《临证指南医案》奇经论治不孕症特色及奚嘉教授运用心得

The therapeutic characteristics of infertility with eight extraordinary meridians in Medical Records for Clinical Guidance and Professor Xi Jia′s experience in clinical application

收集整理叶天士《临证指南医案》中有关不孕症的经典医案,总结叶天士奇经辨治不孕症的理法方药特色。叶氏认为不孕症多由冲任气血失调所致,多累及肝及先后天之本,病久则奇经八脉受损,不能成孕。叶氏奇经辨治不孕症以“通补”为原则,“通因”为治法,遵循“专药入奇经,分经用药”的原则。奚嘉教授继承叶氏奇经理论,利用叶氏奇经思想辨治不孕症,结合自身丰富的临床经验,在其基础上主张“宣通奇经,填补肝肾脾胃”“填益精髓,调补肝肾”,以补为主,以通为用,通补结合,走出了具有自身特色的“奇经辨治不孕症”之路,为临床治疗不孕症提供借鉴。

The classic medical cases of infertility in Ye Tianshi′s Medical Records for Clinical Guidance are collected and sorted out,and his therapeutic characteristics of principle-method-recipe-medicine in treating infertility with eight extraordinary meridians are summarized.Ye Tianshi believes that infertility is mostly caused by disorder of qi and blood in chong vessel and conception vessel,which mostly involve the liver and the congenital base and postnatal base.If the disease lasts for a long time,the eight extraordinary meridians are damaged and the patient could not become pregnant.The treatment of infertility with eight extraordinary meridians by Ye Tianshi is based on the principle of“dredging and tonifying”and the treatment method of“treating diarrhea with purgative”.It follows the principle of“special medicines going into the eight extraordinary meridian,and medication being given according to different meridians”.Professor Xi Jia inherits and uses Ye′s theory of eight extraordinary meridians to differentiate and treat infertility.Combined with her own rich clinical experience,Prof.Xi Jia advocates the idea of“dredging the eight extraordinary meridians and reinforcing liver-kidney-spleen-stomach”and“supplementing essence and marrow and adjusting and nourishing liver-kidney”,which focuses on the combination of tonifying(for base)and dredging(for aim).Prof.Xi Jia has gone out of her own unique way to differentiate and treat infertility with eight extraordinary meridians,which can provide reference for clinical treatment of infertility.