原发性痛经中医病因病机的研究概况

Research overview of TCM etiology and pathogenesis of primary dysmenorrhea

原发性痛经是指盆腔无明显器质性改变,且女性行经期间出现周期性的小腹部及腰骶部疼痛的妇科常见病与多发病。近年来,其发病越来越趋向于年轻化,发病率逐年增高,严重影响女性的生活质量。西医认为本病的发生主要与前列腺素、缩宫素、雌激素、孕激素、血管活性因子、β-内啡肽及子宫本身的因素密切相关,故治疗多采用药物或手术治疗。中医则认为本病病因病机主要概括为"不通则痛""不荣则痛"。治疗以"通则不痛""荣则不痛"为基础,多采用中药、针灸等。其治疗手段多样,且具有疗效确切、不良反应小、操作简便等优势。因此,对于本病的病因病机的研究显得尤为重要,文章从外感风、寒、湿、热之六淫邪气;内伤于肝、脾胃、心、肺、肾之五腑及冲脉、任脉、督脉、足少阴肾经、足厥阴肝经、足太阳脾经、足太阳膀胱经之经络循行三个角度总结了原发性痛经中医病因病机的研究概况。并通过对现有的病因病机的研究,指出目前在病因病机研究方面仍需要注重的三个问题:一是病因病机的研究与临床病因学相关联;二是从实验角度进一步证实经络与胞宫的具体相关性;三是研究环境及体质因素对痛经发病的影响,进一步合理规范痛经的个体化治疗方案,为临床治疗原发性痛经提供新思路。

Primary dysmenorrhea refers to the gynecological common diseases and frequently-occurring diseases with no obvious organic changes in the pelvic cavity and periodic pain in the lower abdomen and lumbosacral region during menstruation in women.In recent years,the incidence of the disease tends to be younger and higher year by year,which seriously affects the quality of life of women.Western medicine believes that the occurrence of this disease is mainly related to the factors of prostaglandin,oxytocin,estrogen,progesterone,vasoactive factor,endorphin and the uterus itself,so the treatment is mostly drugs or surgical treatment.Traditional Chinese medicine holds that the etiology and pathogenesis of the disease is mainly summarized as“pain caused by stagnation”,“pain caused by no nourishment”.The treatment is based on“removing stagnation”and“nourishment”,in which traditional Chinese medicine,acupuncture and moxibustion are frequently used.Its treatment methods are varied,and it has the advantages of exact curative effect,small toxic and side effects,simple operation and so on.Therefore,it is particularly important to study the etiology and pathogenesis of this disease.In this paper,six pathogenic factors,namely wind,cold,humidity and heat,which are externally sensed are summarized.The etiology and pathogenesis of primary dysmenorrhea are summarized from three aspects:internal injury to the liver,spleen and stomach,heart,lung and kidney organs,Chong meridian,Ren meridian,Du meridian,foot Shaoyin kidney meridian,foot Jueyin liver meridian,foot Taiyang spleen meridian,foot Taiyang bladder meridian.And based on the current research on etiology and pathogenesis,it points out that the current research on the etiology and pathogenesis still needs to pay attention to the three problems,one is that the study of the etiology and pathogenesis is associated with clinical etiology,the second is to further confirm that the correlation with the specific cellular palace of main and collateral channels from the experiments,the third is to study the environment and physical factors,which influence on dysmenorrhea disease,to find further reasonable specification dysmenorrhea individualized treatment plan,and provide new ideas for clinical treatment of primary dysmenorrhea.