马大正应用攻下法治疗盆腔结缔组织炎的经验介绍  

MA Dazheng’s Experience in Treating Pelvic Connective Histitis with Gongxia Method

作　　者：陈祥艳[1] 马大正[1] CHEN Xiangyan;MA Dazhang(Wenzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine,Wenzhou,Zhejicuig,325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院

出　　处：《浙江中医药大学学报》2019年第6期568-570,共3页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]总结马大正应用攻下法治疗盆腔结缔组织炎(Pelvic connective histitis,PCH)的辨证特点和选方经验。[方法]分析马大正对盆腔结缔组织炎病因病机及诊断要点的认识,阐述攻下法在临床应用中的理论依据,分析桃核承气汤组成、方义及功用,并附典型临床案例佐证。[结果]马大正认为寒、湿、瘀、热等邪毒留滞胞宫是盆腔结缔组织炎的重要病因病机,其诊断要点在于腰骶部疼痛,且妇科三合诊触摸到两侧子宫骶骨韧带时有痛感。临床治疗采用破血、下瘀、泻热之攻下法,以桃核承气汤为根本,包括桃仁、大黄、炙甘草、桂枝、芒硝等药,取桃仁活血破瘀及大黄下瘀泻热之力,配伍芒硝泻热软坚、桂枝通行血脉,使邪有出路,而诸症自平。所附临床案例病因在于气血瘀滞局部,初诊时伴素体寒凉,故治疗时兼顾温通活血、下瘀行气,取桃核承气汤加红藤、蒲公英、升麻等药,使寒凉得解后遵循月经周期继予攻下之法,病症随局部气血复通而消失。[结论]马大正运用攻下法治疗盆腔结缔组织炎的临床经验,值得学习效法。[Objective]To summarize MA Dazheng’s clinical experience in treating pelvic connective histitis with Gongxia method in the paper.[Method]The pathogenesis and diagnostic essentials of pelvic connective histitis were analyzed by MA Dazheng.Components and effect of Taohe Chengqi decoction were described through a typical case.[Results]MA Dazheng believes the most important etiology and pathogenesis of pelvic connective histitis are cold,wet,stasis and heat.The symptom of pelvic connective histitis is lumbosacral pain.The bilateral jarjavay’s ligaments pain is appeared in gynecological triple diagnosis.The method of Gongxia uses Taohe Chengqi decoction including peach kernel,rheum officinale,radix glycyrrhizae preparata,cassia twig,glauber salt,et al.Peach kernel could activat blood circulation and break blood stasis.Rheum officinale could lower blood stasis and heat.Glauber salt could purge heat and soft firmness.Cassia twig could pass blood vein.Taohe Chengqi decoction is helpful for cleaning cold,wet,stagnation and heat.The etiology of the attached clinical case was local stagnation of Qi and blood,accompanied by cold body at first diagnosis.Therapeutic methods were warming and activating blood circulation,promoting Qi through blood stasis.Taohe Chengqi decoction plus red rattan,dandelion,cimicifuga and other drugs was used.Following the menstrual cycle after the cold disappeared,continue to use the attack method.The symptoms disappeared with local Qiblood recanalization.[Conclusion]The method of Gongxia from MA Dazheng was effective in treating pelvic connective histitis and was worth learning and imitating.

关 键 词：盆腔结缔组织炎 攻下法 桃核承气汤 马大正 医案 名医经验 

分 类 号：R272[医药卫生—中医儿科学]