“女子以肝为先天”在绝经综合征中的应用
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摘要
[目的]总结陈霞波教授运用"女子以肝为先天"理论辨治绝经综合征的经验。[方法]通过侍诊学习、收集整理陈霞波教授的医案,总结陈教授运用"女子以肝为先天"理论阐释绝经综合征病因病机和治疗方法的临床经验。并举验案一例以佐证。[结果]陈教授认为绝经综合征发病以肝为主导,治疗以调肝为要,创疏肝、清肝、滋肝、养肝四法,并注重乙癸同补、心肝同治、气血并调。而"女子以肝为先天"理论的核心内容强调了肝对于女子生理病理的重要性,提倡女科病从肝论治,这与绝经综合征病机特点和治疗方法如出一辙。所举验案辨为肝郁肾虚、阴阳失和之证,其肝郁之象显著,予丹栀逍遥散化裁疏肝解郁、协调阴阳治疗后,诸患皆和,可为证验。[结论]"女子以肝为先天"理论对于绝经综合征的诊断和治疗具有指导意义,值得后学借鉴。
[Objective] To summarize Professor CHEN Xiabo's experience in the treatment of menopausal syndrome with the theory of "the female take the liver as congenital". [Methods] Through the consultation, studying and collecting the medical records of Professor CHEN Xiabo, the clinical experience of Professor CHEN's in using of "the female take the liver as congenital" was summarized to explain the pathogenesis and treatment of menopausal syndrome. And a test case was presented to prove.[Results] Professor CHEN Xiabo believes that the onset of menopausal syndrome is dominated by the liver. The treatment is to adjust the liver, and to create the four methods of soothing the liver, clearing the liver, nourishing the liver and moisturizing the liver, and attention should be paid to simultaneous conditioning of liver and kidney, heart and liver, Qi and blood. The core content of "the female take the liver as congenital" is to emphasize the importance of liver for women's physiology and pathology and to advocate the treatment of female diseases from the liver, which is similar to the characteristics and treatment methods of menopausal diseases. The test case is identified as the Qi stagnation of liver, deficiency of the kidney, Yin and yang disorders, and the image of liver stagnation is remarkable. After using the Modification of Danzhi Xiaoyao Decoction to soothing the liver and coordinating yin and yang, all symptoms were alleviated and the theory and experience was verified.[Conclusion] The theory of "the female take the liver as congenital" has guiding significance for the diagnosis and treatment of menopausal syndrome, and is worth the future generations to learn from.
[Objective] To summarize Professor CHEN Xiabo's experience in the treatment of menopausal syndrome with the theory of "the female take the liver as congenital". [Methods] Through the consultation, studying and collecting the medical records of Professor CHEN Xiabo, the clinical experience of Professor CHEN's in using of "the female take the liver as congenital" was summarized to explain the pathogenesis and treatment of menopausal syndrome. And a test case was presented to prove.[Results] Professor CHEN Xiabo believes that the onset of menopausal syndrome is dominated by the liver. The treatment is to adjust the liver, and to create the four methods of soothing the liver, clearing the liver, nourishing the liver and moisturizing the liver, and attention should be paid to simultaneous conditioning of liver and kidney, heart and liver, Qi and blood. The core content of "the female take the liver as congenital" is to emphasize the importance of liver for women's physiology and pathology and to advocate the treatment of female diseases from the liver, which is similar to the characteristics and treatment methods of menopausal diseases. The test case is identified as the Qi stagnation of liver, deficiency of the kidney, Yin and yang disorders, and the image of liver stagnation is remarkable. After using the Modification of Danzhi Xiaoyao Decoction to soothing the liver and coordinating yin and yang, all symptoms were alleviated and the theory and experience was verified.[Conclusion] The theory of "the female take the liver as congenital" has guiding significance for the diagnosis and treatment of menopausal syndrome, and is worth the future generations to learn from.
引文
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[2]刘完素.素问病机气宜保命集[M].北京:人民卫生出版社,2017:140.
[3]叶天士.临证指南医案[M].北京:人民卫生出版社,2006:432.
[4]叶天士.未刻本叶氏医案[M].上海:上海科学技术出版社,2010:88.
[5]王明晶,王鑫杏,刘燕,等.浅谈肝司生殖[J].中华中医药杂志,2016,31(12):4953-4955.
[6]张介宾.景岳全书[M].杭州:浙江古籍出版社,2013:521.
[7]马遇春,丛慧芳,王振侠.论“枢机不利”为经断前后诸证的病机关键[J].湖北中医杂志,2015,37(3):43-44.
[8]丛春雨.中医妇科临床经验选[M].北京:中国中医药出版社,1994:135-137.
[9]王小云.路志正教授从湿论治更年期综合征经验介绍[J].新中医,2003,35(7):12-13.
[10]凌博越,傅萍,马娴.傅萍治疗围绝经期综合征经验[J].浙江中医药大学学报,2015,39(1):32-34.
[11]周学海.读医随笔[M].北京:中国中医药出版社,2007:170.
[12]谭程,李晓君.女子以肝为先天理论源流及临床应用[J].北京中医药大学学报(中医临床版),2010,17(4):30-31.