廖慧慧治疗子宫腺肌病的思路探讨

Exploration of the Thoughts of LIAO Hui-Hui in Treating Adenomyosis

子宫腺肌病在中医学中可归属“癥瘕”“痛经”“月经失调”“不孕”等范畴。廖慧慧教授认为,子宫腺肌病为虚实夹杂之证,但在不同阶段虚实各有所侧重,“瘀”和“寒”是本病的病理基础及关键因素,其病机之本为血瘀,致瘀关键责之于寒凝。治疗上主张中西医辨病与辨症结合。对于子宫腺肌病以癥瘕、痛经为主者,需分期论治,非经期以消为主,重在活血消癥散结,方拟加味桂枝茯苓丸;经期以通为用,重在温通化瘀止痛,方拟少腹逐瘀汤加减;针对月经过多,主张经期补气摄血、化瘀止血,平时温补气血、消癥散结。针对子宫腺肌病所致不孕患者,则需根据患者年龄、子宫大小、痛经程度,可优先采用中药调经止痛助孕,再考虑中西医结合助孕。临证时根据不同兼症,灵活立法选方,同时注重情志和养生调治,以取显效。

Adenomyosis can be classified as“abdominal mass”“dysmenorrhea”“menstrual disorders”and“infertility”in the field of traditional Chinese medicine.Professor LIAO Hui-Hui believes that the syndrome differentiation of adenomyosis is characterized by deficiency interweaved with excess,while the predominance of deficiency syndromes or excess syndromes varies in different stages of the disease.Blood stasis and cold accumulation contribute to the pathological basis and the key pathogenic factors.The fundamental pathogenesis is due to blood stasis and cold accumulation is the key to the formation of the blood stasis.During the clinical treatment,Professor LIAO advocates the integration of disease and symptom differentiation and treatment.In the case of abdominal mass and dysmenorrhea,the treatment should performed in stages.In the non-menstrual period,the treatment of adenomyosis should be focused on elimination therapy with the methods of activating blood,eliminating abdominal mass and dissipating mass,and the modified Guizhi Fuling Pills can be adopted;in the menstrual period,the treatment of adenomyosis should be focused on unblocking therapy with the methods of warming and unblocking,resolving blood stasis to relieve pain,and modified Shaofu Zhuyu Decoction can be adopted.For patients with menorrhagia,professor LIAO advocates that the methods of replenishing qi to arrest blood,resolving stasis to stop bleeding can be used during menstrual period,and the methods of warming and supplementing qi and blood,eliminating abdominal mass and dissipating mass can be used during the nonmenstrual period.For infertile patients,Professor LIAO suggests that Chinese herbal medicine for regulating menstruation and relieving pain,and promoting gestation can be used firstly and then a combination of Chinese and western medicine can be adopted to assist pregnancy by considering the age of the patients,size of the uterus and degree of dysmenorrhoea of the infertile patients.In order to achieve significant results in the clinical practice,the prescriptions should be chosen flexibly according to the accompanied symptoms,and attention should be also paid to the emotional regulation and health preservation.