马堃从心肾论治围绝经期排卵障碍性异常子宫出血经验

MA Kun's Experience in Treating Perimenopausal Abnormal Uterine Bleeding Ovulatory-Dysfunction From Heart and Kidney

总结马堃教授从心肾论治围绝经期排卵障碍性异常子宫出血的临证经验。认为肾虚血瘀、心肾不交是本病核心病机,提出以补肾活血、交通心肾为基本治法。根据“急则治其标,缓则治其本”的指导原则,出血期重视止血治标,自拟益肾止血宁心方以补肾宁心、交通心肾、益气养阴,达止血目的;血止后根据患者临床证候辨证论治以固本防复,针对肾气阴两虚、肾阳虚、肾阴阳两虚证,分别以二至丸合生脉散、右归丸、二仙汤合二至丸进行加减化裁;同时将活血化瘀法贯穿治疗全程。

This paper summarized professor MA Kun's clinical experience in treating perimenopausal abnormal uterine bleeding-ovulatory-dysfunction(AUB-O)from heart and kidney.Kidney deficiency with blood stasis,and failure of heart and kidney to interact are the core pathogenesis.It is proposed to supplement kidney and activate blood,restore interaction between the heart and the kidney as the basic treatment principle.According to the theory that“in urgent conditions,treat the branch,while in moderate conditions,treat the root”,it is critical to stanch bleeding and treat the branch during the bleeding period,and self-made Yishen Zhixue Ningxin Formula(益肾止血宁心方)is recommended to supplement kidney and calm heart,restore interaction between the heart and the kidney,boost qi and nourish yin,thereby stanching the bleeding.Thereafter,syndrome-differentiated formulas are used to prevent recurrence.In terms of deficiency of both kidney qi and yin,kidney yang deficiency,and kidney yin and yang deficiency,Er Zhi Pill with Sheng Mai Powder(二至丸合生脉散),You Gui Pill(右归丸),Er Xian Decoction with Er Zhi Pill(二仙汤合二至丸)in modifications are used,respectively.Meanwhile,it is necessary to activate blood and dissolve stasis throughout the whole treatment process.