基于“血不利则为水”理论探讨卵巢子宫内膜异位囊肿辨治  

Study on the Differentiation and Treatment of Ovarian Endometriosis Cyst Based on the Theory That"If Blood Does Not Circulate Freely,it Will Transform into Water"

作　　者：罗喜 黄紫薇 张伶俐[1,2] LUO Xi;HUANG Ziwei;ZHANG Lingli(The First Affiliated Hospital of Hunan College of Traditional Chinese Medicine,Hunan Provincial Hospital of Traditional Chinese Medicine,Zhuzhou,Hunan,China,412000;Hunan University of Chinese Medicine,Changsha,Hunan,China,410208)

机构地区：[1]湖南中医药高等专科学校附属第一医院,湖南省直中医医院,湖南株洲412000 [2]湖南中医药大学,湖南长沙410208

出　　处：《河南中医》2023年第12期1825-1829,共5页Henan Traditional Chinese Medicine

基　　金：湖南省医药卫生科研计划课题项目(B2015-77)。

摘　　要：血瘀是卵巢子宫内膜异位囊肿的核心病理因素,“因虚、积冷、结气”是导致血瘀的原因,瘀血日久化水,水积成痰,痰瘀互结,发为该病。基于“血水同源”的生理基础和“血不利则为水”的病机演化,以活血散瘀,化痰散结为基本治法,佐以益气、温阳、补血、散寒、行气等。活血散瘀,化痰散结用桂枝、牡丹皮、赤芍、桃仁、茯苓、水蛭、■虫、皂角刺、昆布、石打穿等。气虚血瘀者,当佐以益气健脾药物如黄芪、党参、白术等;血虚夹瘀者,以桂枝茯苓丸为基础方,合四物汤加减;阳虚瘀结者,当温阳化浊,化瘀止痛,以补肾活血散瘀汤,或桂枝茯苓丸合温经汤、附子理中汤合桂枝茯苓丸或消瘰丸加减;寒凝者,当散寒活血,化痰散结,以桂枝茯苓丸合温经汤,或用少腹逐瘀汤为基础方加减;气滞者,当活血行气、化痰散结并重,以桂枝茯苓丸合失笑散或膈下逐瘀汤,配合化痰散结之品治疗。Blood stasis is the core pathogenesis of ovarian endometriotic cysts,caused by yin deficiency,accumulation of cold,and stag-nation of qi.Long-time blood stasis turns into water,and water accumulates and transforms into phlegm.Then phlegm and blood stasis intertwine,leading to the onset of this disease.Based on the physiological basis of"blood and water being homologous"and the patho-genesis evolution that"If blood does not circulate freely,it will transform into water",the basic treatment method is to promote blood circulation and dispel stasis,dissolve phlegm and disperse stagnation,supplemented by tonifying qi,warming yang,supplementing blood,dispelling cold,and promoting qi circulation.For promoting blood circulation and dispelling stasis,dissolving phlegm and dispersing stagnation,Guizhi(Ramulus Cinnamomi),Mudanpi(Cortex Moutan),Chishao(Radix PaeoniaeRubra),Taoren(Semen Persicae),Fuling(Poria),Shuizhi(Hirudo),Zhechong(EupolyphagaseuSteleophaga),Zaojiaoci(SpinaGleditsiae),Kunbu(ThallusLaminari-ae),Shidachuan(Herba Salviae Chinensis),etc.can be used.For patients with qi deficiency and blood stasis,it is necessary to promote blood circulation and disperse stasis,dissolve phlegm and remove stagnation,and supplement with tonifying qi and invigorating the spleen.The basic formula is Ramulus Cinnamomi and Poria Pill in Synopsis of the Golden Chamber,plus Huangqi(Radix Scutellariae),Dangshen(Radix Codonopsis),Baizhu(Rhizoma Atractylodis Macrocephalae),etc.For those combined with blood deficiency and blood stasis,the basic formula is Ramulus Cinnamomi and Poria Pill,and Four Substances Decoction is also used.For those with yang defi-ciency and blood stasis,it is necesary to warm yang to remove turbidity,resolve blood stasis and relieve pain,so Kidney-Supplementing and Blood-Activating and Stasis-Dispersing Decoction,or Ramulus Cinnamomi and Poria Pill combined with Channel-Warming Decoc-tion,Modified Aconite Middle-Regulating Pill combined with Ramulus Cinnamomi and Poria Pill plus Scrofula-eliminating Pill can be use

关 键 词：卵巢子宫内膜异位囊肿 “血不利则为水” 血水同源 血水同治 

分 类 号：R271.911[医药卫生—中西医结合]