洪家铁按经期阶段从气血论治痛经

Hong Jiatie According to the Menstrual Period from Blood on Treatment of Dysmenorrhea

洪家铁教授认为＂妇人月水来腹痛由劳伤血气,以致体虚,受风冷之气客于胞宫,损伤冲任之脉＂,妇人以血为事,痛经乃气血失调,冲任胞脉受阻,气血运行不畅,伴随月经周期而反复发作,有虚实之分,＂全实者少,夹虚者多＂;根据经期前后气血变化规律,实证当因势利导活血通经,虚证当益气养血;强调治疗时机,据月经不同时期冲任气血阴阳虚实变化规律及致病因素特点,审证求因,择时给药;实证经前或经前半期发作,疼痛较重,此期冲任胞宫气血偏实,应乘其实以导之;经期冲任胞宫气血半虚半实,应就顺其势以调之;经后冲任胞宫气血偏虚,宜就其虚以补之;导即疏导,即以活血通经为主,方药用益母草、延胡索、当归、炒白芍、川芎、川楝子、五灵脂、莪术为基本方,寒凝加肉桂、炮姜;气滞加柴胡、郁金、青皮、香附;血瘀重者加牡丹皮、三棱、刘寄奴,经前7d开始服用,经行第3d停药;虚证痛经均在经后发作,疼痛较轻,隐痛或绵绵作痛,宜用补法,以益气养血为主,黄芪、益母草、白芍、党参、当归、白术、砂仁、阿胶、甘草为主方,偏寒加艾叶、炮姜;肾虚加菟丝子、续断,经期后半期开始服用,连服7d。治疗3~4个月经周期。洪师还嘱患者注意日常调护,经期防寒保暖,避免剧烈运动,消除紧张恐惧心理,放松心态,注意饮食,少食生冷、辛辣之品。

Professor HONG Jiatie believes that ＂woman month water to abdominal pain by workers injured blood gas, so that the body is weak, affected by air cooled gas off in the uterus, injury of Chong and Ren meridian,＂ woman with blood thing, dysmenorrhea of Qi and blood disorders, Chong and Ren cell pulse blocked, blood runs sluggish, accompanied by menstrual cycle and repeated attacks, the actual situation of the, ＂totally real persons less, clip virtual multi＂; according to the law of Qi and blood changes before and after menstruation, empirical when in the light of its general trend activating blood flow, deficiency when the replenishing qi and blood; emphasizes the timing of treatment, according to different periods of menstruation Chong and Ren Qi and blood deficiency and excess of yin and Yang and the variation characteristics of pathogenic factors, request for the trial evidence, timing of administration;Empirical through before or during the first half of the episode, severe pain, this period of Chong and Ren uterus blood partial, should take in order to guide; menstruation Chong and Ren uterus blood half virtual, should be with the potential to adjust; Ren uterus blood by the backlash partial deficiency, should be to fill the empty the guide is grooming, namely; to live blood pass through the main,Medicinal Yimucao,Yanhusuo, Danggui,Chaobaishao,Chuanxiong,Chuanlianzi,Wulingzhi,Ezhu for basic square, cold coagulation with cinnamon, Rougui,Paojiang; Qi stagnation and blood stasis or peel, Cyperus rotundus; plus tree peony bark, Chaihu,Yujin,Xiangfu, after 7 days before the start of the third day stop taking medicine syndrome of deficiency of both; dysmenorrhea attack in the classics, less pain, pain or ache rain, appropriate for law, with Replenishing Qi and blood, Huang Qi,Yimucao,Baishao,Dangshen,Danggui,Baizhu,Sha ren,Ejiao,Gancao,based parties, partial cold plus Aiye,Paojiang etc; deficiency of the kidney and Tusizi,Xuduan menstrual period the second half started taking, and even served 7 days. Treatment of 3-4 cycle. Hong Division also ask patients pay attention to the daily nursing, menstrual cold warm, avoid strenuous exercise, eliminate nervous fear, relaxed state of mind, pay attention to diet, eat less cold, spicy products.