吴育宁从“痰瘀毒热互结”论治子宫腺肌病经验

Wu Yuning’s experience in treating adenomyosis from“phlegm,blood stasis,toxin and heat intermingle”

子宫腺肌病是一种比较难治的妇科疾病,其病灶呈进行性加重,使子宫逐渐增大,常伴严重痛经、月经量多,治疗难度很大。首都国医名师吴育宁诊治此病经验丰富,认为“痰瘀毒热互结”是其基本病机,病位在胞络、胞宫。因非经期临床症状不明显,而经期症状较重,故提出宜分期论治。非经期治本,以逐瘀祛痰、解毒消癥为主,兼顾月经周期。善用虫药,同时注重扶正祛邪,保护胃气。月经期治标,以“调经方”活血化瘀,止痛调经。灵活运用经方,缓解痛经症状,控制经量。用药独到,临床效果显著。本文对吴育宁治疗子宫腺肌病的临床经验进行总结,学习国医名师学术经验,提高临床诊疗水平,并附典型医案1则,以飨同道。

Adenomyosis is a kind of gynecological disease that is difficult to treat.Its focus is progressive aggravation,which makes the uterus gradually increased.It is often accompanied by severe dysmenorrhea and excessive menstruation,so it is very difficult to treat.Wu Yuning,a famous medical teacher of capital state,has rich experience in the diagnosis and treatment of this disease.She believes that“phlegm,blood stasis,toxin and heat intermingle”is its basic pathogenesis,and the disease is located in the collaterals and uterus.Because the clinical symptoms of non menstrual period are not obvious,but the symptoms in menstrual period are serious,so she proposed to discuss the treatment in stages.For the treatment of non menstrual period,it is mainly to eliminate blood stasis and phlegm,remove toxicity for eliminating accumulation,and take into account the menstrual cycle.She is good at using insect medicine,and pays attention to strengthening righteousness,dispelling evil,and protecting stomach qi.Menstrual symptoms should be treated with“Tiaojing Decoction”to promote blood circulation and remove blood stasis,which is also used to relieve pain and regulate menstruation.She used the prescriptions flexibly to relieve the symptoms of dysmenorrhea and control the amount of menstruation.The drug is unique and the clinical effect is remarkable.In this paper,Wu Yuning’s clinical experience in the treatment of adenomyosis is summarized.Moreover,the academic experience of famous Chinese doctors can be learned,the level of treatment can also be improved.Last but not least,a typical medical case is attached for peer’s reference.