盆腔炎性疾病后遗症分期辨体辨证辨病论治内涵初探
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摘要
盆腔炎性疾病后遗症亦称为慢性盆腔炎,其业已成为当今社会妇女常见的疾患之一,当然这种现象的产生与现代妇女流产的增多和生活习性的改变都有着密切的联系。这不单在身心方面给妇女们带来诸多不便,也因之造成不少后续影响,许多不孕症和宫外孕患者就曾经有过慢性盆腔炎病史,而这也进一步加深了对妇女身心的伤害。与此同时,也引发了不少家庭和社会潜在的问题,因此笔者认为很有必要对盆腔炎的治疗作出相关阐述,并对其运用的内涵进行尝试性探讨,以便于更好地解决妇女的身心问题。
慢性盆腔炎是现代医学的病名,古代医籍中无此病名,相类似的症状散见于“带下病”、“妇人腹痛”、“症瘕”等疾病之中,因此希望通过对于病名的梳理和古今医家治疗的比较,进行粗略的归拢,理清脉络,令其更具有整体的可观性,如此在具体问题的认识上就不致有偏颇之见。
在慢性盆腔炎的治疗中,不同的医家其入手点均有不同,或活用周期,或详察证候明于辨病,或有对体质问题的思考,因而便尝试从时间周期、体质分型、证候辨别、辨病论治四个部分探讨其对慢性盆腔炎治疗的影响,同时对其内涵进行初步探究。在探寻其内在关联的过程中,着重从医理方面进行阐释,以期从更大的一个格局上看待这个问题,务求明理为先,则临证方有变化之妙。
时间周期古今医家均可见其运用,临床所见多从妇人月经的周期上着眼,而这里所论述的时间周期则从更广义的角度来看,既包含了天地的运行周期,也包含了人身的周期。因为人位于天地气交之中,要想以不病而调病,两者的规律就需兼而明之。而天地的规律则从岁运、四时、月相、昼夜依次而言,虽大小不同,然生长收藏则一。以人身而论则也有生理的大小周期。如此两者参合,何时当用何时当舍只在医者之裁夺。
体质辨识由来已久,于《内经》中便可窥其概貌,后世医家亦有所阐发,然而诸多体质的提法究竟何者最切用于妇人乃至于临床,唯有仔细甄别并验之于后人。不可否认的是通过体质的辨识,只要对患者出现的复杂证候与不同体质类型的大致归属性拥有整体把握,就能较好的掌控治疗方向,这在治疗上的指导意义是较大的。
证候辨别是古今医家诊疾治病的核心,具有不可替代的地位,尽管慢性盆腔炎的证候并不复杂,然而要想辨认精准提高疗效,却需回归到古人认清辨证的内涵和运用的关键,深入了解其演变的内因何在,如此才能在新的时代中彰显其内在的精义,更好的服务于临床。
辨病于中医学上溯源则早于辨证论治,晋唐时期是其发展的鼎盛时期,后于宋明而相对隐没,时至现今已形成了自身较为完整的体系,然而西医学对疾病的认识亦有其独到而详尽的一面,两者在实际的治疗中应如何需找其契入点是值得寻思的。当然现代医家运用西医的辨病已有所成效,而在理论的融通上若能取得突破也许能进一步提高疗效。
四个部分的论述旨在对其内涵的探讨,其中难免有未尽详明之处,然存疑之处亦是进步之处,唯有求之于临床以兹检验。
Sequelae of pelvic inflammatory disease, also known as chronic pelvic inflammatory disease, has become one of the common disorder of women in society today, of course, the generation of this phenomenon with modern women to have abortions increased and living habits of the change are closely linked. This is not only physically and mentally give the women a lot of inconvenience, but also consequent to cause a lot of follow-up impact of infertility and ectopic pregnancy in patients who had a history of chronic pelvic inflammatory disease, which further deepened the women's physical and mental harm. At the same time, it also raised a lot of family and social potential problems, so1believe it is necessary for the treatment of pelvic inflammatory disease related to elaborate, and its use of the connotation of the tentative explore in order better to address women's physical and mental problems.
Chronic pelvic inflammatory disease is a disease name of modern medicine, no such disease name in the ancient medical books, similar to the symptoms of gynecological disease scattered woman, abdominal pain, pelvic mass, and other diseases, so I hope by the comb for nonaggressive comparison of treatment and ancient and modern physicians, roughly a trace-to clarify the context, making it more overall impressive, so on the understanding of specific issues will not be a biased opinion.
In the treatment of chronic pelvic inflammatory disease, different physicians starting points are different, or utilize the cycle, or the detailed observation syndrome by disease, or thinking of the physical problem, and thus they try, physical type from the time periodsyndrome to identify, distinguish the disease on the Treatment of four parts to investigate the treatment of chronic pelvic inflammatory disease, while its connotation to conduct a preliminary inquiry. Focus from the medical knowledge in the process of exploring its inherent associated interpretation in order to look at this issue from a bigger pattern, in order to sensible first, the Clinical side of change.
Time period of ancient and modern physicians can see the use of clinical findings on the focus from the woman menstrual cycle, the time period here discussed from a broader point of view, includes both the run cycle of the heavens and the earth, but also includes personal cycle. Because people in the world gas pay into, in order to adjust disease without disease, both the law would need to part and Ming. The laws of heaven and earth from the old Wan, seasons month phase, day and night, in turn, although of different sizes, then the growth of the collection is. Personal terms, the size of the physiological cycle. So the two parameters together, when when when when homes only doctors who consider and decide.
A long history of physical identification, Neijing can see the overview Doctors later also elucidate, however, many physical reference to exactly what is cut for a woman even clinical, only carefully screened and experience in later generations. It is undeniable that physical identification, as long as the overall grasp of complex syndrome patients with different types of constitutions generally attributable to have, you can better control treatment direction, guiding significance in the treatment of larger.
Card waiting to identify the core of ancient and modern physicians attending disease treatment, has an irreplaceable position, although the syndrome of chronic pelvic inflammatory disease is not complicated, however, in order to identify the precise improve efficacy, but need to return to the ancients a clear understanding of the dialectic of meaning and use of the key, in-depth understanding of what the evolution of the internal, in order to highlight the new era of its inner essence, to better serve the clinical.
By disease in the medical traceable earlier than diagnosis and treatment, the Jin and Tang period was the heyday of its development, after the Song and Ming relatively hidden, to the present has its own complete system, however, Western medicine is the understanding of disease its unique and detailed, both in how the actual treatment need to find the Contact point is worth wondering. Of course, by disease of the modern physician use of Western medicine has been the effectiveness of in the theory of intermediation, if a breakthrough might be able to further improve efficacy.
The four-part discusses the aims of its connotation, which will inevitably not entirely full and clear the natural doubts at the progress at the only help of trend clinical certificates for inspection.
慢性盆腔炎是现代医学的病名,古代医籍中无此病名,相类似的症状散见于“带下病”、“妇人腹痛”、“症瘕”等疾病之中,因此希望通过对于病名的梳理和古今医家治疗的比较,进行粗略的归拢,理清脉络,令其更具有整体的可观性,如此在具体问题的认识上就不致有偏颇之见。
在慢性盆腔炎的治疗中,不同的医家其入手点均有不同,或活用周期,或详察证候明于辨病,或有对体质问题的思考,因而便尝试从时间周期、体质分型、证候辨别、辨病论治四个部分探讨其对慢性盆腔炎治疗的影响,同时对其内涵进行初步探究。在探寻其内在关联的过程中,着重从医理方面进行阐释,以期从更大的一个格局上看待这个问题,务求明理为先,则临证方有变化之妙。
时间周期古今医家均可见其运用,临床所见多从妇人月经的周期上着眼,而这里所论述的时间周期则从更广义的角度来看,既包含了天地的运行周期,也包含了人身的周期。因为人位于天地气交之中,要想以不病而调病,两者的规律就需兼而明之。而天地的规律则从岁运、四时、月相、昼夜依次而言,虽大小不同,然生长收藏则一。以人身而论则也有生理的大小周期。如此两者参合,何时当用何时当舍只在医者之裁夺。
体质辨识由来已久,于《内经》中便可窥其概貌,后世医家亦有所阐发,然而诸多体质的提法究竟何者最切用于妇人乃至于临床,唯有仔细甄别并验之于后人。不可否认的是通过体质的辨识,只要对患者出现的复杂证候与不同体质类型的大致归属性拥有整体把握,就能较好的掌控治疗方向,这在治疗上的指导意义是较大的。
证候辨别是古今医家诊疾治病的核心,具有不可替代的地位,尽管慢性盆腔炎的证候并不复杂,然而要想辨认精准提高疗效,却需回归到古人认清辨证的内涵和运用的关键,深入了解其演变的内因何在,如此才能在新的时代中彰显其内在的精义,更好的服务于临床。
辨病于中医学上溯源则早于辨证论治,晋唐时期是其发展的鼎盛时期,后于宋明而相对隐没,时至现今已形成了自身较为完整的体系,然而西医学对疾病的认识亦有其独到而详尽的一面,两者在实际的治疗中应如何需找其契入点是值得寻思的。当然现代医家运用西医的辨病已有所成效,而在理论的融通上若能取得突破也许能进一步提高疗效。
四个部分的论述旨在对其内涵的探讨,其中难免有未尽详明之处,然存疑之处亦是进步之处,唯有求之于临床以兹检验。
Sequelae of pelvic inflammatory disease, also known as chronic pelvic inflammatory disease, has become one of the common disorder of women in society today, of course, the generation of this phenomenon with modern women to have abortions increased and living habits of the change are closely linked. This is not only physically and mentally give the women a lot of inconvenience, but also consequent to cause a lot of follow-up impact of infertility and ectopic pregnancy in patients who had a history of chronic pelvic inflammatory disease, which further deepened the women's physical and mental harm. At the same time, it also raised a lot of family and social potential problems, so1believe it is necessary for the treatment of pelvic inflammatory disease related to elaborate, and its use of the connotation of the tentative explore in order better to address women's physical and mental problems.
Chronic pelvic inflammatory disease is a disease name of modern medicine, no such disease name in the ancient medical books, similar to the symptoms of gynecological disease scattered woman, abdominal pain, pelvic mass, and other diseases, so I hope by the comb for nonaggressive comparison of treatment and ancient and modern physicians, roughly a trace-to clarify the context, making it more overall impressive, so on the understanding of specific issues will not be a biased opinion.
In the treatment of chronic pelvic inflammatory disease, different physicians starting points are different, or utilize the cycle, or the detailed observation syndrome by disease, or thinking of the physical problem, and thus they try, physical type from the time periodsyndrome to identify, distinguish the disease on the Treatment of four parts to investigate the treatment of chronic pelvic inflammatory disease, while its connotation to conduct a preliminary inquiry. Focus from the medical knowledge in the process of exploring its inherent associated interpretation in order to look at this issue from a bigger pattern, in order to sensible first, the Clinical side of change.
Time period of ancient and modern physicians can see the use of clinical findings on the focus from the woman menstrual cycle, the time period here discussed from a broader point of view, includes both the run cycle of the heavens and the earth, but also includes personal cycle. Because people in the world gas pay into, in order to adjust disease without disease, both the law would need to part and Ming. The laws of heaven and earth from the old Wan, seasons month phase, day and night, in turn, although of different sizes, then the growth of the collection is. Personal terms, the size of the physiological cycle. So the two parameters together, when when when when homes only doctors who consider and decide.
A long history of physical identification, Neijing can see the overview Doctors later also elucidate, however, many physical reference to exactly what is cut for a woman even clinical, only carefully screened and experience in later generations. It is undeniable that physical identification, as long as the overall grasp of complex syndrome patients with different types of constitutions generally attributable to have, you can better control treatment direction, guiding significance in the treatment of larger.
Card waiting to identify the core of ancient and modern physicians attending disease treatment, has an irreplaceable position, although the syndrome of chronic pelvic inflammatory disease is not complicated, however, in order to identify the precise improve efficacy, but need to return to the ancients a clear understanding of the dialectic of meaning and use of the key, in-depth understanding of what the evolution of the internal, in order to highlight the new era of its inner essence, to better serve the clinical.
By disease in the medical traceable earlier than diagnosis and treatment, the Jin and Tang period was the heyday of its development, after the Song and Ming relatively hidden, to the present has its own complete system, however, Western medicine is the understanding of disease its unique and detailed, both in how the actual treatment need to find the Contact point is worth wondering. Of course, by disease of the modern physician use of Western medicine has been the effectiveness of in the theory of intermediation, if a breakthrough might be able to further improve efficacy.
The four-part discusses the aims of its connotation, which will inevitably not entirely full and clear the natural doubts at the progress at the only help of trend clinical certificates for inspection.
引文
[1]、张晓丹, 《中西医结合妇产科学》,人民军医出版社
[2]、妾嗣明,盆腔炎的中西医结合治疗体会,医学信息2010年12月第23卷第12期
[3]、叶凌玫,浅谈盆腔粘连研究的现状与发展,长江大学学报(自然科学版)2011年10月第8卷第10期
[4]、李仁杰,经燕,许润三教授运用补法治疗慢性盆腔疼痛经验,中华中医药杂志2007年12月第22卷第12期
[5]、任慕兰,沈杨,袁晓琳,慢性盆腔炎的中医治疗近况概述,医学与哲学(临床决策论坛版)2009年8月第30卷第8期总第387期
[6]、寿清和,补肾活血法在慢性盆腔炎治疗中的应用价值,现代中西医结合杂志,2007年4月,16(12)
[7]、张亚丽,消痛散外敷治疗慢性盆腔炎40例[J],中医外治杂志,2004,8(1)：54-55
[8]、曲如玫,范杰先,外用活血化瘀法治疗慢性盆腔炎临床观察[J],实用医技杂志,2005,12(24)：3707
[9]、郭国田,张华,穴位注射治疗慢性盆腔炎56例疗效观察[J],吉林中医药,2005,25(8)：34
[10]、许佩华,2种保留灌肠法治疗慢性盆腔炎的疗效比较[J],现代中西医结合杂志,2005,14(10)：1302-1303
[11]、凌霞,吴英会,杨宗孟教授临床诊治经验探析[J],中华中医药学刊,2009,27(1)：113-114
[12]、方震,温针治疗慢性盆腔炎65[J], 山东中医杂志,2008,27(2)：107-108
[13]、罗元恺主编, 《中医妇科学》,人民卫生出版社,p377
[14]、清代傅山, 《傅青主男女科》,中国中医药出版社
[15]、陈慧侬, 《妇科盆腔疼痛症的中医诊治》,广西民族出版社
[16]、潘鸿硕,李凤梅,《妇女炎症中医治疗学》,人民卫生出版社
[17]、王清,经燕,试述许润三教授之慢性盆腔炎非“炎” 说,2006年第21卷第4期中华中医药杂志(原中国医药学报)
[18]、王停主编,《秦氏妇科经验辑要》,中国中医药出版社
[19]、任慕兰,沈杨,袁晓琳,慢性盆腔炎的中医治疗近况概述,医学与哲学(临床决策论坛版)2009年8月第30卷第8期总第387期
[20]、辨体质、辨病、辨证“三位一体”诊疗模式与糖尿病临床实践,赵进喜,丁英钧,王颖辉,李景,中华中医药杂志2009年8月第24卷第8期
[21]、陈树东；浅析《内经》月节律补泻论治思想,,光明中医2010年5月第25卷第5期
[22]、刘炳权,苏详主编,《古今时间医学一一择时诊病服药针灸》,广东科技出版社
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[26]、郭志强主编,郭志强临床经验辑要,人民军医出版社
[27]、李仁杰,经燕,许润三教授运用补法治疗慢性盆腔疼痛经验,中华中医药杂志(原中国医药学报)2007年12月第22卷第12期CJTCMP
[28]、张庆祥,辨病论治与辨证论治关系探析,辽宁中医杂志2005年第32卷第2期
[29]、李鸿芝,胡秀荣,治疗输卵管阻塞性不孕症的经验,1993年第8卷第3期中国医药学报
[30]、贫秀莲,戴朝寿,薏苡附子败酱散治疗输卵管积液52例,国医论坛1996年第11卷第5期(总59期)
[31]、王海燕,乔杰, 马彩虹,陈新娜,范燕宏,王丽娜,李蓉,腹腔镜下治疗输卵管粘连及远端梗阻的临床结局,中国微创外科杂志2007年3月第7卷第3期
[2]、妾嗣明,盆腔炎的中西医结合治疗体会,医学信息2010年12月第23卷第12期
[3]、叶凌玫,浅谈盆腔粘连研究的现状与发展,长江大学学报(自然科学版)2011年10月第8卷第10期
[4]、李仁杰,经燕,许润三教授运用补法治疗慢性盆腔疼痛经验,中华中医药杂志2007年12月第22卷第12期
[5]、任慕兰,沈杨,袁晓琳,慢性盆腔炎的中医治疗近况概述,医学与哲学(临床决策论坛版)2009年8月第30卷第8期总第387期
[6]、寿清和,补肾活血法在慢性盆腔炎治疗中的应用价值,现代中西医结合杂志,2007年4月,16(12)
[7]、张亚丽,消痛散外敷治疗慢性盆腔炎40例[J],中医外治杂志,2004,8(1)：54-55
[8]、曲如玫,范杰先,外用活血化瘀法治疗慢性盆腔炎临床观察[J],实用医技杂志,2005,12(24)：3707
[9]、郭国田,张华,穴位注射治疗慢性盆腔炎56例疗效观察[J],吉林中医药,2005,25(8)：34
[10]、许佩华,2种保留灌肠法治疗慢性盆腔炎的疗效比较[J],现代中西医结合杂志,2005,14(10)：1302-1303
[11]、凌霞,吴英会,杨宗孟教授临床诊治经验探析[J],中华中医药学刊,2009,27(1)：113-114
[12]、方震,温针治疗慢性盆腔炎65[J], 山东中医杂志,2008,27(2)：107-108
[13]、罗元恺主编, 《中医妇科学》,人民卫生出版社,p377
[14]、清代傅山, 《傅青主男女科》,中国中医药出版社
[15]、陈慧侬, 《妇科盆腔疼痛症的中医诊治》,广西民族出版社
[16]、潘鸿硕,李凤梅,《妇女炎症中医治疗学》,人民卫生出版社
[17]、王清,经燕,试述许润三教授之慢性盆腔炎非“炎” 说,2006年第21卷第4期中华中医药杂志(原中国医药学报)
[18]、王停主编,《秦氏妇科经验辑要》,中国中医药出版社
[19]、任慕兰,沈杨,袁晓琳,慢性盆腔炎的中医治疗近况概述,医学与哲学(临床决策论坛版)2009年8月第30卷第8期总第387期
[20]、辨体质、辨病、辨证“三位一体”诊疗模式与糖尿病临床实践,赵进喜,丁英钧,王颖辉,李景,中华中医药杂志2009年8月第24卷第8期
[21]、陈树东；浅析《内经》月节律补泻论治思想,,光明中医2010年5月第25卷第5期
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