杨春以疏肝理气法论治更年期女性特发性水肿  

YANG Chun’s treatment of idiopathic edema in menopausal women with the method of soothing the liver and regulating Qi

作　　者：王晓英 杨春[2] 张志明 WANG Xiaoying

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]天水市中医医院,甘肃天水741000 [3]甘肃省中医院,甘肃兰州730000

出　　处：《中医临床研究》2023年第11期19-21,共3页Clinical Journal Of Chinese Medicine

摘　　要：有些女性到了更年期,会出现一种莫名其妙的全身性水肿,现代研究称这种找不出病因的水肿为特发性水肿。此病病情时而缓解时而加重,有的可持续数年或数十年,久治不愈,成为临床常见的一种疑难症。研究发现,大约40%的中年妇女会出现不同的双下肢水肿。临床上西医常以利尿剂和激素以及通过改善毛细血管通透性药物进行治疗,但利尿剂会引起不同脏器的损害和机体出现功能性紊乱,不良反应大。甘肃天水市中医医院杨春主任医师认为常见水肿的病因病机主要归于肺、脾、肾三脏,肺失宣肃,不能通调水道,水液不循常道,发为水肿;脾虚不运,水液运化失司,水湿停滞,乃成水肿;肾阳不足,不能温化水湿,使得津液代谢失常,泛溢于肌肤,则面目四肢浮肿。杨主任还认为更年期女性除常见病因病机外,更有这一群体的独特之处,肝气不疏,气机不利,加之脾肾不足,肾阳亏虚,成为此病之关键病机。他以温肾助阳、利水消肿为主,以疏肝解郁、理气健脾为辅,对更年期女性特发性水肿进行对症治疗,强调在利水的同时注重温补肾阳,调畅气机,取得了较为明显的效果。文章通过案例,介绍杨春主任医师治疗更年期女性特发性水肿的经验,以期为临床提供参考。Some women reach menopause and develop an inexplicable form of systemic edema,which modern research calls this unexplained edema idiopathic edema.The disease sometimes eases and sometimes worsens,and some can last for years or decades,and it has become a common clinical problem.Studies have found that about 40%of middle-aged women develop edema of different lower extremities.Clinically,Western medicine often uses diuretics and hormones and drugs to improve capillary permeability,but diuretics can cause damage to different organs and functional disorders in the body,and adverse reactions are obvious.YANG Chun,chief physician of Gansu Tianshui Traditional Chinese Medicine Hospital,believes that the causes of common edema are mainly attributed to the lungs,spleen and kidneys.The lungs are unsuspended,the waterway cannot be adjusted,and the water does not follow the usual path,resulting in edema.Spleen deficiency is not transported,water transport is lost,moisture stagnant,and edema.Kidney Yang(阳)is insufficient,can not warm the water moisture,so that the metabolism of Jinye(津液)is abnormal,overflowing on the skin,and the face and limbs are puffy.Director YANG also believes that in addition to the common causes and pathogenesis,menopausal women also have the unique features of this group,such as liver Qi(气)is not loose,Qi is unfavorable,coupled with insufficient spleen and kidney,kidney Yang deficiency,has become the key pathogenesis of this disease.He mainly treats idiopathic edema in menopausal women by warming the kidneys and helping the Yang,water and swelling,and thinning the liver and relieving depression,rationalizing Qi and strengthening the spleen,emphasizing that while reserving water.He pays attention to warming the kidney Yang and regulating Qi movement,and has achieved more obvious results.This article introduces the experience of Chief Physician YANG Chun in the treatment of idiopathic edema in menopausal women through cases,in order to provide clinical reference..

关 键 词：疏肝理气 温阳利水 更年期 特发性水肿 

分 类 号：R256.51[医药卫生—中医内科学]