程叙五辨治产后病经验探析

CHEN Xuwu’s Feature in Treating Puerperal Disease

[目的]探析安徽名医程叙五辨治产后病的证治经验。[方法]通过研读徽医程叙五所著治疗产后病相关医案,从四个方面总结程老辨产后病机特色和诊治产后病相关临证经验:(1)产后眩晕,无失气血;(2)产后痛证,从血论之;(3)条达木郁,以通为补;(4)产后错杂,稳中求变。并举5则验案加以佐证。[结果]程氏辨产后病之病机总以气血亏虚、阴阳俱损为主,具有虚实寒热错杂的特点,认为产后眩晕多责脑窍失养,直需补血养精,而产后痛症虚实夹杂,不通必兼不荣,不荣也必兼不通,故治疗时当从血论之。治疗上其特点鲜明,选药精准,善用道地清轻花类药材,喜条达木郁,以疏为补,同时全方寒热同调,稳中求变,疗效甚佳。所举验案也展现了程老以上辨治特点。[结论]程氏在治疗产后病方面,辨证精确,尤其对产后眩晕和产后痛症立法切合独到,形成了相对明确的病因病机认识,并且遣方用药因地制宜,稳中求变,对当今临床产后类病治疗极具借鉴价值。

[Objective]To explore the treatment experience of puerperal disease from CHEN Xuwu,a widely-acclaimed local Xin’an scholar in Anhui.[Methods]Through remaining CHEN’s medical records of puerperal disease,we categorized and summarized his characteristics of diagnosis and treatment ideas of puerperal disease.[Results]The pathogenesis of puerperal disease in CHEN’s perspective is the deficiency of Qi and blood.With different categories of puerperal disease,CHEN has distinct characteristics,such as focusing Qi and blood of patient with postpartum dizziness;Starting with blood when treating postpartum pain syndrome;Prescription is flexible while preserving stability,and also soothes liver-Qi stagnation,guarantee its running smoothness.[Conclusion]CHEN’s diagnosis and treatment of puerperal disease has definite mechanism,clear treatment method and obvious curative effect,which is of great reference value to the treatment of puerperal diseases in clinic today.