.海螵蛸对胃黏膜损伤保护及其凝血、止血功效之研究[D].福州:福建农林大学,2015.
[14]杨艳芳.中原门氏家传方乌茜断丝散治疗崩漏经验[J].中医学报,2018,33(5):774-777.
[15] WANG W D,ZHANG N N,CHANDA W,et al. Antibacterial and anti-biofilm activity of the lipid extract from Mantidis ootheca on Pseudomonas aeruginosa[J]. Journal of Zhejiang UniversitySCIENCE B,2018,19(5):364-371.
[16]何燕飞,周祺,陈华,等.中药炭药的临床应用及作用机理研究[J].氨基酸和生物资源,2015,37(3):1-6.
[17]石丽,宋莹莹,陈云侠.中药炮制对中药微量元素的影响研究[J].河北医药,2011,33(18):2854-2855.