王永宏基于“腑以通为用”论治子宫肌瘤经验

Wang Yong-hong′s Experience of Treating Hysteromyoma Based on"The Six Hollow Viscera Keeping its Unobstructed State"

王永宏教授认为,"腑以通为用"是对六腑生理特点的概括,重点在"通"。子宫肌瘤基本病机以瘀血为主,但常与寒凝、湿热、痰湿、气滞等病邪互相胶结,虚实夹杂,邪正相争,互为因果,治疗当以"通"法为治则,即通过疏通法、补通法、温通法疏利肝气、升降脾胃气、补益肾气、调节冲任。疏通法主要从肝论治,临证时在自拟疏肝消瘤方的基础上辨证施治,心、肺、脾、肾四脏兼顾;补通法以脾肾为先,治疗上应平衡补泻,自拟补虚消瘤方;温通法以温经散寒、祛瘀消癥为主要治法,常用少腹逐瘀汤加减,并结合中医外治法。王教授强调,在治疗的同时忌食发物,调畅情志,谨慎起居,使已成之肌瘤渐消,防患肌瘤复发。

Professor Wang Yong-hong believes that"The six hollow viscera keeping its unobstructed state"is a generalization of the physiological characteristics of the six fu organs,focusing on"dredging."The basic pathogenesis of hysteromyoma is mainly blood stasis,but it is often intermingled with cold coagulation,dampness heat,phlegm dampness and qi stagnation,with deficiency and excess in complexity,pathogenic qi fighting with healthy qi being mutual cause and effect.Professor Wang stresses that the treatment of hysteromyoma should take the"dredging"method as the treatment principle,that is,through method of dredging by dispersing,method of dredging by nourishing,and method of dredging by warming to disperse liver qi,ascend and descend spleen and stomach qi,tonify kidney qi,and regulate TV and CV.Method of dredging by dispersing is mainly based on the treatment of liver.In the clinical practice,hysteromyoma is treated according to syndrome differentiation on the basis of self-made Liver-Dispersing and Hysteromyoma-Removing Formula,taking into account the four viscera of heart,lung,spleen and kidney.Method of dredging by nourishing focuses on the spleen and kidney first,and the treatment should balance between reinforcement and reduction,so that qi and blood are in harmony,accumulation can disperse,and self-made Deficiency-Nourishing and Hysteromyoma-Removing Formula is often used.Method of dredging by warming focuses on warming meridians and dispersing cold,removing blood stasis and eliminating masses.Modified Lower Abdominal Stasis-Expelling Decoction combined with TCM external therapies is often used.Professor Wang stresses that in the treatment at the same time,the patient should avoid stimulating food,regulate emotions,and live a careful daily life,so as to gradually eliminate the existing hysteromyoma and prevent the recurrence of hysteromyoma.