杨桂云从肾虚血瘀论治子宫内膜异位症

YANG Guiyun's Treatment of Endometriosis from the Perspective of Kidney Deficiency and Blood Stasis

子宫内膜异位症是困扰育龄女性的常见病、疑难病,常导致疼痛、包块、不孕等症状,病情反复,迁延难愈。笔者从病机要领、治法方药等方面阐述杨桂云教授从肾虚血瘀论治子宫内膜异位症的学术思想和遣方用药经验。杨桂云教授认为肾虚血瘀是子宫内膜异位症的病机关键,主张以温肾益气、活血消癥法贯穿疾病治疗始终,临证兼顾调肝健脾、理气化痰,配合运用“二期疗法”灵活加减。创制温肾消癥汤、补肾活血汤,前者侧重活血止痛,用以缓解子宫内膜异位症相关性痛经和盆腔痛,后者则长于补肾助孕,改善子宫内膜容受性,多用于子宫内膜异位症性不孕患者,均获得较好临床疗效。

Endometriosis is a common and challenging condition that afflicts women of reproductive age,often causing symptoms such as pain,masses,and infertility.The disease is characterized by recurrent and refractory nature.From the aspects of pathogenesis,treatment,medicinals and formulae,the author expounds Professor Yang Guiyun's academic thought and experience of treating endometriosis from the perspective of kidney deficiency and blood stasis.Professor Yang Guiyun believes that kidney deficiency and blood stasis is the key pathogenesis of endometriosis.Her therapeutic approach emphasizes the application of warming kidney,replenishing qi,activating blood and eliminating concretions throughout the course of the treatment.In clinical practice,the professor combines regulating the liver,fortifying the spleen,regulating qi and resolving phlegm,and flexibly adds and subtracts medicinals with the use of“two-stage therapy”.The professor has developed experienced formulae,Wenshen Xiaozheng decoction and Bushen Huoxue decoction.The former focuses on activating blood and alleviating pain and is commonly employed to mitigate endometriosis-related dysmenorrhea and pelvic pain,and the latter excels in tonifying the kidney to facilitate fertility by enhancing uterine endometrial receptivity,primarily applied to endometriosis-associated infertility.Both formulae have yielded favorable clinical outcomes.