荆楚名医刘云鹏从肝论治妇科疾病经验探赜

LIU Yunpeng’s experience for treating gynecological diseases from liver

荆楚名医刘云鹏出生于中医世家,从事临床工作80余年,20世纪50年代即被誉为沙市八大名医之一,是中国知名中医妇科专家,国家中医药管理局确定的第一批、第四批名老中医学术经验继承工作指导老师。刘老一生矢志中医,名扬杏林,博采众长,善于创新,临证提倡“调肝为主,疏肝为先”。本研究以“调肝十一法”为主线,系统梳理了刘老从肝论治妇科疾病的学术脉络和理论渊源,归纳总结了其从肝论治妇科疾病的学术思想和临证经验,具体说来,一是妇科之疾,多责之肝,二是肝木之疾,实多虚少,实者多为气郁,虚者多为血虚,三是治肝当以疏肝为先,尚需辨清虚实寒热。刘老调肝诸法虽源于先贤又有所创新,其自拟的多首调肝经验效方即是体现,如疏肝理气、活血调经用于月经前后诸证的调经Ⅰ号方和调经Ⅱ号方,疏肝开郁、化痰散结用于乳癖的疏肝散结汤,清热解毒、疏肝活血、化瘀消癥用于盆腔炎性包块的柴枳败酱汤等。最后列举其典型医案一则进行思辨分析,以期为后学者中医临床提供参考。

LIU Yunpeng,a famous doctor in Jingchu(荆楚)area,was born in a family of traditional Chinese medicine and engaged in clinical work for more than 80 years.In the 1950s,LIU Yunpeng was honored as one of the eight famous doctors in Changsha City.LIU Yunpeng is a well-known expert in gynecology of TCM in China,and the first and fourth batch of well�known instructors for inheriting academic experience of TCM determined by the State Administration of Traditional Chinese Medicine.Mr.LIU devoted his life to TCM,learned from others and was adept in innovation.In clinical practice,he advocated the theory of regulating liver mainly and soothing liver first.Taking eleven methods of regulating the liver as the main thread,this paper systematically combs the academic context and theoretical origin of treating gynecological diseases from the perspective of liver by Mr.LIU,and summarizes his academic thought and clinical experience in the treatment of gynecological diseases.Specifically speaking,the first is gynecological disease,which is mostly caused by the liver.The second is the liver wood disease,which is characterized by more excess syndrome and less deficiency syndrome;excess syndrome is mostly Qi(气)depression,while deficiency syndrome is mostly blood deficiency.Third,soothing the liver should be the first in the treatment of liver diseases,and it is still necessary to distinguish deficiency from excess,and cold from heat.Although the methods of regulating the liver of Mr.LIU originated from ancient sages,there were also innovative,which were reflected by a mount of self-designed empirical effective prescriptions of regulating liver,such as Tiaojing No.I(调经I号方)and Tiaojing No.II(调经II号方)for treating various symptoms around menstruation to soothe the liver and regulate Qi,and promote blood circulation and regulate menstruation.The Shugan Sanjie decoction(疏肝散结汤)for treating mammary lump to soothe the liver and relieve depression,and dissipate phlegm and disperse stagnation;and the Chaizhi Baijiang decoction(柴枳败酱汤)for treating pelvic inflammatory masses to clear away heat and detoxify,soothe the liver and activate blood circulation,and remove blood stasis and eliminate masses.At the end of this paper,a typical medical case is listed for speculative analysis,in order to provide a reference for later scholars in TCM clinic.