历代医家对痛经的认识及诊疗经验

TCM Studies and Treatment Experiences of Dysmenorrhea in History

历代医家对痛经的治疗,大多以理气行气药、活血化瘀药、补益药、温里药为主。其中汉唐时期以《金匮要略》《小品方》的通治方为主,相对的补益药为多;到了宋金元时期,大多以活血化瘀、温里、补益药为主,体现了此时期调气血的理论,治法基本是理气、活血、补气、养血、散寒五个方面;明代医家基本传承宋金元时期,以活血化瘀药和补益药的运用为主,增加清热药物的运用,并以经前痛多为实,经后痛多为虚为虚实辨证的原则;清代和民国医家,用药多重视补益,以著名医家傅青主为典范,认为治疗痛经应当重视调补肝肾法,用以补肾水、调肝气之药,反应了该时期用药的特色。

Most physicians of different dynasties treat dysmenorrheal with drugs with effects of regulating and activating qi, promo- ting blood circulation and dispelling blood stasis,tonifying,warming the interior. Among them,doctors in Han and Tang dynasties mostly apply general treatment prescriptions in Synopsis of Golden Chamber and Xiaopin Prescriptions, and the tonics are domi- nant. In Song-Jin-Yuan period, most commonly used drugs are with effects of promoting blood circulation and dispelling blood sta- sis,tonifying,warming the interior,reflecting the idea of regulating qi and blood during that period,and the methods basically in- clude regulating qi,activating blood flow,tonifying qi,nourishing blood and dispersing cold. The doctors in Ming dynasty inherits the therapies of physicians in Song-Jin-Yuan period and they mainly apply drugs with effects of promoting blood eirculation, dis- pelling blood stasis and tonifying, but additionally apply heat-clem＇ing drugs. Besides, the treatment is based on the principle of ex- cess syndrome before menstruation and deficiency syndrome after menstruation. In Qing dynasty and the Republic of China period, doctors stress tonification and famous doctor Fu Qingzhu is a classical one,advocating tonifying and regulating the liver and kidney during treating dysmenorrheal with drugs which can tonify kidney water and regulate liver qi ,and this reflects the features of drug use during that period.