产后淋证源流与辨治

Origin and Syndrome Differentiation and Treatment of Postpartum Stranguria

产后淋证的主要病因可以概括为“热”“瘀”“虚”及“胞损”四个方面,而“热”为最重要的致病因素,“瘀”“虚”皆可生“热”,而“热”最易影响膀胱,致使膀胱功能失调,发为淋证。根据其病机,分为不同证型进行辨治。热袭膀胱证,治以清热通淋;瘀热互结证,治以清热活血通淋;阴虚生热证,治以养血补阴,滋阴清热;胞损证,治以大补气血,使气血快速恢复。也有医家将淋证分为热淋、血淋、虚淋三种。热淋者予滑石散清热通淋;血淋者凉血止血;虚淋分为肺虚与肾虚两类,肺虚者以补中益气汤培土生金,肾虚者以六味丸滋补肝肾,使虚得补而淋自止。各医家或按病因病机辨证论治,或按症状表现分而治之,治疗以热者清之,虚者补之,瘀者逐之为原则。

The main causes of postpartum stranguria can be summarized as"heat","blood stasis","deficiency"and"bladder damage",and"heat"is the most important pathogenic factor."Blood stasis"and"deficiency"can produce"heat",and"heat"is most likely to affect the bladder,resulting in bladder dysfunction and stranguria.According to its pathogenesis,it is divided into different syndrome types for syndrome differentiation and treatment.For the syndrome of heat attacking the bladder,the treatment is to clear away heat and remove stranguria.For the syndrome of blood stasis and heat in complexity,the treatment is to clear away heat,activate blood circulation and remove stranguria.For the syndrome of yin deficiency generating heat,the treatment is to nourish blood and yin,tonify yin and clear away heat.For bladder damage syndrome,the treatment is to greatly replenish qi and blood and make the rapid recovery of qi and blood.Some doctors also divide stranguria into three types:heat stranguria,blood stranguria,and deficiency stranguria.For heat stranguria,Talcum Power is used to clear away heat and remove stranguria.For blood stranguria,it is necessary to cool blood and stop bleeding.Deficiency stranguria is divided into lung deficiency and kidney deficiency.For lung deficiency stranguria,Center-Supplementing and Qi-Boosting Decoction is used for banking up earth to benefit metal.For kidney deficiency stranguria,Six-Ingredient Pill is used to nourish liver and kidney,so that deficiency can be replenished and stranguria can be removed.Various doctors either treat postpartum stranguria t according to the syndrome differentiation of etiology and pathogenesis,or treat it according to the symptoms and manifestations.The principle of treatment is to clear the heat,supplement the deficiency,and expel the blood stasis.