缪希雍吐血三要法在经行吐衄用运中疗效观察

Clinical observation on treating epistaxis by the therapy of three means of Miaoxi Yongtuxue

目的:观察明代医家缪希雍提出的止血三法,即"宜行血不宜补血,宜补肝不宜伐肝,宜降气不宜降火"运用于中医妇科,治疗经行鼻衄的临床疗效,体现了妇科血证皆一气的流转失常病理特点,从肝主藏血,介于水火之间,内寄少阳相火,要依赖脾土的栽培,肝随脾升,但升而无制,则化热化火,冲气上逆,则肺之肃降不及,出现经行吐衄,少阳内藏相火,胆随胃降,温煦下焦责成气化之本,胆气不降,则相火妄动,心主藏神,心动则五志之火内动,相火易起,无时不有煎熬真阴,阴虚冲气上逆,从多点位,多层次进行考究,拓宽中医治疗范围,从气化的角度对其病理机制进行探讨,总结出更有效的治疗途径。方法:筛选了60例2009年6月-2016年6月的门诊就诊的患者,将60例经行鼻衄患者随机分为观察组30例和对照组30例,观察组,采用了缪希雍吐血三要法及所创的方药治疗,对照组采用中医妇科教课书中清肝引经汤、顺经汤辨证选方。两组均以观察比较其疗效。结果:观察组优于对照组,治疗后不但经行吐衄随访一年没有反复,而且月经正常,治疗前后差异具有统计学意义(P<0.05)。结论:其法及方药治疗行经鼻衄疗效显著,并有很好的促排卵、健黄体及调经作用,该法及方药治疗经行吐衄既符合妇女的生理特点,又切合经行吐衄的病机,从心肝脾肾肺五脏配五行的生环和克环关系调节气机的升降,其疗效满意。

Objective:To observe the Ming Dynasty in three means of Miaoxi Yongtuxue,which is suitable for”promotingcirculation of blood not to enrich the blood.The clinical curative effect for the treatment of epistaxis,reflect the pathological features ofall gynecological blood circulation.To explore the pathological mechanism of the disease,and to summarize a more effective treatmentfrom multi point,multi-level research.Methods:60patients with epistaxis were randomly divided into observation group of30cases and30cases in the control group,the observation group,with three means of Miaoxi Yongtuxue and a prescription treatment,the control grouptook the Qinggan Yinjing decoction.Results:With one year of follow-up and normal menstruation,statistically significant differences werethere before and after the treatment(P<0.05).Conclusion:the method and prescription treatment were effective on the symptoms.