从脏腑之形神浅述崩漏的“形神一体观”

The concept of the unity of body and spirit of metrorrhagia and metrostaxis

崩漏是妇科常见的疑难杂症,患者“身心俱病”,会影响家庭和谐,为崩漏寻找有效的治疗方法迫在眉睫。文章以中医学“形神一体观”理论为基础,浅析崩漏之形神、脏腑之形神与崩漏以及崩漏与冲任二脉之间的关系。崩漏的症状为形病,患者焦虑、急躁等消极情绪为神病,主要从心、肝、脾、肾的形神论述崩漏的成因。冲任二脉与女子月经息息相关,崩漏的治疗必须要考虑到冲任二脉。在治疗上崩漏之形神应同治,止崩漏以调形,畅情志以调神,“形神同治”方可有稳定的远期疗效。临床上以气虚证、血热证和血瘀证常见。气虚证选用固本止崩汤,恢复脾胃之功,化生水谷精微养神;血热证选用荆芩四物汤或清热固经汤,以清热凉血、滋阴敛血,热去则神安;血瘀证选用生化汤,祛瘀血,生新血,使肝魂得养,祛除抑郁之感以安神。文章重视脏腑所化生的精神情志与崩漏的关系,有别于传统脏腑理论,从病因病机分析到治疗都以“形神一体观”为基础,为治疗崩漏提供稳定的远期佳效。

Metrorrhagia and metrostaxis are common and difficuit diseases in gynecology,making the patients sick physically and mentally,which will affect family harmony.It is urgent to find effective treatment for metrorrhagia.Based on the theory of the concept of the integration of form and spirit in TCM,this paper analyzes the relationship between the form and spirit of metrorrhagia,the form and spirit of viscera and metrorrhagia,as well as the relationship between metrorrhagia and the two channels ofM Chong and Ren meridians(冲任二脉).The symptoms of metrorrhagia and metrorrhagia are psychosis,and the patients’negative emotions such as anxiety and impatience are psychosis.It mainly discusses the causes of metrorrhagia from the shape and spirit of heart,liver,spleen and kidney.The Chong and Ren meridians are closely related to women’s menstruation.The treatment of metrorrhagia must take into account the Chong and Ren meridians.In treatment,the form and spirit of metrorrhagia should be treated together,the form of metrorrhagia should be regulated to stop metrorrhagia,and the mood should be regulated to regulate the spirit.Treating the form and spirit together show a stable long-term effect.Qi(气)deficiency syndrome,blood-heat syndrome and blood stasis syndrome are common in clinic.For the syndrome of Qi deficiency,the Guben Zhibeng decoction(固本止崩汤)is used to restore the function of the spleen and stomach,transform the essence of water and grain,and nourish the mind.For blood-heat syndrome,the Jingqin Siwu decoction(荆芩四物汤)or the Qingre Gujing decoction(清热固经汤)is selected to clear heat and cool blood,nourish Yin(阴)and collect blood,and remove heat to calm the nerves.For blood stasis syndrome,the Shenghua decoction(生化汤)is used to remove blood stasis,generate new blood,nourish the liver and soul,remove depression and calm the nerves.This article attaches importance to the relationship between the mental emotion generated by the viscera and metrorrhagia,which is different from the traditional viscera theory.From the cause analysis to the symptom treatment,it is based on the concept of body and spirit integration,providing a stable long-term good effect on metrorrhagia.