基于《金匮要略》“因虚、积冷、结气”理论辨治卵巢储备功能减退  

Treatment of Diminished Ovarian Reserve Based on Theory of"Deficiency,Cold Accumulation and Qi Stagnation"Proposed in Jin Gui Yao Lue

作　　者：李久现[1] 刘妍 王浩贤 孙烁 李香玉 张晓丹[1] LI Jiuxian;LIU Yan;WANG Haoxian;SUN Shuo;LI Xiangyu;ZHANG Xiaodan(Department of Obstetrics and Gynecology,The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000;The First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第一附属医院妇产科,河南郑州450000 [2]河南中医药大学第一临床医学院,河南郑州450000

出　　处：《中医学报》2024年第9期1863-1867,共5页Acta Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承项目{国中医药人教函〔2022〕76号};河南省第二批中医药青苗人才培养项目{豫卫中医函〔2021〕16号};河南省卫生健康委员会国家中医临床研究基地科研专项项目(2022JDZX 011);2022年度河南省中医药科学研究专项课题项目(2022 ZY2011)。

摘　　要：张仲景在《金匮要略》中提出“因虚,积冷,结气”为妇人病的主要病因病机,素体亏虚,寒冷久积,或肝气郁结均可导致妇科疾病的发生。故“因虚、积冷、结气”可作为卵巢储备功能减退的辨证总纲。卵巢储备功能减退的病机有肾阴虚、肾阳虚、寒凝、肝郁、血瘀。临床可根据此理论遣方用药,以“滋、温、疏、活”为治疗大法,采用自拟滋癸二至汤、温阳暖巢方、疏郁柴附汤、活血通巢方辨证治疗,并根据月经周期的阴阳消长变化和胞宫藏泻规律灵活化裁,滋天一之水,温肾中真阳,疏肝木之郁,活凝泣之血。Zhang Zhongjing proposed that"deficiency,Cold accumulation and Qi stagnation"are the main causes and pathogenesis of gynecological diseases.Physical deficiency,Cold accumulation for a long time,or Liver Qi stagnation can lead to the occurrence of gynecological diseases.Therefore,"deficiency,Cold accumulation and Qi stagnation"can be used as a general outline of syndrome differentiation for ovarian reserve decline.The pathogenesis of ovarian reserve deficiency includes Kidney Yin deficiency,Kidney Yang deficiency,Cold coagulation,Liver Qi depression and blood stasis.Clinically,according to this theory,"nourishing,warming,dispersing and activating"prescriptions are always the treatment methods in treatment.Self-made Zigui Erzhi Decoction,Wenyang Nuanchao Formula,Shuyu Chaifu Decoction and Huoxue Tongchao Formula can be used in syndrome differentiation treatment,based on the changes of Yin and Yang in the menstrual cycle and the physiology law of uterine,to nourish the Kidney Essence,warm the Kidney Yang,soothe the depressed Liver Qi,and activate blood circulation.

关 键 词：卵巢储备功能减退 《金匮要略》 “因虚、积冷、结气” 滋癸二至汤 温阳暖巢方 疏郁柴附汤 活血通巢方 

分 类 号：R271.14[医药卫生—中医妇科学]