黄尧洲教授辨治膀胱过度活动症的经验

Professor Huang Yaozhou’s experience in the treatment of overactive bladder

膀胱过度活动症多是由膀胱逼尿肌的不稳定收缩而产生的一组以“尿急、尿频,伴或不伴有尿失禁”为主要临床表现的症候群。北京市名老中医黄尧洲教授认为此病属“虚劳病”范畴,与肝脾肾三脏关系密切。“肾为先天之本,脾为后天之本”,对五脏六腑具有充实濡养之用,若脾肾亏虚,肝气横逆,气机失调,水液代谢异常,则可出现小便不利的症状。本病发病特点以“脾肾亏虚(虚劳)为本,肝气横逆(里急)为标”,符合“虚劳里急”的特点,从“虚劳里急”论治该病有较好的临床意义。《金匮要略》中“血痹虚劳”病篇所列方剂对膀胱过度活动症的治疗,有一定的借鉴意义。

Overactive bladder is a group of syndromes arising from the unstable contraction of bladder urethral muscle,with“urinary urgency and frequency,with or without urinary incontinence”as the main clinical manifestations.Professor Huang Yaozhou,a famous veteran Chinese medicine practitioner in Beijing,believes that overactive bladder belongs to the category of“deficiency disease”,and it is closely related to the three viscera of the liver,spleen,and kidney.“Kidney being congenital origin,spleen being acquired foundation”which has the role of supplemental moistening to the five zang viscera and six fu viscera.If the spleen and kidneys are deficient,liver qi is rebellious,the qi is out of order,and the metabolism of water and liquid is abnormal,then the symptoms of unfavourable urination can appear.The pathogenesis of this disease is characterized by“deficiency of the spleen and kidney(deficiency labour)as the root cause of disease,and the liver qi transverse(internal urgency)as the manifestation root cause of disease”,which is in line with the characteristics of“deficiency labour and internal urgency”,and the treatment of this disease from the theory of“deficiency labour and internal urgency”has a better clinical significance.The formulas listed in the chapter of“blood paralysis and deficiency labour”in Synopsis of Golden Chamber are of some reference significance for the treatment of overactive bladder.