基于相火妄动论述围绝经期女性反复尿路感染

Recurrent urinary tract infection in perimenopausal women was discussed based on hyperactivity of ministerial fire

反复尿路感染是围绝经期女性的常见病症,具有发病率高、病程长且容易反复发作的特点,临床治疗较为困难。其核心病机是“相火妄动”,具体而言,肝肾阴虚致相火失于制约,少阳枢机不利致相火失于疏泄,心不藏神致相火失于统帅。以上因素共同导致相火妄动,且循经下扰于膀胱,发为尿路感染。同时,相火炎热炽盛煎灼肝肾阴血,相火与湿相蒸阻滞少阳枢机,相火上扰心君使君火不得安宁。以上因素综合作用,进一步导致相火妄动为害,如此循环往复,最终导致尿路感染反复发作。治疗上以滋阴降火、疏利少阳、清心通淋为原则,选用大补阴丸合柴苓汤合导赤散为基础方加减治疗,最终使相火安位,围绝经期女性的反复尿路感染病症得以有效控制。

Recurrent urinary tract infections is a common disease in perimenopausal women,which is characterized by high incidence,long course of disease and easy recurrence,and it is difficult to treat clinically.Its core pathogenesis is“hyperactivity of ministerial fire”,specifically,yin deficiency of liver and kidney can lead to the ministerial fire lose restriction;dysfunctios of Shaoyang Pivot cause the ministerial fire lose dispersion;the heart does not stores the spirit,causing the ministerial fire will lose government.All the above factors together cause the ministerial fire to be out of position,and the ministerial fire interfere with the bladder along meridians,resulting in urinary tract infections.At the same time,the ministerial fire is hot and exuberant,which burns yin of the liver and kidney;mutual transpiration of ministerial fire and moisture blocks the Shaoyang pivot;ministerial fire disturbs the heart,causing the heart's fire to be restless.The combined effect of the above factors further leads to more harm by ministerial fire,which in turn leads to repeated episodes of urinary tract infection.The treatment is based on the principle of nourishing yin and falling fire,smoothing Shaoyang,clearing away the heart-fire and relieving stranguria,and Dabuyin Pill,Chailing Decoction,and Daochi Powder are selected as the basic prescriptions for treatment,we can ultimately make ministerial fire stay in original place and effectively control recurrent urinary tract infection in perimenopausal women.