从“虚气流滞”论治子宫腺肌病  

Treatment of adenomyosis from"deficiency of Qi with flow stagnation"

作　　者：王欣 张全英 陈一诺 王润涵 师伟[3] WANG Xin;ZHANG Quanying;CHEN Yinuo;WANG Runhan;SHI Wei(Master Degree Candidate of Traditional Chinese Gynecology Enrolled in 2022,the First School of Clinical Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Master Degree Candidate of Traditional Chinese Gynecology Enrolled in 2023,the First School of Clinical Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Department of Gynecology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China)

机构地区：[1]山东中医药大学第一临床医学院2022级中医妇科学专业硕士研究生,济南250014 [2]山东中医药大学第一临床医学院2023级中医妇科学专业硕士研究生,济南250014 [3]山东中医药大学附属医院妇科,济南250014

出　　处：《中国性科学》2025年第3期120-124,共5页Chinese Journal of Human Sexuality

基　　金：泰山学者青年专家(tsqn201909185);山东省自然科学基金创新发展联合基金项目(ZR2023LZY024);山东省自然科学基金面上项目(ZR2021MH198);山东省中医药科技面上项目(M-2023259)。

摘　　要：子宫腺肌病(AM)指子宫内膜的腺体和间质侵入子宫肌层而产生的病变。本文基于“虚气流滞”理论阐释AM的病因病机并指导治疗。认为“虚气”为AM发病之本,以脾肾阳气亏虚为主。“流滞”为发病之标,以瘀血为主,兼有痰、郁、毒。治疗上,以“补虚通滞”为基本原则,化裁经方,采用通脉化癥汤温阳益气,化瘀散结;根据AM患者症状各异、主诉不同的特点,以临床问题为导向,采用分流论治,用药各有所侧重;并宗“杂合以治”之旨,内服外用相结合,提高疗效,缩短病程;针对AM病情缠绵、正气亏虚日久、“流滞”之邪难以肃清的特点,采用丸剂或中成药长期管理,调理善后。Adenomyosis(AM)refers to the pathological changes caused by the invasion of endometrial glands and stroma into the myometrium.Based on the theory of"deficieney of Qi with flow stagnation",this paper explains the etiology and pathogenesis of AM and guides the treatment.It is considered that"deficiency of Qi"is the foundamental of AM,mainly due to deficieney of spleen and kidney yang."Flow stagnation"is the manifestation of the disease,mainly blood stasis,with phlegm,depression and toxicity.In treatment,based on the basic principle of"tonifying deficiency and dredging stagnation",the prescription of menstruation is modified,and Tongmai Huayu Decoction is used to warm Yang and replenish Qi,dissipate blood stasis and disperse stagnation.According to the characteristics of different symptoms and different chief complaints of AM patients,clinical problems are taken as the guide,and the treatment is divided into different streams,with different emphasis on medication.Combined with the purpose of"hybrid treatment",the combination of oral administration and external use can improve the curative effect and shorten the course of disease.In view of the lingering condition of AM,the deficiency of vital Qi for a long time,and the evil of"stagnation"is difficult to clear quickly,pills or Chinese patent medicine are used for long-term management,conditioning and rehabilitation.

关 键 词：虚气流滞 子宫腺肌病 辨治 

分 类 号：R275[医药卫生—中医皮科]