孟安琪教授治疗慢性盆腔炎经验总结
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摘要
慢性盆腔炎是妇科常见病、多发病,好发于性生活活跃期的育龄期妇女,绝经后或未婚者本病少见。正常情况下,女性的生殖系统的防御机制较完善,若患者抵抗力下降,或因饮食、起居不慎,或急性盆腔炎未彻底治愈,转为慢性盆腔炎所致,但临床也可无急性炎症病史。病情较顽固,易反复发作,如机体抵抗力低下时,或气候炎热时,可有急性发作或症状加重,严重影响妇女的生活及工作,造成家庭及社会的负担。本病西医多以抗炎、理疗治疗为主,临床效果欠佳,现多以中医药治疗为主,临床疗效甚佳。中医认为慢性盆腔炎属妇人腹痛范畴,易发于生育年龄妇女,是指妇女不在行经、妊娠、产后期间发生的小腹或少腹疼痛,甚者痛连腰骶。本病常因经期产后失于调理,感受寒凉湿热之邪或情致不畅,气血运行不畅或素体脾肾阳虚,邪从寒化,以致冲任虚衰,胞脉失养,“不荣则痛”,或冲任不通,胞脉失畅,“不通则痛”。
导师孟安琪教授认为此病多以慢性腹痛为主,多属虚证,临床表现为本虚标实。孟教授灵活运用中医辨证论治思想,对慢性盆腔炎进行中医分型治疗,将慢性盆腔炎分为肾虚兼血瘀、脾虚湿阻两个症型,对于不同症型结合全身症状运用中药治疗,采用补虚为主兼以祛邪之法,分别治以补肾培元、活血化瘀,健脾祛湿,并从饮食、起居、情致等方面进行调理,临床取得满意疗效,故现对导师治疗慢性盆腔炎经验进行总结。
Chronic pelvic inflammatory disease is a gynecological common disease, occur in the sexually active period of women of childbearing age, postmenopausal, or unmarried rare in this disease. Under normal circumstances, the female reproductive system of defense mechanisms better, if the resistance in patients with decreased or diet, living carelessly, or acute pelvic inflammatory disease have not fully healed due to chronic pelvic inflammatory disease, but can also be no acute clinical inflammatory history. Condition more stubborn, easy to repeated attacks, such as low body resistance, or hot weather, may have aggravated symptoms of acute attack or a serious impact on women's life and work, resulting in the burden on families and society. The disease mostly Western anti-inflammatory, physical therapy-based, clinical ineffective, mostly of Chinese medicine are mainly very good clinical effect. TCM is a woman with chronic pelvic pain areas prone to women of childbearing age, is not passing women, pregnancy, postpartum belly or Shaofu during pain, pain with lumbosacral fraudulent claims. The disease often lost in the postpartum period due to conditioning, feeling cold and cool damp heat evil, or the delight poor, or poor blood running ferrite spleen and kidney yang, evil from the cold, that it Chong and Ren virtual failure, cell pulse dystrophy, "No Wing is pain," or red either blocked, loss of cell connections Chang, "General Principles of pain is not." Instructor Professor Meng Anqi that the disease occurs in chronic abdominal pain, mostly deficiency, clinical performance-based vacuity. Professor Meng flexible use of traditional Chinese medicine, thinking, chronic pelvic inflammatory type of TCM treatment of chronic pelvic inflammatory disease will be divided into the kidney and blood stasis, dampness deficiency syndrome type 2, for different types associated with systemic disease symptoms using traditional Chinese medicine, used mainly tonic and to dispel an evil of law rule to kidney culture yuan respectively, blood circulation, spleen and dampness, and from eating, living, the delight in areas such as conditioning, to achieve a satisfactory clinical efficacy, it is the treatment of the instructor summarize the experience of chronic pelvic inflammatory disease.
导师孟安琪教授认为此病多以慢性腹痛为主,多属虚证,临床表现为本虚标实。孟教授灵活运用中医辨证论治思想,对慢性盆腔炎进行中医分型治疗,将慢性盆腔炎分为肾虚兼血瘀、脾虚湿阻两个症型,对于不同症型结合全身症状运用中药治疗,采用补虚为主兼以祛邪之法,分别治以补肾培元、活血化瘀,健脾祛湿,并从饮食、起居、情致等方面进行调理,临床取得满意疗效,故现对导师治疗慢性盆腔炎经验进行总结。
Chronic pelvic inflammatory disease is a gynecological common disease, occur in the sexually active period of women of childbearing age, postmenopausal, or unmarried rare in this disease. Under normal circumstances, the female reproductive system of defense mechanisms better, if the resistance in patients with decreased or diet, living carelessly, or acute pelvic inflammatory disease have not fully healed due to chronic pelvic inflammatory disease, but can also be no acute clinical inflammatory history. Condition more stubborn, easy to repeated attacks, such as low body resistance, or hot weather, may have aggravated symptoms of acute attack or a serious impact on women's life and work, resulting in the burden on families and society. The disease mostly Western anti-inflammatory, physical therapy-based, clinical ineffective, mostly of Chinese medicine are mainly very good clinical effect. TCM is a woman with chronic pelvic pain areas prone to women of childbearing age, is not passing women, pregnancy, postpartum belly or Shaofu during pain, pain with lumbosacral fraudulent claims. The disease often lost in the postpartum period due to conditioning, feeling cold and cool damp heat evil, or the delight poor, or poor blood running ferrite spleen and kidney yang, evil from the cold, that it Chong and Ren virtual failure, cell pulse dystrophy, "No Wing is pain," or red either blocked, loss of cell connections Chang, "General Principles of pain is not." Instructor Professor Meng Anqi that the disease occurs in chronic abdominal pain, mostly deficiency, clinical performance-based vacuity. Professor Meng flexible use of traditional Chinese medicine, thinking, chronic pelvic inflammatory type of TCM treatment of chronic pelvic inflammatory disease will be divided into the kidney and blood stasis, dampness deficiency syndrome type 2, for different types associated with systemic disease symptoms using traditional Chinese medicine, used mainly tonic and to dispel an evil of law rule to kidney culture yuan respectively, blood circulation, spleen and dampness, and from eating, living, the delight in areas such as conditioning, to achieve a satisfactory clinical efficacy, it is the treatment of the instructor summarize the experience of chronic pelvic inflammatory disease.
引文
[1]乐杰.妇产科学.北京:人民卫生出版社,2008:246.
[2]马宝璋.中医妇科学.[M]第一版.北京:中国中医药出版社,2004:293.
[3]赖冠珍,尤昭玲.慢性盆腔炎中医研究进展.中医药导报.2005,11(11):76-78.
[4]刘祖如.中医综合疗法治疗慢性盆腔炎湿热瘀结证疗效观察.河北中医.2005,27(12):893-894.
[5]曹大农.中医药治疗慢性盆腔炎的临床思维.中医药学报.2003,31(2):8-9.
[6]尹香花,匡继林,刘文娥.尤昭玲教授巧用药对治疗慢性盆腔炎经验拾萃.中医药学刊.2005,23(9):1572-1573.
[7]王清,经燕.试述许润三教授之慢性盆腔炎非“炎”说.中华中医药杂志.2006.21(4):223.
[8]盂静寿.辩证治疗慢性盆腔炎106例.辽宁中医杂志.2003,30(3):207.
[9]王晓元,夏桂成用调周法治疗慢性盆腔炎的经验.江苏中医.1999,20(11):6
[10]杨越.慢性盆腔炎的辩证与治疗.辽宁中医杂志.2004,31(1):53.
[11]陈玉伟.加减丹栀逍遥散治疗慢性盆腔炎60例临床观察.中医药导报.2005,11(5):33-34.
[12]陈华琴.化瘀消炎汤治疗慢性盆腔炎238例.山东中医杂志.1992,11(4):19.
[13]杨嘉珍.张达旭治疗慢性盆腔炎25例经验总结.山西中医杂志.1999,15(3):32.
[14]陈万秋.中药治疗慢性盆腔炎22例疗效观察.中国保健杂志.2006,14(2):114.
[15]连燕燕.中药保留灌肠治疗慢性盆腔炎100例分析.World Health Digest,2006,3(10):29 .
[16]田素芳,朱爱玲,宫巧红.中药灌肠治疗慢性盆腔炎96例疗效观察.中国社区医师.2003,19(2I):40 .
[17]郑红.温化活血汤保留灌肠治疗慢性盆腔炎86例.浙江中医杂志.200l, 36(10):426.
[18]秦蝉娟,刘蕾.秦氏化瘀止痛膏治疗慢性盆腔炎.河南中医.1999,19(2):45.
[19]王燕,蔡玉华,艾莉.阴道用药治疗慢性盆腔炎55例.中国医药学报.1998,13(2):33-34.
[20]耿萍.针灸治疗盆腔炎208例临床观察.针灸临床杂志.2000,16(2):24-25 .
[21]王雨波,李晓辉.中药内服灌肠治疗慢性盆腔炎90例.辽宁中医杂志.2003,30(8):654.
[22]李枫.慢性盆腔炎的综合治疗.中国医药导报.2008,5(24):218.
[23]栗双禺.盆腔炎病原体及其药敏检测情况分析.现代妇科进展.2003,12(2):142.
[24]任立强.中药治疗慢性盆腔炎36例.中国中医急症.2006,15(7):790.
[25]杨珍花.阿奇霉素配合中药治疗慢性盆腔炎52例疗效观察.广西医学.2008,30(7):1085.
[26]薛美华.抗生素联合用药辅助中药治疗慢性盆腔炎.现代中西医结合杂志.2007,16(3):344.
[27]岳邦振.细菌加L型菌组合培养在慢性盆腔炎诊治中的运用.中国基层医药.2004,11(2):185.
[28]缪江霞.从微生态角度研究中医妇科湿热证本质的思路和方法.2000,17(4):239-240.
[29]张三元.大肠杆菌所致大鼠慢性盆腔炎模型的建立.医学研究通讯.2001,30(2):11.
[30]周曰序等.大剂量糖皮质激素综合用药治疗慢性盆腔炎及其后遗症的探讨.天津医药.1995,23(11):675.
[31]李晶.超短波抗炎作用的机制探讨.中华理疗学杂志.1998,13(4):201.
[32]袁三衡.“音频电”配合药物治疗慢性前列腺炎120例.中华理疗学杂志.2000,13(4):207.
[33]曹泽毅.中华妇产科学.北京:人民卫生出版社,2000:1212.
[34]乐杰,谢幸,丰有吉.妇产科学.北京:人民卫生出版社,2005(第6版):274-275.
[35]曹泽毅.中华妇产科学.北京:人民卫生出版社,2005(第二版):1364-1365.
[2]马宝璋.中医妇科学.[M]第一版.北京:中国中医药出版社,2004:293.
[3]赖冠珍,尤昭玲.慢性盆腔炎中医研究进展.中医药导报.2005,11(11):76-78.
[4]刘祖如.中医综合疗法治疗慢性盆腔炎湿热瘀结证疗效观察.河北中医.2005,27(12):893-894.
[5]曹大农.中医药治疗慢性盆腔炎的临床思维.中医药学报.2003,31(2):8-9.
[6]尹香花,匡继林,刘文娥.尤昭玲教授巧用药对治疗慢性盆腔炎经验拾萃.中医药学刊.2005,23(9):1572-1573.
[7]王清,经燕.试述许润三教授之慢性盆腔炎非“炎”说.中华中医药杂志.2006.21(4):223.
[8]盂静寿.辩证治疗慢性盆腔炎106例.辽宁中医杂志.2003,30(3):207.
[9]王晓元,夏桂成用调周法治疗慢性盆腔炎的经验.江苏中医.1999,20(11):6
[10]杨越.慢性盆腔炎的辩证与治疗.辽宁中医杂志.2004,31(1):53.
[11]陈玉伟.加减丹栀逍遥散治疗慢性盆腔炎60例临床观察.中医药导报.2005,11(5):33-34.
[12]陈华琴.化瘀消炎汤治疗慢性盆腔炎238例.山东中医杂志.1992,11(4):19.
[13]杨嘉珍.张达旭治疗慢性盆腔炎25例经验总结.山西中医杂志.1999,15(3):32.
[14]陈万秋.中药治疗慢性盆腔炎22例疗效观察.中国保健杂志.2006,14(2):114.
[15]连燕燕.中药保留灌肠治疗慢性盆腔炎100例分析.World Health Digest,2006,3(10):29 .
[16]田素芳,朱爱玲,宫巧红.中药灌肠治疗慢性盆腔炎96例疗效观察.中国社区医师.2003,19(2I):40 .
[17]郑红.温化活血汤保留灌肠治疗慢性盆腔炎86例.浙江中医杂志.200l, 36(10):426.
[18]秦蝉娟,刘蕾.秦氏化瘀止痛膏治疗慢性盆腔炎.河南中医.1999,19(2):45.
[19]王燕,蔡玉华,艾莉.阴道用药治疗慢性盆腔炎55例.中国医药学报.1998,13(2):33-34.
[20]耿萍.针灸治疗盆腔炎208例临床观察.针灸临床杂志.2000,16(2):24-25 .
[21]王雨波,李晓辉.中药内服灌肠治疗慢性盆腔炎90例.辽宁中医杂志.2003,30(8):654.
[22]李枫.慢性盆腔炎的综合治疗.中国医药导报.2008,5(24):218.
[23]栗双禺.盆腔炎病原体及其药敏检测情况分析.现代妇科进展.2003,12(2):142.
[24]任立强.中药治疗慢性盆腔炎36例.中国中医急症.2006,15(7):790.
[25]杨珍花.阿奇霉素配合中药治疗慢性盆腔炎52例疗效观察.广西医学.2008,30(7):1085.
[26]薛美华.抗生素联合用药辅助中药治疗慢性盆腔炎.现代中西医结合杂志.2007,16(3):344.
[27]岳邦振.细菌加L型菌组合培养在慢性盆腔炎诊治中的运用.中国基层医药.2004,11(2):185.
[28]缪江霞.从微生态角度研究中医妇科湿热证本质的思路和方法.2000,17(4):239-240.
[29]张三元.大肠杆菌所致大鼠慢性盆腔炎模型的建立.医学研究通讯.2001,30(2):11.
[30]周曰序等.大剂量糖皮质激素综合用药治疗慢性盆腔炎及其后遗症的探讨.天津医药.1995,23(11):675.
[31]李晶.超短波抗炎作用的机制探讨.中华理疗学杂志.1998,13(4):201.
[32]袁三衡.“音频电”配合药物治疗慢性前列腺炎120例.中华理疗学杂志.2000,13(4):207.
[33]曹泽毅.中华妇产科学.北京:人民卫生出版社,2000:1212.
[34]乐杰,谢幸,丰有吉.妇产科学.北京:人民卫生出版社,2005(第6版):274-275.
[35]曹泽毅.中华妇产科学.北京:人民卫生出版社,2005(第二版):1364-1365.