基于“痰、郁、火”辨治更年期综合征

Treatment of Menopausal Syndrome Based on Phlegm,Stagnation,and Fire

更年期综合征多以肾虚为本,肾主藏精而司先天,肾水不足,肝木失养则易致肝郁化火;肾元亏虚,脾失于温煦,水湿运化无力则易生痰蕴火;肾阴衰少,水火失济,则易致心火偏亢,故临床常见由痰、郁、火导致的潮热、失眠、心烦心悸等症状。基于此,治疗之初应首治其标,以化痰、解郁、清火为法,常用黄连温胆汤、抑肝散、柴胡加龙骨牡蛎汤、清心滋肾饮等,在快速改善患者潮热汗出、烦躁易怒、多梦易惊等症状后,再予补益肾阳、滋养肾阴之品,以达祛邪扶正、标本兼治的目的,能更好地缓解患者症状。

Menopausal syndromes are mostly based on kidney deficiency,which could be expalined that kidney governing essence storage and controlling innateness,so when the kidney water was deficient and the liver fail to nourish,then led to liver depression and transform into fire;deficiency of the kidney,loss of warmth of the spleen,and inability to transport and transform the water and dampness will easily lead to phlegm and fire;the decline of the kidney yin and loss of water and fire will easily cause the exuberance of heart fire.Therefore,clinical symptoms of hot flashes,insomnia,and palpitations are common due to phlegm,depressions,and fire.Based on this,at the beginning of the treatment,we should treat the symptoms firstly by resolving phlegm,relieving depression and clearing fire,and com⁃monly use Huanglian Wendan Decoction(黄连温胆汤),Yigan Powder(抑肝散),Chaihu plus Longgu Muli Decoction(柴胡加龙骨牡蛎汤),and Qingxin Zishen Decoction(清心滋肾饮),etc.After improving the symptoms of hot flashes and sweating,irritability,dreaming and frightening,then we should give the prescriptions to tonify kidney yang and nourish kidney yin,in order to eliminate the pathogens and reinforce healthy qi,and to treat both the manifestations and the root cause,so that the symptoms of the patients can be better alleviated.