康幼雯辨证治疗围绝经期综合征经验  

Professor Kang Youwen′s Experience in Differentiated Treatment of Perimenopausal Syndrome

作　　者：冯静 康幼雯 FENG Jing;KANG Youwen(Xuchang Hospital of Traditional Chinese Medicine,Xuchang,Henan,China,461000)

机构地区：[1]许昌中医院,河南许昌461000

出　　处：《河南中医》2024年第9期1355-1360,共6页Henan Traditional Chinese Medicine

基　　金：河南省第二批中医药青苗人才培养项目(仲景人才工程){豫卫中医[2020]61号}。

摘　　要：康幼雯教授认为,围绝经综合征病机以肾精亏虚为主,肾阴亏虚在临床比较常见,常累及心肝脾等脏。康教授认为,肾阴阳失衡,肾精亏虚是本病的发病基础,故治疗应以补肾填精,滋阴益肾、育阴潜阳、平衡阴阳为主,肾阴不足日久,则致肾精亏虚,故在滋养肾阴基础上补益肾精,兼宁心安神、养血润燥。常用药物有:熟地黄、淫羊藿、何首乌、当归、山萸肉、菟丝子、枸杞子、龟板胶、杜仲、菟丝子、玄参、牡丹皮、柏子仁、茯神、怀牛膝、墨旱莲、女贞子等。阴虚盗汗者加地骨皮、青蒿、鳖甲、牡蛎、浮小麦等滋阴潜阳,敛汗止泄;口燥咽干者加麦冬、沙参、玉竹、知母、白薇滋阴润燥;夜寐难安、易醒者加夜交藤、龙眼肉、酸枣仁等养心安神;腰膝酸软者加熟地黄、女贞子、墨旱莲、杜仲、菟丝子、仙茅、龟板胶、丹参、牡丹皮;五心烦热者加地骨皮、生地黄、牡丹皮。女性至更年期,由于肾阴无法滋养心阴,导致心失所养,心火偏亢则会引起心烦易怒、失眠多梦等症状,治疗更年期女性心烦易怒、失眠多梦等应以滋补肾阴、清心安神为原则,常用药物有:钩藤、莲子心、珍珠母、黄连、牡蛎、百合、郁金、琥珀等清心潜阳安神。心悸者加茯神、远志等;失眠多梦者加夜交藤、合欢皮、茯神、酸枣仁等。当肝脾功能失调时,更年期女性由于肾精亏损、肝血不足等原因,容易出现潮热、盗汗、心悸、失眠等症状,治疗当以调补肝脾以资化源为原则,常用药物有:党参、黄芪、半夏、陈皮、淮山药、白术、茯苓、白芍。同时,更年期女性在日常生活中要注意调节情绪,保持心情愉悦,建议女性多参加社交活动、进行适当的运动、保持健康的饮食习惯等,以促进身体的康复。肾阴虚常伴随有肝阴血不足,阴不敛阳,肝阳上亢,补肾填精的同时勿忘养血柔肝,疏肝解郁、调畅情�Professor Kang Youwen believes that the pathogenesis of perimenopausal syndrome(PMS) primarily involves kidney essence deficiency,with kidney yin deficiency being particularly common in clinical cases,often affecting the heart,liver,and spleen.Professor Kang asserts that the imbalance of kidney yin and yang and the deficiency of kidney essence are the fundamental causes of PMS.Therefore,the treatment should focus on nourishing the kidney,replenishing essence,nourishing yin,benefiting the kidneys,fostering yin,subduing yang,and balancing yin and yang.Prolonged kidney yin deficiency can lead to kidney essence depletion;hence,while nourishing kidney yin,it is also necessary to replenish kidney essence,calm the heart,and nourish blood to relieve dryness.Commonly used drugs include Shudihuang(Radix Rehmanniae Praeparata),Yinyanghuo(Herba Epimedii),Heshouwu(Radix Polygoni Multiflori),Danggui(Radix Angelicae Sinensis),Shanyurou(Fructus Corni),Tusizi(Semen Cuscutae),Gouqizi(Fructus Lycii),Guibanjiao(Colla Testudinis Plastri),Duzhong(Cortex Eucommiae),Xuanshen(Radix Scrophulariae),Mudanpi(Cortex Moutan),Baiziren(Semen Platycladi),Fushen(Sclerotium Poriae Pararadicis),Huainiuxi(Radix Achyranthis Bidentatae),Mohanlian(Herba Ecliptae),Nvzhenzi(Fructus Ligustri Lucidi),etc.For those with night sweating due to yin deficiency,Digupi(Cortex Lycii),Qinghao(Herba Artemisiae Annuae),Biejia(Carapax Trionycis),Muli(Concha Ostreae),Fuxiaomai(Fructus Tritici Levis),etc.are added to nourish yin,subdue yang,and arresting sweating.For those with dry mouth and throat,Maidong(Radix Ophiopogonis),Shashen(Radix Adenophorae seu Glehniae),Yuzhu(Rhizoma Polygonati Odorati),Zhimu(Rhizoma Anemarrhenae),and Baiwei(Radix et Rhizoma Cynanchi Atrati) are added to nourish yin and relieve dryness.For those with difficulty in sleeping and frequent waking,Yejiaoteng(Caulis Polygoni Multiflori),Longyanrou(Arillus Longan),Suanzaoren(Semen Ziziphi Spinosae),etc.are added to nourish the heart and calm the mind.For those with sore lower back and knees,Shudihua

关 键 词：围绝经期综合征 中医辨证治疗 肾精亏虚 肾阴亏虚 康幼雯 

分 类 号：R271.11*6[医药卫生—中医妇科学]