许斌从郁-补虚辨治乳癖  

XU Bin's Application of Jieyu and Buxu in the Treatment of Breast Hyperplasia

作　　者：李庆瑶 许斌[2] LI Qingyao;XU Bin(Liaoning University of Traditional Chinese Medicine ： 2016 Clinical Direction of Integrated Chinese and Western Medicine;Surgery of Integrated Traditional Chinese and Western Medicine of Affiliated Hospital,Shenyang 110847,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属医院中西医结合外科,沈阳110847

出　　处：《实用中医内科杂志》2018年第8期17-20,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：许斌教授认为乳癖主要为肝郁气滞、痰凝血瘀,兼有脾肾两虚;肝主疏泄,维持全身气机疏通畅达,通而不滞,散而不郁;肝气郁滞,气机不畅,经脉不疏,胸胁、乳房疼痛,同时伴情志抑郁易怒,善太息;乳房肿块、疼痛是外在表现,止痛,散结等只能解决其标,非治本;乳癖多与"郁与虚"相关,尤以郁结密切相关。"虚"既指脾虚,脾虚运化失常,痰湿内结阻塞经脉上至乳房则乳房结块,疼痛,伴多思善虑,面色少华,神疲倦怠,心悸少寐,舌淡,苔薄白,脉细;"虚"亦指肝肾不足,先天不足或后天失调,生育过多等因素至肾精亏损,从而精血不足、水不涵木,导致肝火上升或灼津液为痰,痰瘀互结,聚而成核,此证多伴有头晕耳鸣,腰酸乏力,月经不调,舌苔薄白,脉弦细数等。须从根本出发,审因论治,创立乳癖方I号(柴胡、白芍、夏枯草、瓜蒌、元胡、枳壳、枳实、厚朴、香附、郁金、白术、茯苓、川芎、赤芍、女贞子、菟丝子、旱莲草、甘草),方中柴胡、白芍、香附、郁金四味药疏肝解郁,柴胡为主,入肝胆经,升发阳气,药性苦平,疏肝解郁,不可服用过久;白芍敛阴、柔肝止痛,加郁金、香附加强柴胡疏肝解郁、行气,畅达气机而止痛。随症加减,注意药物配伍及剂量轻重变化;追根溯源,缓解肝郁后在着手散结。附双侧乳腺轻增生伴结节/右乳囊性结节验案。Professor XU Bin believes that the mammary gland hyperplasia machine is liver Qi stagnation, sputum clotting phlegm, and both spleen and kidney deficiency. The main function of the liver is to relieve it. It can maintain the smooth flow of the whole body, and it will not stagnate, but not stagnate. LiverQi stagnation, poor air movement, meridians are not sparse, chest flank, breast pain, accompanied by emotional depression, irritability, goodness and interest.Breast lumps and pain are external manifestations. Pain relief, the solution can only solve the surface problems. Hyperplasia of mammary glands is related to ＂depression and deficiency＂, especially stagnation. ＂Deficiency＂ mainly refers to the spleen deficiency. Spleen asthenia transport of abnormal, phlegm dampness obstruction of the meridian to breast lump, pain, pain, with more thought, face color less, tired, heart palpitations, little sleep, tongue thin, thin white tongue, pulse thin; ＂Deficiency＂ also refers to the deficiency of liver and kidney, the deficiency of the sky or the acquired disorder, the excessive fertility and other factors to the loss of kidney essence, so that the blood is insufficient and the water does not contain the wood, which leads to the rise of the liver fire or the burning body fluid as phlegm, the mutual knot of phlegm and blood stasis, and the nucleation, which is accompanied by the dizziness of the tinnitus, the fatigue of the waist, the irregular menstruation, the thin white tongue and the detail of the veins.It is necessary to set out from the fundamental point of view, to establish the I（radix bupleuri, radix paeoniae, prunella, trichosanthes, fructus pivoidae, fructus trifoliate, fructus aurantii immaturus, magnolia officinalis, tulip, rhizoma atractylodes, tuckahoe, chuanxiong, radix paeoniae, ligustrum lucidum, dodder, rhizoma licorice, licorice）, four herbs of radix bupleuri, white peony, fragrant and tulip. Hu is the main body, entering the liver and gallbladder meridian, raising the Yangqi, the medi

关 键 词：乳癖 乳腺增生症 乳腺结构不良 郁 补虚 乳腺轻增生伴结节 右乳囊性结节 许斌 老中医经验 中医药治疗 中药复方 

分 类 号：R249[医药卫生—中医临床基础] R269[医药卫生—中医学]