叶天士应用“肝-胃”理论辨治月经不调探析

Analysis of YE Tianshi’s Application of“Liver-stomach”Theory in Differentiation and Treatment of Irregular Menstruation

肝与胃对于维持月经具有重要作用,肝藏血、主疏泄功能与胃生血功能息息相关,两者功能失常可相互影响,致生血与行血障碍,从而引发月经不调。叶天士治疗月经不调体现了此思想,其著作《临证指南医案》调经篇所载医案,肝胃同病者通常以疏肝和胃为基本治法,肝气舒畅可助和胃之效,胃和则肝疏泄有常。除此之外,在以肝为病变中心及以胃为病变中心的医案中,考虑到肝病可下传胃,胃不和可致肝功能失常,常常肝胃同治。

The liver and stomach play an important role in maintaining menstruation.The liver’s function of storing blood and governing free flow of qi is closely related to the stomach’s function of generating blood.Dysfunction of liver and stomach can affect each other,leading to disorders in blood production and circulation,resulting in irregular menstruation.This thought was reflected in the treatment of irregular menstruation by YE Tianshi.According to the medical records in the chapter of regulating menstruation of his book Guide to Clinical Practice with Medical Records,patients with disease involving both liver and stomach usually rely on soothing liver and harmonizing stomach as the basic treatment method.Soothing liver qi can assist the efficacy of harmonizing stomach,while harmonizing stomach leads to free flow of liver qi.In addition,in the medical cases with liver as the center of disease and stomach as the center of disease,considering that liver disease can transmit to stomach,and stomach disorder can cause liver dysfunction,the liver and stomach are often treated together.