中医二联疗法治疗湿热瘀阻型慢性盆腔炎验案1则

Treating one case of chronic pelvic inflammatory disease with dampness-heat stasis by TCM combined therapy

慢性盆腔炎是妇科常见的一种疾病,临床上常表现为急慢性腹痛、性交痛等,可归属于中医带下病、不孕、经病疼痛等范畴,中医认为此病发病多与肝脾肾功能失调相关。随着社会发展,其发病率日益增高,严重影响育龄期女性及绝经期妇女生活质量及身心健康,同时盆腔炎患者发生卵巢恶性肿瘤的概率更高,故此病的治疗现已成为国内外一大研究热点。西医治疗此病多采用抗生素,其长期使用耐药性及不良反应也让越来越多的慢性盆腔炎患者望而却步。大量研究表明,中医治疗此病可避免耐药性及肝肾功能损害等不良反应,保留灌肠的使用又可以通过肠道吸收直达病所,改善盆腔微环境,避免通过肠道吸收所带来的肠道不良反应,两者联用有较好效果。付金荣教授为蔡氏妇科第八代传承人,继承蔡老学术思想,又结合自己治疗理论,在治疗慢性盆腔炎患者时有独特见解与思路,她认为该病病机主要为肾虚脉络不通与湿热瘀阻共同作用,其中肾虚为本,湿、热、瘀为标,相关转换,互为因果,致此病缠绵难愈。在治疗时付金荣教授主张活血清热,利湿止痛并举,育肾培元,内外同治,采用中药口服联合保留灌肠二联疗法,其临床疗效显著,附验案1则佐证。

Chronic pelvic inflammatory disease is a common gynecological disease,which often manifestes as acute and chronic abdominal pain,dyspareunia,etc.It can be classified into vaginal discharge diseases,infertility,menstrual pain and so on in TCM.TCM believes that the onset of this disease is related to liver,spleen and kidney dysfunction.With the development of society,its incidence is increasing,which seriously affects the quality of life and physical and mental health of childbearing age women and menopausal women.At the same time,the incidence of ovarian malignant tumor in patients with pelvic inflammatory disease is higher,so the treatment of this disease has become a hot topic at home and abroad.Antibiotics are used in Western medicine to treat this disease,and their long-term drug resistance and adverse reactions have discouraged more and more patients with chronic pelvic inflammatory disease.A large number of studies have shown that not only the TCM treatment of this disease avoids adverse reactions such as drug resistance and liver and kidney function damage,but also the use of retention enema can directly reach the disease through intestinal absorption,improve the pelvic microenvironment,and avoid intestinal adverse reactions caused by intestinal absorption.The combination of the two has a good effect.Professor FU Jinrong is the eighth generation successor of CAI’s gynecology,inheriting CAI’s academic thought and combining her own treatment theory,she has her own unique insights and ideas in the treatment of chronic pelvic inflammatory disease.She believes that the main pathogenesis of this disease is kidney deficiency,meridian obstruction and damp-heat stasis,which are caused by the joint action of kidney deficiency,humidity,heat and blood stasis.Among them,kidney deficiency is the root cause,humidity,heat,blood stasis are the symptoms,which are mutually transacting and the mutual causes and effects,causing the disease lingering and difficult to be cured.In the treatment,Professor FU Jinrong advocates promoting blood circulation and clearing heat,reducing dampness and relieving pain,nourishing kidney and cultivating the essence by combining the internal and external treatment,namely,applying the oral administration of Chinese medicinal materials combined with retention enema combination therapy,of which the clinical effect is significant,and one test case is attached as evidence.