从脾胃虚损论治重症肌无力合并无排卵性异常子宫出血  

Treatment of Myasthenia Gravis Complicated with Anovulatory Abnormal Uterine Bleeding from the Perspective of Spleen and Stomach Deficiency

作　　者：曾宇华 区晓榆 陈燕芬 谢琳玲 卢如玲[2] 曾蕾[2] ZENG Yu-Hua;OU Xiao-Yu;CHEN Yan-Fen;XIE Lin-Ling;LU Ru-Ling;ZENG Lei(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2023年第10期2661-2665,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：白云山中一药业中青年科研基金项目(编号:20190802)。

摘　　要：重症肌无力(myasthenia gravis,MG)可归属于中医的“痿证”范畴,无排卵性异常子宫出血(abnormal uterine bleeding,AUB)可归属于中医的“崩漏”范畴。中医在辨证论治原则指导下,认为MG合并无排卵性AUB患者具有共同的病因病机,即脾胃虚损导致气血失调。从脾胃虚损论治MG合并无排卵性AUB,当以止血为先,可予二稔汤合补中益气汤加减健脾益肾、固冲止血,以防气随血脱,导致病情进一步发展为重症肌无力危象;血止之后需重视调周善后,可拟补中益气汤合生脉饮加减,以健脾益气、滋阴养血,恢复月经周期,防止反复的月经周期紊乱导致MG进一步加重。Myasthenia gravis(MG)can be classified as“atrophy-flaccidity syndrome”and anovulatory abnormal uterine bleeding(AUB)can be classified as“metrorrhagia and metrostaxis”in the field of traditional Chinese medicine(TCM).Guided by the principles of syndrome differentiation and treatment,it is believed that patients with MG combined with anovulatory AUB share a common etiology and pathogenesis,i.e.,deficiency of spleen and stomach leading to disharmony of qi and blood.In treating MG combined with anovulatory AUB from the perspective of deficiency of the spleen and stomach,the first priority is to arrest bleeding,and Erren Decoction combined with modified Buzhong Yiqi Decoction can be used to invigorate spleen and nourish kidney,strengthening thoroughfare vessel to check bleeding,so as to prevent qi collapse following blood exhaustion and to prevent the MG from resulting into MG crisis.After the bleeding has been arrested,attention should be paid to the regulation of the menstrual cycle.The modified Buzhong Yiqi Decoction combined with Shengmai Decoction can be used to invigorate spleen and replenish qi,enrich yin and nourish blood,so as to restore the menstrual cycle and prevent the repeated menstrual cycle disorders from resulting into the aggravation of MG.

关 键 词：重症肌无力 无排卵性异常子宫出血 痿证 崩漏 脾胃虚损 补中益气汤 二稔汤 生脉饮 

分 类 号：R255.6[医药卫生—中医内科学] R271.12[医药卫生—中医学]