郭志强教授运用一贯煎从肝血论治妇科疾病验案四则

Four Experimental Cases of Professor GUO Zhiqiang Using Yiguanjian to Treat Gynecological Diseases from Liver-Blood Theory

女子以血为本,以肝为先天,肝、血失调是妇科疾病的常见病机。郭志强教授认为女性肝郁致病,与男子肝气横逆之实证不同,多因阴血不足、血不柔肝而致肝失疏泄,故提出治疗时“柔肝胜于疏肝”。郭志强教授独辟蹊径地以养血柔肝的代表方剂一贯煎为基础方进行随证加减,对于肝、血失调引起的妇科疾病疗效颇著,也充分体现了“异病同治”的中医辨证论治特色。本文所载郭志强教授运用一贯煎从肝、血论治妇科疾病验案四则:(1)滋阴养血柔肝,佐以补肾健脾,治疗肾虚肝郁型下丘脑性闭经;(2)滋阴养血、引火归元治疗虚阳上浮所致经行口糜;(3)滋阴养血,佐以引热下行,治疗经行衄血之虚热证;(4)滋阴养血,柔筋通络治疗阴血亏虚、筋脉失养所致产后身痛。并深入分析郭教授“妇人柔肝胜于疏肝”的学术思想在妇科疾病中的临床应用,以供借鉴。

Liver and blood disorders are the common pathogenesis of gynecological diseases.Professor GUO Zhiqiang believes that liver stagnation in women is different from the actual symptoms of liver Qi in men,which are mostly caused by deficiency of Yin and blood,and lack of blood to soften the liver,resulting in loss of liver circulation.Therapy is therefore"better to soften the liver than to clear it".Professor GUO Zhiqiang’s unique approach of adding and subtracting with the evidence based on the formula,which is representative of nourishing blood and softening liver,is very effective in treating gynecological diseases caused by imbalance of liver and blood,also fully reflecting the characteristic of"treating different diseases with the same evidence"in Chinese medicine.This article contains four cases of professor GUO Zhiqiang using Yiguanjian to treat gynecological diseases from the perspective of liver and blood:①Nourishing Yin and blood to soften liver,supplemented by tonifying kidney and strengthening spleen to treat hypochondriac amenorrhea caused by kidney deficiency and liver depression.②Nourishing Yin and blood,inducing fire to return to the vital energy to treat menstrual erosion due to deficiency of Yang.③Nourishing Yin and blood,supplemented by inducing heat to move downward to treat deficiency of heat due to epistaxis during menstruation.④Nourishing Yin and blood,softening tendons and opening the ligaments to treat postpartum body pain caused by deficiency of Yin and blood and loss of nourishment of tendons and veins.This article also provides an in-depth analysis of the clinical application of professor Guo’s academic thought that"for women,softening the liver is better than detoxifying it"in gynaecological diseases.