基于土壅木郁探析《临证指南医案·调经》的辨治经验

Exploring the Diagnostic and Therapeutic Experience in“Clinical Guidance on Menstruation”from the Perspective of“Earth Stagnation,Wood Depression”

本文基于“土壅木郁”理论探析叶桂辨治女性月经疾病的经验。文章对“土壅木郁”的源流与内涵进行探析,并系统分析《临证指南医案·调经》医案,总结叶桂从“土壅木郁”的角度辨治月经病的经验。认为叶桂诊断月经病病机是以冲任失调为根结,“土壅木郁”为重点,从天人、形神相应,脏腑、经络一体的角度对患者病因、症状、病机进行诊察。治法崇尚《内经》、仲景思想,善用健脾和胃之法以生化气血、调节气津,助肝气畅达、肝血旺盛,使冲任气血和合、经水调畅。处方用药简洁灵动,直指病所,对后世治疗月经病启迪甚多,值得进一步挖掘研究。

This review analyzes Ye Gui's experience in diagnosing and treating female menstrual disorders based on the theory of“Earth Stagnation,Wood Depression”.It delves into the origin and connotation of“Earth Stagnation,Wood Depression”and systematically analyzes the medical cases in“Clinical Guidance on Menstruation”.It summarizes Ye Gui's experience in diagnosing and treating menstrual disorders from the perspective of“Earth Stagnation,Wood Depression”.It is believed that Ye Gui diagnosed menstrual disorders with the dysregulation of Chong and Ren channels as the root cause and“Earth Stagnation,Wood Depression”as the key focus.He diagnosed the patient's etiology,symptoms,and pathogenesis from the perspective of the correspondence between nature and man,body and spirit,and the integration of organs and meridians.His treatment methods adhered to the thoughts of“Inner Canon of Medicine”and Zhongjing,emphasizing the use of spleen-strengthening and stomach-harmonizing methods to promote the production of qi and blood,regulate qi and body fluids,and assist the smooth flow of liver qi and liver blood,thereby harmonizing the qi and blood of Chong and Ren channels and smoothing menstrual flow.His prescriptions were concise and targeted,providing much inspiration for later generations in the treatment of menstrual disorders,and deserving further exploration and research.