基于“异病同治”思想探析桂枝茯苓丸加减在妇科癥瘕病中的应用  

Application of modified Guizhi Fuling Pill in the treatment of gynecological abdominal masses based on"treating different diseases with the same method"

作　　者：梁伟 贡欣[2] 李树苗 张晓晓 LIANG Wei;GONG Xin;LI Shumiao;ZHANG Xiaoxiao(Beijing University of Chinese Medicine,Beijing 100105,China;Department of Gynecology,Dong Fang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100105 [2]北京中医药大学东方医院妇科,北京100078

出　　处：《吉林中医药》2024年第11期1269-1273,共5页Jilin Journal of Chinese Medicine

基　　金：首都卫生发展科研专项项目(首发2018-4-4204)。

摘　　要：子宫肌瘤、子宫腺肌病、盆腔炎性疾病后遗症慢性盆腔痛、卵巢囊肿是临床常见的妇科疾病,临床症状各有不同,中医学认为血瘀是其共同的病因病机,同属于“癥瘕”范畴。这与“异病同治”的思想内涵高度契合,即“疾病不同,病机相同”。桂枝茯苓丸出自《金匮要略》,功专活血散瘀消癥,为治疗妇科癥瘕病的代表方剂,体现了中医“异病同治”的治疗原则,即“疾病不同,治法相同”。从现代药理学研究与中医病因病机角度入手,揭示“异病同治”思想的科学内涵,并以“辨证论治”为指导,结合“异病同治”思想,探究桂枝茯苓丸加减治疗癥瘕病的可行性,以期为临床治疗提供新的思路。Uterine fibroids,adenomyosis,chronic pelvic pain,and ovarian cyst are common gynecological diseases.Although their clinical symptoms are different,they are considered in traditional Chinese medicine(TCM)to have a common etiology(all caused by blood stasis)and belong to the category of"obstruction in the abdomen".This vision is highly consistent with the concept of"treating different diseases with the same method"as they bear the same pathogenesis.Guizhi Fuling Pill,recorded in the Synopsis of the Golden Chamber,is specifically applied for activating blood circulation,dispersing blood stasis and eliminating abdominal obstructions.As a representative formula for the treatment of gynecological abdominal masses,the prescription embodies the therapeutic principle of"treating different diseases with the same method"in TCM.Based on the perspective of modern pharmacological research and the theories of etiology and pathogenesis of TCM,this article aims to reveal the scientific connotation of the idea of"treating different diseases with the same method".Guided by the theory of"syndrome differentiation and treatment",combined with the idea of"treating different diseases with the same method",this article explores the feasibility of modified Guizhi Fuling Pill in the treatment of gynecological abdominal masses,hoping to provide a new idea for its clinical treatment.

关 键 词：异病同治 桂枝茯苓丸 子宫肌瘤 子宫腺肌病 盆腔炎性疾病后遗症慢性盆腔痛 卵巢囊肿 

分 类 号：R271.1[医药卫生—中医妇科学]