黃震洲 張龍梅 榮寶山
摘 要:痛經(jīng)是婦科常見病,多發(fā)病,特別是年輕患者居多。黃海波教授認(rèn)為其病因總不離“寒”、“瘀”二字。在證治上緊密圍繞“不榮則痛”、“通則不痛”辯證。臨床常以溫經(jīng)活血祛瘀之品治療痛經(jīng),喜用經(jīng)方溫經(jīng)湯加減,臨床療效滿意。
關(guān)鍵詞:痛經(jīng);老中醫(yī)經(jīng)驗;寒;淤
中圖分類號:R271.1 文獻(xiàn)標(biāo)識碼:B DOI:10.3969/j.issn.1006-1959.2018.17.063
文章編號:1006-1959(2018)15-0191-02
Abstract:Dysmenorrhea is a common disease in gynecology.In particular,the majority of young patients.Professor Huang Haibo believes that its etiology is always"cold","stasis"two words.In the treatment of evidence,it is closely related to the dialectic of"no nourishment,no pain"and"smoothness is not painful".Clinically,it is often used to treat dysmenorrhea with warming and blood circulation.He likes to use the prescription of Wenjing Decoction,the clinical effect is satisfactory.
Key words:Huang Haibo;Dysmenorrhea;Old Chinese medicine experience
痛經(jīng)(dysmenorrhea)亦稱經(jīng)行腹痛。中醫(yī)典籍中有月水來腹痛、經(jīng)水來腹痛、經(jīng)行腹痛、月經(jīng)來腹痛、月信來腹痛等別名。是目前最常見的婦科疾病之一,多見于年輕未婚或已婚未育婦女。醫(yī)學(xué)調(diào)査顯示[1],在國內(nèi)女性中原發(fā)性痛經(jīng)的發(fā)生率為33.05%?!督饏T要略·婦人雜病脈證并治第二十三》:“帶下,經(jīng)水不利,少腹?jié)M痛,經(jīng)一月再見者,土瓜根散主之;婦人經(jīng)水不利下,抵當(dāng)湯主之。亦治男子膀胱滿急,有瘀血者”。可以說是有關(guān)痛經(jīng)癥狀、病因病機(jī)的最早記載。痛經(jīng)之病因,《金匱要略》中有:“婦人之病,因虛、積冷、結(jié)氣,為諸經(jīng)水?dāng)嘟^,至有歷年,血寒積結(jié),胞門寒傷,經(jīng)絡(luò)凝堅”的記載?!吨嗅t(yī)婦科學(xué)》教材將痛經(jīng)的病因病機(jī)概括為:氣滯血瘀、寒凝血瘀、氣血虛弱等。楊愛萍[1]等研究發(fā)現(xiàn):原發(fā)性痛經(jīng)的病機(jī)不論虛實,均有“瘀”這一關(guān)鍵病理因素。鄭媛媛[2]研究亦發(fā)現(xiàn):歷代醫(yī)家治療痛經(jīng)使用頻率較高的藥物依次是:活血化瘀類藥、補(bǔ)虛類藥、理氣類藥。
1典型病例
李某,27歲,公務(wù)員,2017年9月15日初診。患者述14歲月經(jīng)初潮即輕度痛經(jīng),逐年加重。行經(jīng)期間少腹冷痛難耐,甚則不能動作,喜溫、拒按,得暖則減,遇冷、潮濕癥狀加重?!?br>