李赟运用“一基三分法”论治剖宫产疤痕憩室所致的经期延长  

LI Yun Treating Prolonged Menstruation Caused by Cesarean Scar Diverticulum with Rule of“One-Base Three-Part Method”

作　　者：吴燕 李赟[2] WU Yan;LI Yun(Anhui University of Chinese Medicine,Anhui Hefei 230012,China;The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui Hefei 230012,China)

机构地区：[1]安徽中医药大学,安徽合肥230012 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2023年第8期1491-1494,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：2020年安徽中医药大学国家级大学生创新创业训练项目(202006180115);2021年安徽中医药大学省级大学生创新创业训练项目(S202110369148)。

摘　　要：剖宫产疤痕憩室(CSD)是剖宫产术后的远期并发症之一,随着近年来剖宫产率的相对增高,发生疤痕憩室的几率也同步增高。临床表现多为经期延长、经间期出血,甚至是继发性不孕等。目前西医对于该病的治疗以手术修补疤痕憩室为主,尚无特效药物,但手术效果不佳,存在憩室复发可能,并且患者担忧手术切口再发愈合不良,故此治疗方式接受度低。李赟主任是全国第5批名老中医梁文珍教授的继承人,从事妇科临床多年,认为剖宫产疤痕憩室导致月经延长的主要病因病机为产时金刃阻断胞脉,切口愈合不良,日久形成切口憩室,经血长期蓄于腔隙内,引流不畅形成瘀血,瘀血阻滞冲任,致血难归经,导致经期迁延。并提出运用“一基三分法”治疗此病,将患者分3度(轻度、中度、重度)、分2类(有无生育要求)、分3证(脾气虚证、阴虚血热证、瘀热互结证)灵活论治,并以梁文珍教授自拟方化癥汤为基础方,重视通因通用,因势利导使邪有出路。Cesarean scar diverticulum(CSD)is one of the long-term complications after cesarean section.With the relative increase of cesarean section rate in recent years,the probability of cesarean diverticulum also increases simultaneously.The clinical manifestations are mostly prolonged menstruation,intermenstrual bleeding,and even secondary infertility.At present,Western medicine mainly treats the disease with surgical repair of scar diverticulum.There is no specific drug,but the surgical effect is not good,there is a possibility of diverticulum recurrence,and patients are worried about the recurrence of poor healing of the surgical incision,so the acceptance of this treatment method is low.Director LI Yun is the successor of Professor LIANG Wenzhen,the fifth batch of famous old Chinese medicine practitioners in the country.He has been engaged in gynecological clinical practice for many years.He believes that the main etiology and pathogenesis of prolonged menstruation caused by cesarean section scar diverticulum is that the golden blade blocks the cell veins during delivery and the incision heals poorly.,Over time,the incision diverticulum is formed,and menstrual blood accumulates in the cavity for a long time,and the drainage is not smooth to form blood stasis.And proposed to use the“one base three points method”to treat the disease,divide the patients into 3 degrees(mild,moderate,severe),2 types(with or without fertility requirements),and 3 syndromes(spleen deficiency syndrome,yin deficiency and blood syndrome)Heat Syndrome,(Stasis-Heat Interaction Syndrome)is treated flexibly,and based on Professor LIANG Wenzhen’s self-made prescription Huazheng Decoction,it pays attention to general causes and general use,and makes the best use of the situation to make the evil have a way out.

关 键 词：剖宫产疤痕憩室 经期延长 一基三分法 化癥汤 李赟 

分 类 号：R271.43[医药卫生—中医妇科学]