经行吐衄源流考

Investigation on Origin and Development of Menstrual Hematemesis and Epistaxis

作者通过查阅相关书籍文献,分析历代医家对经行吐衄病名、病因病机的论述,并对其治法进行总结,以冀有益于现代临床诊疗。早在南宋齐仲甫《女科百问》首次提出“经行吐衄”之病因证治;后至明清医家对此病论述较详,清代《医宗金鉴》首次提出“经行吐衄”之名;近现代医家对本病认识日臻全面。理其源流,梳理其病名包括“倒经”“逆经”“错经妄行”,病因病机概括为肝经郁火、胃热炽盛、阳盛阴虚,治法以清泄肝火,导血下行;清泻胃火,凉血调经;清热凉血,引血下行;活血通络,引血下行;滋阴清热,降逆调经为主。

Through consulting relevant books and literature, the author analyzed the discussion of epistaxis, etiology and pathogenesis of menstrual hematemesis and epistaxis and summarized its treatment, so as to benefit modern clinical diagnosis and treatment.As early as in QI Zhongfu′s One Hundred Questions on Gynecology,the etiology and treatment of menstrual hematemesis and epistaxis were first proposed.From the later to the Ming and Qing Dynasties, doctors discussed this disease in detail.The name of menstrual hematemesis and epistaxis was first put forward in Golden Mirror of Medical Tradition in the Qing Dynasty.Modern doctors have a comprehensive understanding of the disease.After studying its origin and combing its disease name including “inverted menstruation”,“reverse menstruation”,“wrong menstruation”,the etiology and pathogenesis was summarized as fire depression in liver meridian, heat burning in stomach and Yang excess and Yin deficiency.The treatment is mainly to clear liver fire and induce blood downward;clear away stomach fire, cool blood and regulate menstruation;clear heat and cool blood, induce blood downward;activate blood circulation and dredge collaterals, induce blood downward;nourish Yin and clear heat, reduce adverse reactions and regulate menstruation.