从肝论治妇人腹痛

Treatment of Women′s Abdominal Pain from the Liver

盆腔炎性疾病遗留的慢性盆腔痛是妇科常见病、多发病,病因繁杂。现代医学治疗该病主要以抗炎及抗生素治疗为主,在疾病急性发作期疗效显著,但在改善远期并发症方面见效匮乏。中医古籍文献中未见关于盆腔炎的记载,临证根据其发病特点将其归属于“妇人腹痛”“带下病”等疾病范畴。中医药治疗妇人腹痛具有独特优势,疗效已通过长期大量的研究证实,尤其是在降低远期并发症发生率、改善症状、减轻不良反应方面具有显著优势。本研究通过参考古今文献,并结合自身临床实践,发现妇人腹痛乃虚实夹杂,以实为主,主要病机在于肝枢不畅,气滞于内,不通则痛,故临证诊治该病时,察色按脉,先辨虚实,疏肝解郁,以畅气机,用药遣方遵从轻灵平稳,药少力专,临证每获良效。

Chronic pelvic pain caused by pelvic inflammatory disease is a common and frequently-occurring disease in gynecology.Its etiology is complicated.Modern medical treatment of chronic pelvic pain is mainly based on anti-inflammatory and antibiotic treatment,which has significant effect in the acute attack of the disease,but lack effect in improving long-term complications.There is no record of pelvic inflammatory disease in the ancient literature of traditional Chinese medicine.According to the characteristics of its pathogenesis,in traditional Chinese medicine,it is classified into the category of woman′s abdominal pain,leukorrhagia and other diseases.Traditional Chinese medicine has unique advantages in the treatment of woman′s abdominal pain,and its curative effect has been confirmed by a large number of studies,especially in reducing the incidence of long-term complications,improving symptoms and reducing side effects.By referring to ancient and modern literature and combining with clinical practice,the author finds that women′s abdominal pain is mixed with deficiency and excess,mainly with excess.The main pathogenesis is that the liver pivot is not smooth,stagnation of Qi,and stagnation leads to pain.Therefore,clinical diagnosis and treatment of this disease should first distinguish deficiency and excess,soothing the liver and relieving depression to smooth the Qi movement.The prescription should comply with the princeple of less in medicine and special in efficacy,and the clinical effect is good.