从《黄帝内经》阳气理论探析妇人月事

Exploring Menstrual Physiology and Pathology by Yang Qi Theory in Inner Canon of Yellow Emperor

[目的]从《黄帝内经》阳气理论出发,分析女子月经的生理过程及月经病的病因病机,探讨其临床辨证论治特色。[方法]以阳气理论为纲,结合各家对其女子月经相关经文的注解,阐述《黄帝内经》对妇人月事正常生理之内涵,及其对月经后期、月经量少、闭经、崩漏、痛经等病理过程的辨证论治。[结果]阳气理论是《黄帝内经》的重要学术思想之一,在论述阴阳二者相反相成、互根互用时,以阳为主导,强调阳固阴秘、阳主阴从。在对女子月经初潮的发生及相应的生理变化、月经错后之经闭不月、非时而下之崩漏、阳被阴乘之痛经的病理变化的论述中,处处体现了“阳气为本”的阳气理论。因此,在月经病的辨证论治中,提倡无问其病在阴在阳,皆需时时固护阳气。[结论]《黄帝内经》以阳气为女子月事发生、化生之根源,辨治时主张先谨察阴阳之所在,强调阳密固阴,阳生化长,从而调周整期,经汛如常。

[Objective]To analyze the physiological process,etiology and pathogenesis of women’s menstruation,and discuss the clinical characteristics of syndrome differentiation and treatment to emmeniopathy,based on the Yang Qi theory of Inner Canon of Yellow Emperor.[Methods]Based on the Yang Qi theory,combined with the annotations of various scriptures related to women’s menstruation,this paper expounded the connotation of normal physiology of women’s menstruation in Inner Canon of Yellow Emperor,and the syndrome differentiation and treatment of late period,scanty periods,amenorrhea,bleeding,dysmenorrhea and other pathological processes.[Results]Yang Qi theory is one of the important academic ideas in Inner Canon of Yellow Emperor.When discussing the opposite and mutual complementarity of Yin and Yang,Yang was regarded as the dominant factor.Inner Canon of Yellow Emperor emphasized that Yang was the key to Yin,and Yang was the principal while Yin was the subordinate.In the discussion about the occurrence of menarche,the physiological development and pathological changes of menstruation,the theory of Yang Qi was embodied everywhere in Inner Canon of Yellow Emperor.In the treatment of menstrual diseases based on syndrome differentiation,no matter the disease is of Yin or Yang,it is necessary to protect Yang Qi from time to time in order to regulate the menstrual cycle and normalize menstruation.[Conclusion]Inner Canon of Yellow Emperor takes Yang Qi as the root of the occurrence and transformation of women’s menstruation,and advocates careful observation of Yin and Yang first.Inner Canon of Yellow Emperor emphasizes that the closeness of Yang could consolidate Yin,so that Yang can change the invisible into tangible,adjusting the women’s menstrual cycle,and keep the menstruation as usual.