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基于"主客交"学说论阴道微生态与宫颈上皮内瘤变的关系

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试从吴有性《瘟疫论》中"主客交"学说阐述阴道微生态与宫颈上皮内瘤变的关系。本文认为,"主"素有任脉不固、带脉失约以致阴道微生态失衡,"客"乃湿热、阴虚、血瘀等致病因素,主客交浑而致宫颈上皮内瘤变。正愈虚,则邪愈盛,使疾病进展,病邪久留,乘精血之衰而深入阴分和血脉之中,并与瘀滞之气血互结,是宫颈上皮内瘤变进展且最终发展为宫颈癌的重要病机。在治疗宫颈上皮内瘤变上,应初起"未病先防,既病防变","扶正祛邪"一以贯之;继而兼以清热利湿,行气活血;病瘥后注重调护,维持阴道微生态稳定。
On the Relationship between Vaginal Microecology and Cervical Intraepithelial Neoplasia Based on the Theory of Pathogen Invading Nutrient and Blood Aspects
The relationship between vaginal microecology and cervical intraepithelial neoplasia was expounded from Wu Youxing's theory of pathogen invading nutrient and blood aspects in the Treatise on Pestilence(Wen Yi Lun).This paper believes that the insecurity of the conception vessel(CV)and the failure of the belt vessel(BV)to regulate meridians result in vaginal microecological imbalance,which,together with the pathogenic factors such as dampness-heat,yin deficiency,and blood stasis,causes cervical intraepithelial neoplasia.The deficiency of healthy qi facilitates pathogen invasion,which promotes disease progression and lingering of pathogen.Further,the pathogen invades the declining essence and blood and goes deep into the yin,blood,and vessels to combine with the stagnated qi and blood,which is the key pathogenesis for the progression of cervical intraepithelial neoplasia and the final onset of cervical cancer.The principles of prevention before disease onset and controlling development of the existing disease are suggested for the prevention and treatment of cervical intraepithelial neoplasia.Reinforcing healthy qi and expelling pathogen should be implemented throughout the treatment course.The methods of clearing heat,draining dampness,moving qi,and activating blood should be adopted according to patient conditions.During the recovery stage,attention should be paid to maintain the vaginal microecological balance.

vaginal microecologycervical intraepithelial neoplasiapathogen invading nutrient and blood aspects

林雨晴、吴冬梅、陈秋燕

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福建中医药大学(福建 福州 350122)

福建中医药大学附属第二人民医院妇产科(福建 福州 350001)

阴道微生态 宫颈上皮内瘤变 主客交

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

2024

基层中医药
中国中医科学院中医研究所

基层中医药

ISSN:2097-1222
年,卷(期):2024.3(2)
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