陈无咎辨治妇科疾病学术思想初探

Preliminary Exploration of CHEN Wujiu’s Academic Thoughts on Diagnosis and Treatment of Gynecological Diseases

[目的]探析陈无咎对妇科疾病的辨治思路及方药应用。[方法]通过研读《陈无咎医学八书》中有关妇科疾病的论述及医案,总结陈无咎治疗妇科疾病的理论特色、证治经验、组方及用药特点。[结果]陈无咎认为百病皆由三焦失调,故而妇科疾病应从三焦论治,妇人三十六病,实则冲、任、带三脉为病,治疗尤重视冲、任、带三脉辨治。妊娠脉主张先诊心肝,次诊养月。治病必宗《黄帝内经》,在辨证论治的基础上,善于将《黄帝内经》理论灵活运用于临床实践中。不孕症首责子宫有湿,应从湿而治;带下病辨色论治,若五带俱全,应先除黑带,再除青带,次除红带、黄带、白带;妊娠病防治并重;呕吐从子宫论治;鬼胎凭脉辨真假。组方独创主、从、导、引,善用当归调肝,安胎必用白术、黄芩。[结论]陈无咎治疗妇科疾病师古而不泥古,理法方药独具特色,对后世妇科疾病的辨治具有重要的指导意义。

[Objective]To explore CHEN Wujiu’s thoughts on differentiation and treatment of gynecological diseases and the application of prescription and medication.[Methods]By studying the content and medical records of gynecological diseases in Eight Works on Medicine of CHEN Wujiu,this paper summarized CHEN Wujiu’s treatment of gynecological diseases of the theoretical characteristics,treatment experience,formulating prescription and medication characteristics.[Results]CHEN Wujiu believed that all diseases were caused by dysfunction of tri-Jiao and the treatment of gynecological diseases should be based on the adjustments of the functions of tri-Jiao;he insisted that there was a very closely relationship between thirty-six diseases of women and Chong,Ren and belt channels,special attention should be paid to Chong,Ren and belt channels on the differentiation and treatment of gynecological diseases.When referring to the pregnancy pulse,doctors should diagnose heart pulse and liver pulse first,then gestational age.Diagnosing and treating diseases all based on the fundamental theory of The Yellow Emperor’s Internal Classic,on the basis of syndrome differentiation and treatment,using the theories of The Yellow Emperor’s Internal Classic flexibly in clinical practice.Treatment of infertility starting with wet,for dampness in the uterus was the leading cause;leukorrheal disease’s diagnosis and treatment were according to its color,if five colors appeared together,clean the black first,then cyan,red,yellow,white;as to gestational diseases,prevention was just important as treatment;treating vomiting from the uterus;distinguishing true or false of Guitai by pulse taking.He formulated new characteristics of prescription creatively,which included dominate,subordinate,conduct,direct four forms;CHEN Wujiu was very good at using Angelicae Sinensis Radix to regulate the function of liver;regularly used Rhizoma Atractylodis Macrocephalae and Scutellaria baicalensis Georgi for tocolysis.[Conclusion]CHEN Wujiu studied the ancients rather than the ancients,his principle-method-recipe-medicines of treating gynecological diseases is very distinctive,which is of great significance to the differentiation and treatment of gynecological diseases in later generations.