黄健玲基于血瘀辨治子宫肌瘤经验  

Experience of HUANG Jian-Ling in Treating Hysteromyoma Based on the Fundamental Pathogenesis of Blood Stasis

作　　者：陈志霞[1] 黄健玲(指导)[1] CHEN Zhi-Xia;HUANG Jian-Ling(Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广东省中医院,广东广州510120

出　　处：《广州中医药大学学报》2020年第11期2223-2226,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：第六批全国老中医药专家学术经验继承工作项目(国中医药办人教函[2017]125号);2019年广东省名中医传承工作室建设项目(粤中医办函[2019]5号)。

摘　　要：子宫肌瘤为妇科常见的良性肿瘤,可归属中医"癥瘕"范畴。黄健玲教授认为血瘀贯穿子宫肌瘤的病程始终,正虚邪实是本病的特点。治疗子宫肌瘤重在活血,扶正与攻伐并用。临床治疗时可辨为气滞血瘀型、寒凝血瘀型、气虚血瘀型论治,处方用药需分平时用方和经期用方,选用的方剂有消癥1方、消癥2方、失笑散、二至丸、桂枝茯苓丸、少腹逐瘀汤、举元煎等。治疗过程中应顺应月经周期并兼顾症状,选用补肾、活血化瘀、理气止痛之药;充分考虑患者年龄特点与生育要求,对生育期患者应采用既能缓解症状甚至使肌瘤消散,又能保留生育功能的治疗方法,对更年期的女性重在定期观察,治疗兼症,使患者平稳过渡到绝经期,以期肌瘤萎缩消散。同时,要加强日常情志及饮食的调护,坚持随访,及时调整治疗方案。Hysteromyoma is a commonly-seen benign gynecologic tumor,which can be classified into the category of abdominal mass in the field of traditional Chinese medicine(TCM).Professor HUANG Jian-Ling believes that the pathogenesis of blood stasis is throughout the course of disease of hysteromyoma,and the disease is characterized by healthy qi being deficiency and pathogenic qi being excess.The therapeutic principles for hysteromyoma are to activate blood and to adopt the therapies of simultaneously supporting healthy qi and removing the pathogenic qi.During the clinical treatment,hysteromyoma can be differentiated as syndrome of qi stagnation and blood stasis,syndrome of cold stagnation and blood stasis,and syndrome of qi deficiency and blood stasis,and the prescriptions should vary in the non-menstrual period and menstrual period.The recipes of Xiaozheng Recipe 1,Xiaozheng Recipe 2,Shixiao Powder,Erzhi Pills,Guizhi Fuling Pills,Shaofu Zhuyu Decoction,and Juyuan Decoction can be chosen.During the treatment,the medication should be different in the nonmenstrual period and menstrual period,the complications should also be taken into account,and herbs for tonifying kidney,activating blood to remove stasis,and regulating qi to relieve pain can be chosen.For the treatment of hysteromyoma,the characteristics of age group and the needs of childbearing of the patients should be taken into account.For the patients in the childbearing period,therapies of relieving symptoms and even dissipating myoma as well as reserving reproductive function can be used;for the climacteric patients,regular observation and relieving complications should be performed to ensure the patients going into the menopausal period steadily,and the atrophy and dissipation of the myoma are expected.Meanwhile,emotional regulation and dietary regulation should be strengthened,and regular follow-up should be carried out so as to adjust the therapy immediately.

关 键 词：子宫肌瘤 血瘀 气滞血瘀型 寒凝血瘀型 气虚血瘀型 消癥1方 消癥2方 黄健玲 

分 类 号：R271.9[医药卫生—中西医结合]