海派中医妇科及其临证特色  

Shanghai Style Chinese Medicine Gynecology and Its Clinical Features

作　　者：杨碧蓉[1] 周华[1] YANG Birong;ZHOU Hua(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai China 201203)

机构地区：[1]上海中医药大学附属曙光医院

出　　处：《中医学报》2019年第12期2538-2542,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81574012);上海市海派中医流派计划项目(LPRC2017032)

摘　　要：海派中医妇科领域流派众多,名家荟萃,以不同的学术思想和治疗心得形成各自独特的治疗经验。在海派中医妇科流派中口碑卓著的主要有南通朱氏、江湾蔡氏、浦东陈氏、浦东王氏、慈溪胡氏、松江骆氏、金山唐氏以及川沙胡氏。海派中医妇科对于月经病的调理重在补肾、顾护脾胃和周期疗法。朱氏妇科着眼于治本,十分擅长在调养奇经、肝肾方面的应用,学说多集中在脏腑、经络、气血上,擅长运用调肝和齐经学说。辩证时主张审证乳部从而判断有无肝气郁结,按压腹部从而辨知胎孕,极具特色。蔡氏妇科处方简而精,多重视肝脾肾的治疗,辅以气血调理,忌用有损气血的峻厉之药,慎用有碍脾胃的瘀滞药物。王氏妇科强调在辩证过程中先抓住主要证候,分清主与次、正与邪、轻与重和阴阳衰盛,治疗的关键在于平衡阴阳、扶助正气、祛除邪气。处方用药中多予健脾和胃之品,同时调血必然理气,使气血畅达,正气旺,则邪病易祛除。胡氏妇科由于受到西方思想传播较早,认为临床保胎应客观公正的判断,如因胚胎发育不良引起的先兆流产应理性对待,不要一味保胎,支持优生优育;对子宫内膜异位症患者,主张活血化瘀同时要升提正气,从而改善临床症状;对流产、产后子宫复旧不全的患者倡导祛瘀务尽。骆氏妇科主张妇人以血为本,以肝为先天。擅长于利用奇经理论治疗妇科相关病症,重视气血调养。胡氏妇科主要以调为主,擅长以调理治疗妇科疾病。用药注重健脾胃、补肝肾、和气血,避免攻伐类药物,用药精而不杂。唐氏妇科精要在于育肾,治疗不孕主张滋肾、养血、温宫,达到恢复卵巢从而受孕的目的;对于滑胎患者,主张补肾气、益气血、健脾胃的三点式治疗。同时结合妇人的生理、病理特点,四时、社会环境的变化,优化组合理法方药。蔡氏妇科诊治不孕�There are many genres in Shanghai in the field of gynecology in Chinese medicine,and there are many famous scholars who have formed their own unique treatment experiences with different academic ideas and treatment experiences.Among the outstanding figures of Chinese medicine gynaecology doctors,there are mainly Nantong Zhu,Jiangwan Cai,Pudong Chen,Pudong Wang,Cixi Hu,Songjiang Luo,Jinshan Tang and Chuansha Hu.The focuses of Shanghai-based Chinese medicine gynecology doctors,in treatment of menstrual disease,are Kidney,Spleen and Stomach as well as cycle therapy.Zhu’s gynecology focuses on searching for the primary cause of disease in treatment,and is very good at the application of regulating Qi Meridians as well as nourishing Liver and Kidney.His doctrines are mostly on the Zang and Fu,meridians,Qi and Blood,and is good at using the theory of regulating Liver and Qi Meridians.In syndrome differentiation,it is advisable to examine the breast to determine whether there is liver Qi stagnation and press the abdomen to identify the fetal pregnancy,which is very unique in skills.Cai’s gynecological prescription is precise.He pays more attention to the treatment of Liver,Spleen and Kidney,supplemented with Qi and Blood regulating and avoiding drugs that leads to Qi and Blood stagnation as well as injure the Spleen and Stomach functions.Wang’s gynecology emphasized that in syndrome differentiation process,the main symptoms should be noted first,including working out the primary and secondary syndrome,getting to know the condition of Zheng Qi and Evil Qi,determining the degree of the syndrome,and distinguishing Yin from Yang syndrome.The key to treatment is to balance Yin and Yang,help the Zheng Qi,and eliminate the Evil Qi.Most of the drugs in the prescription are those that can tonify Spleen and Stomach.At the same time,regulating Blood regulation must be accompanied by regulating Qi,so that Qi and Blood can flow smoothly.When Qi is strong,the evil factors would be easy to get rid of.The medication thoughts of H

关 键 词：海派中医 妇科流派 南通朱氏妇科 江湾蔡氏妇科 浦东陈氏妇科 浦东王氏妇科 慈溪胡氏妇科 松江路氏妇科 金山唐氏妇科 川沙胡氏妇科 

分 类 号：R271.1[医药卫生—中医妇科学]