周惠芳辨治经间期出血经验撷粹  

Zhou Huifang's experience in differentiating and treating intermenstrual bleeding

作　　者：于雅昕 周惠芳[1] Yu Yaxin;Zhou Huifang(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210029)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《山西中医药大学学报》2024年第9期1011-1015,共5页Journal of Shanxi University of Chinese Medicine

基　　金：江苏省社会发展重大项目(BE2021726);中医药古籍文献和特色技术传承专项(GZY-KJS-2021-027)。

摘　　要：经间期出血为临床常见病,周惠芳教授秉承夏桂成国医大师学术思想,结合多年临证经验,认为经间期出血实质上为经间期阴阳转化失衡,以“心肾不交,肝气郁结,夹有瘀滞”为主要脏腑病机。以“交通心肾,辅以疏肝化瘀”为基本治法,顺应经间期“重阴转阳”的节律变化,治疗上擅长分期论治,出血期善加“地榆、仙鹤草、醋香附、益母草”止血为先;恢复期以“补虚”为本。顺应女性月经周期阴阳转化,经后初期自拟“滋肾宁心奠基汤”,滋肾宁心,为子宫内膜增长奠定基础;经后末期平衡心之动摇,活血疏肝,增强内膜稳定性,促使排卵顺利,临床疗效可观。附验案1则以佐证。Intermenstrual bleeding is a common clinical disease.Based on her clinical experience for many years and inheriting the academic thought of TCM master Xia Guicheng,Professor Zhou Huifang believes that intermenstrual bleeding is essentially the imbalanced transformation between Yin and Yang in intermenstrual period,and“heart-kidney imbalance and liver-Qi stagnation combined with and blood stasis”is the main pathogenesis.The basic treatment is based on Yin and Yang as the key line and communicating the heart and kidney,supplemented by soothing the liver and removing blood stasis,which conforms to the rhythm change of“extreme Yin turning into Yang”in the intermenstrual period.Staging treatment should be stressed.In the bleeding stage,Diyu,Xianhecao,Cuxiangfu and Yimucao are used to stop bleeding first and then tonifying deficiency method is used.In the recovery stage,the treatment should conform to the Yin and Yang transformation during the female menstrual cycle.In the early period after menstruation,self-designed Zishen Ningxin Dianji Decoction is used for nourishing the kidney and calming the mind,which can lay the foundation for endometrial growth.At the end of the postmenstrual period,balancing the heart,promoting blood circulation and soothing the liver are used for enhancing endometrial stability and promoting ovulation smoothly,with considerable clinical effect.One proven case is presented as evidence.

关 键 词：经间期出血 心肾不交 肝郁血瘀 周惠芳 经验 

分 类 号：R249[医药卫生—中医临床基础] R271.14[医药卫生—中医学]