黄淑玲治疗围绝经期汗证的临床经验探析  

HUANG Shu-Ling’s Clinical Experience in Treating Perimenopausal Sweating Syndrome

作　　者：邹东凌 傅晓芸[2] 黄淑玲(指导) ZoU Dong-Ling;FU Xiao-Yun;HUANG Shu-Ling(Advisor)(Dongguan Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Dongguan 523000 Guangdong,China;Dongguan People's Hospital,Dongguan 523059 Guangdong,China)

机构地区：[1]广州中医药大学附属东莞中医院,广东东莞523000 [2]东莞市人民医院,广东东莞523059

出　　处：《广州中医药大学学报》2023年第4期1002-1007,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：东莞市社会科技发展(重点)项目(编号:202050715001210)。

摘　　要：围绝经期女性因卵巢功能衰竭,分泌雌激素水平下降,继而引起一系列血管舒缩障碍和神经精神症状,其中异常出汗是绝经前后诸证中最常见的症状。黄淑玲教授认为,围绝经期汗证病性属虚实夹杂,以虚为本,其根本病机为肾精亏虚、阴阳失衡,且与心、肝、脾、肺等脏腑功能失调密切相关。虚者汗出的病机,首因是肾精亏虚,而肝肾同源,精血相生,故滋补肝肾为治疗围绝经期汗证的基础疗法,可选六味地黄汤、左归丸、右归丸、二至丸等方剂加减;其次是脾虚不能散津,影响肺的通调水道及水津的输布,脾虚及肺,治疗需健脾益气固表,可选黄芪、白术、太子参等培土生金,酌加麻黄根、浮小麦、糯稻根等收敛止汗。实者汗出的病机,是因虚致实,肝肾亏虚,肝失所养,肝郁化火,迫津外泄致汗出,治宜疏肝解郁,清解郁热,可选用柴胡疏肝散或丹栀逍遥散加减;肾阴不足,肾水不能上济心火,心火亢盛,也可迫津外泄致汗出,治宜滋阴补血、养心敛汗,可选用归脾汤、天王补心丹等加减。Perimenopausal women suffer from a range of vasomotor disturbance and neuropsychological disorders caused by a decline in the level of estrogen due to ovarian failure, and abnormal sweating is the most common symptom of the menopausal disease in the field of traditional Chinese medicine. Professor HUANG Shu-Ling believes that perimenopausal sweating is characterized by deficiency mingling with excess syndrome, and the deficiency is the root cause. The underlying pathogenesis of perimenopausal sweating is due to the insufficiency of kidney essence and imbalance between yin and yang, and it is closely related to the dysfunction of the heart,liver, spleen and lung. The pathogenesis of sweating with deficiency syndrome is firstly developed from the insufficiency of kidney essence. For the liver and kidney as well as the essence and blood have a common source,therapeutic principle for perimenopausal sweating with deficiency syndrome is to nourish the liver and kidney,and the modified prescriptions such as Liuwei Dihuang Decoction,Zuogui Pills,Yougui Pills and Erzhi Pills can be selected for the treatment. Secondly,sweating with deficiency syndrome can also result from the failure of spleen in dispersing fluid,and the deficiency spleen affects the lung’s function of regulating the waterway and transporting water and body fluid. The therapeutic principle for sweating syndrome due to spleen deficiency involving the lung is to strengthen the spleen, invigorate qi and consolidate the exterior. Herbs of Astragali Radix, Atractylodis Macrocephalae Rhizoma and Pseudostellariae Radix can be used to bank up earth for generating metal, and Ephedrae Radix,Tritici Levis Fructus and Oryzae Glutinosaecan Radix can be added for inducing astringency and arresting sweating. The sweating with excess syndrome originates from the deficiency. If the liver and kidney are deficient, the liver loses its nourishment, and then stagnated liver qi transforms into fire, which forces the leakage of body fluid and results into sweating. The treatm

关 键 词：围绝经期汗证 肾精亏虚 阴阳失衡 六味地黄汤 柴胡疏肝散 归脾汤 天王补心丹 黄淑玲 

分 类 号：R271.116[医药卫生—中医妇科学]