杜小利从脾胃论治产后缺乳经验

Du Xiao-li′s Experience of Treating Puerperal Hypogalactia from Spleen and Stomach

杜小利教授认为,产后乳汁不下,多责之脾胃,常从脾胃论治产后缺乳,重视调理脾胃、通络下乳,常用四君子汤加减。若脾虚甚,加黄芪、陈皮;痰湿甚,加半夏、茯苓、苍术;若肝郁,加白芍、柴胡;若血瘀,酌情加当归、川芎以活血养血;产后缺乳属本虚标实之证,加木通、王不留行、路路通以通络下乳;又恐补气之品碍胃,多加木香、砂仁等芳香醒脾、行气导滞,寓行于补,使得补而不滞。杜教授认为,脾胃为五脏之中州,故治疗时遵从脾宜运、宜升、宜燥,痰湿宜利、气滞宜行、瘀血宜化的原则,时时固护脾胃,以达补中气、利痰湿、行气滞、化瘀血,使脾气得运,实邪得消,乳汁自生且乳络自通而乳汁得以下。

Professor Du Xiao-li believes that puerperal hypogalactia has something to do with the spleen and stomach She often treats it from the spleen and stomach and attaches importance to regulating the spleen and stomach,dredging collaterals,and often uses Modified Four Gentlemen Decoction.For severe spleen deficiency,Huangqi(Radix Astragali)and Chenpi(Pericarpium Citri Reticulatae)are often added.For excessive Phlegm dampness,Banxia(Rhizoma Pinelliae),Fuling(Poria)and Cangzhu(Rhizoma Atractylodis)are often added.For liver depression,Baishao(Radix Paeoniae Alba)and Chaihu(Radix Bupleuri)are often added.For blood stasis,Danggui(Radix Angelicae Sinensis)and Chuanxiong(Rhizoma Chuanxiong)are properly added to promote blood circulation and nourish blood.Puerperal hypogalactia belongs to syndrome of deficiency as primary and excess as secondary,so Mutong(Caulis Akebiae)and Wangbuliuxing(Semen Vaccariae)and Lulutong(Fructus Liquidambaris)can be used to dredge collaterals for producing milk.For fear that the tonic products will hinder the stomach,Muxiang(Radix Aucklandiae)and Sharen(Fructus Amomi)can be used to invigorate the spleen with aromatic herbs,move qi and remove stagnation,nourish deficiency rather than block.Professor Du believes that the spleen and stomach lie in the center of the five zang-organs,so the treatment should follow the principles of activating the spleen,ascending and drying the spleen,resolving phlegm,moving qi stagnation,promoting blood circulation,protecting the spleen and stomach in order to recover the proper function of the spleen,remove excess pathogen,dredge collaterals,and produce milk smoothly.