摘要
近年来,月经过少的患者在门诊就诊患者中的比例逐年上升。肾为先天之本,主藏精、生长发育与生殖,而女子以血为用,女子的排卵与行经均有赖于肝之疏泄,故有“女子以肝为先天”之说,可见肝、肾两脏对女子月经起着决定性作用,故月经过少临床上多责之于肝肾不足、气血亏虚等。作者基于多年临床经验,临证中发现肝肾阴虚型月经过少颇为常见,治疗此类患者,若单纯予以滋补气血则有闭门流寇、事倍功半之虞,作者认为临证此类患者从阴虚入手,使用加减复脉汤有事半功倍的效果。此方出自吴鞠通的《温病条辨》,是治疗下焦温病的著名方剂,以“甘润存津”立法,其组方原则对治疗下焦肝肾阴亏型内科杂病及妇科疾病有很大的启发。作者基于“甘润存津”法运用加减复脉汤治疗肝肾阴虚型月经过少,临床中疗效明显。现将经验总结如下,以资同道共勉。
In recent years,the proportion of patients with oligomenorrhea among outpatients has been increasing year by year.The kidneys are the foundation of congenital constitution,responsible for storing essence,growth,de-velopment,and reproduction.Women’s function is blood,and both ovulation and menstruation depend on the liver’s function.Hence,there’s a saying that“women’s liver is congenital.”The liver and kidneys play a decisive role in menstruation.Therefore,oligomenorrhea is often clinically attributed to liver and kidney deficiency,Qi and blood de-ficiency,and other factors.Based on years of clinical experience,the author has found that oligomenorrhea due to liver and kidney yin deficiency is quite common.Simply treating these patients with Qi and blood tonification can be coun-terproductive,resulting in half the effort and twice the effect.The author believes that treating these patients by target-ing yin deficiency with Jiajian Fumai Decoction is more effective.This prescription,from WU Jutong’s Treatise on Febrile Diseases,is a renowned formula for treating lower-jiao febrile diseases.Based on the principle of“sweet,moist,and retaining body fluid,”its composition has been highly influential in treating miscellaneous internal medicine and gynecological disorders of the lower Jiao characterized by liver and kidney yin deficiency.Based on this principle,the author has demonstrated significant clinical efficacy in treating oligomenorrhea due to liver and kidney yin deficiency using Jiajian Fumai Decoction.The following summarizes this experience for the benefit of fellow practitioners.
作者
陈艳辉
周婧
周昕
CHEN Yanhui;ZHOU Jing;ZHOU Xin(Mianyang Hospital Affiliated to Chengdu University of Traditional Chinese Medicine,Chengdu Mianyang 621000,China)
出处
《中医药临床杂志》
2025年第9期1706-1712,共7页
Clinical Journal of Traditional Chinese Medicine
基金
国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号)
四川省中医药管理局科学技术研究专项课题(2023MS218)。
关键词
月经过少
甘润存津
加减复脉汤
肝肾阴虚
Oligomenorrhea
Sweet,moist,and retaining body fluid
Jiajian Fumai Decoction
Liver and kidney Yin deficiency
