国医大师梅国强治疗产后汗出经验撷华

National master of Chinese medicine MEI Guoqiang's experience in treating postpartum sweating

产后汗出是产后常见疾病。国医大师梅国强从营卫功能角度出发,认为产后汗出之病机总属营卫不和,包括营卫气血虚弱和营卫运行不畅两方面。前者因卫气不固,或营阴不足、浮阳不敛、外迫津液而见汗出,与产后耗气伤血有关。后者则主要责之湿(痰)热邪气阻滞。因营卫出于中焦,中焦太阴脾主运化津液,易生湿邪,阳明胃脘腐熟水谷,易化燥生热,产后盲目进补,中焦运化不及则易生湿热。营卫同出于中焦,易受湿热邪气阻滞而运行不畅,湿热向外蒸腾即发病。以调和营卫、益气固表、清化湿热、分消走泄及收敛止汗为常用治法,使腠理致密、湿去热清、营卫通调,则汗出止,常用方剂包括桂枝汤、玉屏风散、温胆汤(加荷叶、竹叶、丝瓜络)、二妙散等。

Postpartum sweating is a common postpartum disease.MEI Guoqiang,a national master of Chinese medicine,from the perspective of the function of Ying and Wei,believes that the pathogenesis of postpartum sweating is always due to the discord between the Ying and Wei,including the weakness of Qi and blood and the poor operation of Ying and Wei.In the former,sweating is seen due to Wei Qi is not solid,or insufficient of Ying and Yin,uncontrolled floating Yang,and external pressure on body fluid,which is related to postpartum consumption of Qi and injury to blood.The latter is mainly responsible for damp(phlegm)and heat pathogenic stagnation.Because Ying and Wei originates from the middle energizer,the middle energizer Taiyin spleen mainly transports and transforms body fluid,which is prone to dampness pathogens,and the Yangming epigastric cavity is decomposed,which is easy to dissolve dryness and generate heat.After childbirth,it is easy to produce damp and heat if the deficiency is blindly replenished and the middle energizer is not transported.Ying and Wei are both from the middle energizer,so they are easy to be blocked by the evil Qi of damp and heat,and their operation is not smooth.The disease occurs when damp and heat transpiration outward.To reconcile Ying and Wei,invigorate Qi and solidify the surface,clear away dampness and heat,dispel leakage and astringe antiperspirant as common treatment methods,make the stomach dense,remove heat from dampness,clear away heat,and regulate Ying and Wei,then sweating stops.Commonly used prescriptions include Guizhi Decoction,Yupingfeng Powder,Wendan Decoction[with Heye(Nelumbinis Folium),Zhuye(Lophatheri Herba),Sigualuo(Luffae Fructus Retinervus)],Ermiao Powder,etc.