《医宗金鉴·妇科心法要诀》从肝脾论治月经病探析

Treatment of Menstrual Diseases from Perspective of Liver and Spleen in Yi Zong Jin Jian·Fu Ke Xin Fa Yao Jue

《医宗金鉴·妇科心法要诀》作为我国最早的一部官修妇产科教材,详细论述了女子月经病,认为情志内伤、饮食脾胃损伤等因素可损伤肝脾,以致气血、冲任失调产生月经相关疾病,主张治肝脾以疗气血、冲任为本,辨证兼顾虚、实、寒、热为标,治疗在选择四君子汤、四物汤、归脾汤、逍遥散等调理肝脾经典方剂的基础上灵活加减用药。本文试从中医理、法、方、药等方面系统总结《医宗金鉴·妇科心法要诀》从肝脾论治月经病的辨治特色,以期拓宽现代医家治疗月经病的临证思路。

As one of the earliest official textbook of gynecology and obstetrics in China,Yi Zong Jin Jian·Fu Ke Xin Fa Yao Jue discusses women's menstrual disease in detail.It is believed that internal emotional injury,diet,spleen and stomach injury and other factors can damage the liver and spleen,resulting in imbalance of Qi,blood,Chong,Ren,and produce menstrual related diseases.It advocates that the treatment of liver and spleen should be based on the treatment of Qi,blood.Chong and Ren,and the syndrome differentiation should be based on deficiency,excess,cold and heat.The treatment should be based on the selection of classic prescriptions for regulating liver and spleen,such as Sijunzi Decoction,Siwu Decoction,Guipi Decoction and Xiaoyao Powder,on the basis of this,flexible addition and subtraction of drugs.This paper tries to summarize the characteristics of differentiation and treatment of menstrual diseases from the aspects of TCM theory,method,prescription and medicine in Yi Zong Jin Jian·Fu Ke Xin Fa Yao Jue,in order to expand the clinical thinking of modern doctors in the treatment of menstrual diseases.