基于“二阳之病发心脾”从“火”论治早发性卵巢功能不全  

Treating premature ovarian insufficiency from the aspect of fire based on the theory of Er Yang disease is related to heart and spleen

作　　者：沙学文 王翠霞[2] SHA Xuewen

机构地区：[1]辽宁中医药大学,辽宁沈阳110087 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中医临床研究》2024年第10期34-37,共4页Clinical Journal Of Chinese Medicine

摘　　要：中医将早发性卵巢功能不全归为“女子不月”范畴。《黄帝内经》中“二阳之病发心脾,不得隐曲,女子不月”是目前对闭经最早的古籍记载,表明女子不月与二阳、心脾、隐曲等有极大关系。阳明之经燥火煎灼,化生失源,燥热内生,阴血枯涸,气血生化乏源;心脾与经血生成关系密切,火盛燔灼,阴血既被耗又失于化生,心为五脏六腑之大主,火盛于心从而伤及全身,自身统调失司,经血不下,致月经不来;百病皆由气所生,情志失调导致经血不通与不荣,同时情志又与心、肝、脾密切相关,情志过极可致气机升降出入失常,气血生化失调;冲任不盛,胞宫失于濡养,冲任伤于火盛,胞宫精血耗伤,皆可致女性内在生殖激素发生变化,分泌失调,从而卵巢功能下降,窦卵泡数目减少或生长不佳,体现出围绝经期症状,发为闭经,甚至影响女性生殖不孕。文章基于《黄帝内经》原文从“火”来论治女子闭经实证,阐述实火所致闭经的病因病机,以自拟三黄调经汤清阳明、心脾之火,疏情志之郁火,辅以滋阴行血之品,使燥火得清,阴得滋养,血海得充,血道通利,胞宫满盈,经血以时下,从而改善女子闭经及围绝经期症状,改善卵巢功能、激素水平及卵泡质量,为论治早发性卵巢功能不全提供新思路。Premature ovarian insufficiency(POI)is classified as menstrual disease in TCM.In the Huangdi Neijing(《黄帝内经》),it is stated that this disease is related to Er Yang(二阳),heart and spleen,and moodiness during menstruation,which is currently the earliest ancient record of menstrual irregularities disease,indicating that the menstrual irregularities is greatly related to Er Yang,heart and spleen,and moodiness during menstruation.It is caused by Yangming(阳明)dry fire frying,dehydration and loss of source,dry heat endogenous,Yin(阴)blood dry,and Qi(气)and blood deficient source.The heart and spleen are closely related to the generation of menstrual blood,the fire is full of burnt burning,Yin blood is consumed and lost in the metagenesis,the heart is the main master of the five viscera and six-fu organs(六腑),the fire is filled in the heart and thus hurts the whole body,its own regulation is out of control,and the menstrual blood does not come.Mang diseases are caused by Qi.Emotion disorder leads to immobility and inhonor of menstruation.At the same time,emotion is closely related to heart,liver and spleen.Too much emotion can lead to abnormal rise and fall of Qi and disorders of Qi mouement and blood.Chong and Ren channels(冲任)insufficiency,loss of cell palace in nourishing,Chong Ren injured in the fire hyperactivity,and body fluid and blood damages in uterus cause changes in female internal reproductive hormones,and secretion disorders,resulting in decreased ovarian function,and reduced number or poor growth of sinus follicles,reflecting perimenopausal symptoms,ammenia,and even cause female reproduction and infertility.Based on the original text of Huangdi Neijing,this paper discusses the treatment of women’s amenorrhea from fire,expounds the etiology and pathogenesis of amenorrhea caused by solid fire,and takes the Sanhuang Tiaojing decoction(三黄调经汤)to clear the fire of Yangming,and heart and spleen,and lighten the emotion,supplemented by products for nourishing Yin and blood,so as t

关 键 词：二阳之病发心脾 早发性卵巢功能不全 实火证 三黄泻心汤 

分 类 号：R271.1[医药卫生—中医妇科学]