姚美玉论治肝郁型经水早断经验  

Yao Meiyu′s Experience in Treating Early Menstrual Cessation Due to Liver Qi Stagnation

作　　者：张晗[1] 姚美玉[2] ZHANG Han;YAO Meiyu(Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang,China,150040;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang,China,150040)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《河南中医》2024年第9期1340-1343,共4页Henan Traditional Chinese Medicine

基　　金：国家区域诊疗中心黑龙江省名中医传承工作室建设项目{黑中科教便函[2019]2号}。

摘　　要：肝郁型经水早断病机为肝胆气郁,少阳枢机不畅,肾精无以为化,气血无以运行,无血下注胞宫。肝郁为因,肾亏为果,治疗以调畅少阳气机为主,补肾填精,活血化瘀为辅。姚美玉教授认为,调冲任主调气血,调血应先理气,而理气基于疏肝,故选用柴胡汤类方和少阳之气,解肝胆之郁,气散则血行,血行则通。加王不留行化瘀行滞,川芎行郁阻之气,配以六味地黄丸补肾填精、充养天癸。肾阳亏虚较重时,应加大锁阳、淫羊藿用量,以温补壬阳,健旺机能,活血理气同时佐以养血,使气血通畅,气血调和,经水自来。The pathogenesis of early menstrual cessation due to liver qi stagnation involves liver and gallbladder qi stagnation,and unsmooth cardinal,insufficient kidney essence transformation,and inadequate circulation of qi and blood.This results in a lack of blood flow to the uterus,causing early menstrual cessation.Liver stagnation is the cause,and kidney deficiency is the result.The treatment focuses on smoothing the lesser yang qi mechanism,supplemented by tonifying the kidney,replenishing essence,and promoting blood circulation to resolve stasis.Professor Yao Meiyu suggests that regulating the thoroughfare vessel and conception vessel is crucial for adjusting qi and blood.To regulate blood,it is essential to first regulate qi,which is based on soothing the liver.Therefore,classified formulas from Bupleurum Decoction are used to relieve liver and gallbladder qi stagnation.When qi is dispersed,blood circulation improves,and blood flow leads to resolution.Wangbuliuxing(Semen Vaccariae) is added to promote blood circulation and resolve stasis,while Chuanxiong(Rhizoma Chuanxiong) is used to unblock qi stagnation.Six-Ingredient Rehmannia Pill is used to tonify the kidney,replenish essence,and nourish kidney yin,which is essential for menstruation.In cases of severe kidney yang deficiency,increased doses of Suoyang(Herba Cynomorii) and Yinyanghuo(Herba Epimedii) are used to warm and supplement kidney yang and enhance its function.Blood circulation and qi regulation are accompanied by blood nourishment to ensure smooth qi and blood flow,thereby facilitating menstrual recovery.

关 键 词：经水早断 卵巢早衰 肝郁证 和畅枢机 补肾化瘀 柴胡汤类方 姚美玉 

分 类 号：R271.112[医药卫生—中医妇科学]