曾诚从扶阳抑阴论治子宫内膜息肉思路探讨

Discussion on ZENG Cheng’s Thoughts for the Treatment of Endometrial Polyps in Respect of Supporting Yang and Suppressing Yin

子宫内膜息肉可导致异常子宫出血、不孕等,是妇科常见病,且复发率高。岭南罗氏妇科第四代传承人曾诚教授基于《黄帝内经·素问》“阳化气,阴成形”理论,并结合多年经验,认为“阳化气,阴成形”功能失调是子宫内膜息肉的主要病机,其发病以脾肾阳虚、阳化气不足为本;寒凝、痰浊、湿阻、血瘀等“阴成形”相对过盛为标。治疗以扶阳抑阴为原则,处方多用平和或温热性质、疏理气血等走阳分的药物,少用寒凉、滋润等走阴分的药物。治疗时还应结合月经周期和不同年龄阶段分期而治,灵活运用塞流、澄源、复旧三法,必要时中西医结合,配合使用膏方,共同为“阳化气”提供动力,减缓和抑制“阴成形”,提高临床疗效。

Endometrial polyps is a common gynecological disease with high recurrence rate,which could cause abnormal uterine bleeding,infertility,etc.By following the theory of“yang transforming into qi,while yin constituting form”recorded in Plain Questions of Huangdi’s Canon of Medicine and by combining with years of clinical experience,Professor ZENG Cheng,the fourth generation of inheritor of Lingnan LUO’s gynecology,believes that dysfunction of“yang transforming into qi,while yin constituting form”is the main pathogenesis of endometrial polyps.Yang deficiency in spleen and kidney and insufficient yang transforming into qi constitute to the origin of pathogenesis.The cold stagnation,turbid phlegm,damp-obstruction and blood stasis are the symptoms of“yin constituting form”.Treatment for endometrial polyps should be based on the principle of supporting yang and suppressing yin,and the prescriptions are often composed of the mild or warm-heat herbs acting on yang phase with the actions of regulating qi and blood,while the cold-cool herbs acting on yin phase with nourishing action were less used.Professor ZENG Cheng suggests that staging treatment should be performed according to the menstrual period and age groups,and the methods of stopping bleeding,identifying cause,and recovering health can be utilized flexibly.The integrated Chinese and western medicine therapy can be also used when necessary,and the soft extract can be used for daily management,so as to promote“yang transforming into qi”,slow down or inhibit“yin constituting form”,and then the clinical efficacy can be eventually enhanced.