运用郑钦安扶阳思想辨治围绝经期汗证体会

Experience in treating perimenopausal sweat syndrome with ZHENG Qin-an’s thought of strengthening yang

潮热多汗是围绝经期最突出的临床表现之一,属于中医“汗证”范畴。文章围绕围绝经期汗证治疗中“阴阳辨识”的难点,引入郑钦安先生“阳主阴从”的学术思想和“阴火”理论,提出临证中应仔细辨识“神、色、舌、脉”,多汗若见神疲乏力、困倦思睡、少气懒言、面色暗沉、舌淡胖、苔润滑、脉沉或缓,则属阳虚阴盛所致“阴火”。治疗以扶阳固摄为主,并提出围绝经期汗证属“阴火”者可选用潜阳丹和封髓丹。最后通过临床病案分析,加深对围绝经期汗证扶阳辨治思路的理解。

Hot flush hyperhidrosis is the major clinical manifestation in perimenopausal,it belongs to the category of TCM sweat syndrome.This paper focuses on the difficulty of‘yin-yang identification’in the treatment of perimenopausal sweat syndrome,introducing Dr.ZHENG Qin-an’s thought of strengthening yang and the theory of‘yin-fire’.It is proposed that‘spirit,color,tongue and pulse’should be carefully identified in clinical syndrome.If sweating is accompanied by mental fatigue,drowsiness and sleepiness,lack of breath and laziness,the complexion is dark,the tongue is light and fat,the coating is smooth,and the pulse is heavy or slow,it is considered as yang deficiency and yin prosperity.The treatment mainly focused on strengthening yang and absorbing,and suggested that those with perimenopausal sweat syndrome of‘yin fire’could choose Qianyang Pill and Fengsui Pill.Finally,through the analysis of clinical cases,we can deepen our understanding of the treatment of perimenopausal sweat syndrome based on the differentiation of yang.