叶进从肝论治女童性早熟经验

YE Jin's Experience in Treating Girls with Precocious Puberty Based on Liver

[目的]介绍叶进教授从肝辨证论治女童性早熟的学术观点及用药经验。[方法]以性早熟女童首诊三大主症(乳房发育、阴道分泌物及月经来潮)为切入点,从藏象及经络学说两方面探讨肝与女童性早熟发病的关系,介绍叶进教授从肝辨治性早熟的方法和用药经验,并附典型医案一则加以说明。[结果]叶教授认为女童性早熟发病与肝关系尤为密切。肝肾阴虚是性早熟的基本病机,多兼肝气郁滞或肝郁化火等证。在滋阴降火的治疗基础上,叶教授灵活运用柔肝、疏肝、清肝之法,显著改善患儿的临床症状。其选药和配伍符合小儿生理病理特点,重视顾护正气。案例具体展示了女童乳房早发育的肝脏辨证思路和治疗经验。[结论]叶进教授从肝论治女童性早熟取得了良好的临床疗效,值得学习和借鉴。

[Objective]This paper mainly introduced Professor YE Jin＇s experience in treating girls with precocious puberty from liver syndrome differentiation and characteristics of prescription medication.[Methods] On account of three main symptoms of girls with precocious puberty at first visit,including thelarche, leukorrhea and menses, we explore the relation between liver and the causes of this disease from the viscera-state doctrine as well as the meridian theory. Then introduce Professor YE Jin＇s methods and empirical medication in treating girls with precocious puberty based on liver. In order to analyse her experience, a clinical case was reported. [Results]Professor YE holds that the pathogenesis of girl ＇s precociouss puberty closely related to liver. The deficiency of liver-yin and kidney-yin is the basic pathogenesis of precocious puberty, which is often accompanied with liver qi depression or even liver qi depression transforming into fire. On the basis of nourishing yin and purging fire, Professor YE emphasizes treating precocious puberty from liver. In practical terms, flexibly applying the ideas of softening, soothing and clearing liver can effectively improve the clinical symptoms.She makes the selection and compatibility of Chinese medicine comforming to the characteristics of children ＇s physiology and pathology and values the protection of vital energy. The reported case specifically demonstrates treating a girl ＇s thelarche from liver syndrome differentiation as well as the empiric therapy. [Conclusion]Professor YE Jin＇s experience in treating girls with precocious puberty is well worth learning for its significant curative effect.