旷惠桃治疗产后痹验案浅析  

Experience of Kuang Huitao for treating postpartum arthralgia

作　　者：刘沙 曾光[1,2] 周俭 王莘智[1,3] 蔡雄[1,2] 陈芳[1,3] 

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学中医诊断学湖南省重点实验室,湖南长沙410208 [3]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医临床研究》2018年第15期55-57,共3页Clinical Journal Of Chinese Medicine

基　　金：国家自然科学基金青年项目(81403206);中国博士后基金委面上项目(2014M560646);湖南省科技厅社会发展项目(2014SK3042);湖南省教育厅青年项目(2014B131);湖南省研究生科研创新项目(CX2017B447);湖南中医药大学青年项目(2014-43)

摘　　要：产后痹是妇女产褥期出现的以关节肌肉疼痛、酸胀、麻木、怕冷为主要症状的风湿类疾病,病情缠绵难愈,给患者带来极大的痛苦。产后痹以患者自觉症状为主,组织器官及理化检查常无明显异常,故临床医学中没有该病的研究,也没有与之对应的病名和诊断标准。中医对产后痹有较深入研究,旷惠桃教授认为气血亏虚、肝肾不足、瘀血阻滞、情志不畅为产后痹的主要内因,风寒湿等外邪侵袭机体为该病的外因,治疗以益气养血、补益肝肾、散寒除湿、通络止痛、疏肝解郁为大法。旷惠桃教授从痹证的角度出发,结合妇女产后发病的特殊时间,辨证施治,临床处方中重用黄芪、当归益气养血,桂枝、细辛温经散寒,同时配伍祛风除湿之品,扶正祛邪,标本兼顾,扶正不留邪,祛邪不伤正。旷惠桃教授常用养血痛痹汤治疗产后痹气血不足,寒湿痹阻证,该方由当归四逆汤(当归、桂枝、芍药、细辛、通草、甘草、大枣)加黄芪、熟地、威灵仙、川芎组成,既有养血通脉、温阳散寒之功,又有通络止痛之效。Postpartum paralysis is a kind of rheumatic disease with joint muscle pain,soreness,numbness,cold as the main symptoms in women’s puerperium,it is lingering and brings great pain to patients.Postpartum arthralgia is mainly caused by patients’subjective symptoms.There is no obvious abnormality in tissues and organs physical and chemical examination.Therefore,there is no research on this disease in the clinical medicine,and there is no corresponding disease name and diagnostic standard.TCM has in-depth study in treating postpartum paralysis,Kuang Huitao holds that the endopathic of the disease are Qixue Kuixu(气血亏虚),Ganshen Buzu(肝肾不足),Yuxue Zuzhi(瘀血阻滞),Qingzhi Buchang(情志不畅),and the exopathic factor is Waixie Qinxi(外邪侵袭).The disease was treated with Yiqi Yangxue(益气养血),Buyi Ganshen(补益肝肾),Sanhan Chushi(散寒除湿),Tongluo Zhitong(通络止痛)and Shugan Jieyu(疏肝解郁).Kuang Huitao considers the special time of woman’s postpartum morbidity and Syndrome differentiation and treatment.In the clinical prescription,she focuses on nourishing blood,eliminating the astigmatic cold,and the combination of the dispensation and dehumidification to dispel the evil.Kuang Huitao frequently uses the Yangxue Tongbi decoction(养血痛痹汤)for the treatment of post-partum qi and blood deficiency,cold and dampness stasis syndrome.The medicine consists of the Danggui Sini decoction(当归四逆汤)and Astragalus membranaceus,Rehmannia,Clematis,and Rhizoma Chuanxiong.It has the functions of nourishing blood,warming Yang and dispersing cold.There are also effects of meridians and pain relief.

关 键 词：产后痹 养血通痹汤 验案 

分 类 号：R249.8[医药卫生—中医临床基础]