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厉健教授治疗子宫内膜异位症的经验分享

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子宫内膜组织出现在子宫体腔以外部位时,称为子宫内膜异位症,其中卵巢型子宫内膜异位症最为常见.子宫内膜异位症多见于育龄期妇女,是引起盆腔痛的主要原因之一,该病虽为良性病变,但有类似于恶性肿瘤的种植及复发能力.其病因目前尚未明确,在治疗上,西医偏重通过抑制卵巢功能来阻止子宫内膜异位症发展,但常需结合药物不良反应、患者经济能力及治疗意愿,患者依从性不高.厉健教授基于对子宫内膜异位症的多年临床研究,提出活血理气止痛之法.文章附1则病例,介绍其临床治疗经验.纵观该患者就诊过程,痛经症状逐渐减轻,经前或经后腹痛症状消失,且妇科彩超提示总体治疗有效.在为期3个月的治疗过程中,厉健教授从不通则痛、不荣则痛出发,先辨虚实,再辨寒热,谨遵活血化瘀、理气止痛之大法,将其贯穿于行经期、经后期、经间期及经前期四个阶段,兼顾疏肝健脾、温补肝肾、滋阴通便之法,收获颇丰.同时厉健教授还提出要重视对子宫内膜异位症患者的长期管理,每1~3个月随访1次,进行健康宣教,及时了解患者状态,消除患者不良心理情绪等.目前,针对子宫内膜异位症的经验报道不少,本研究希望通过经验提供更多的诊疗思路,以期减轻患者的痛苦.
Professor LI Jian's experience in treating endometriosis
When endometrial tissue appears in areas outside the uterine cavity,it is called endometriosis.Among them,ovarian endometriosis is the most common type.Endometriosis is more often found in women of childbearing age,which is one of the main causes of pelvic pain.Although the disease is a benign lesion,it can implant and relapse like malignant tumors.The cause is not clear at present,in treatment,western medicine focuses on preventing the development of internal disease by inhibiting ovarian function,but often need to combine drug adverse reactions,patient economic ability and treatment willingness,compliance is not high.Based on many years of clinical research on internal diseases,Professor LI Jian proposed the method of promoting blood circulation,regulating Qi(气)and relieving pain.The article introduces one case to introduce the clinical treatment experience.Throughout the patient's treatment process,the symptoms of dysmenorrhea gradually alleviated,and the symptoms of abdominal pain before or after menstruation disappeared.The gynecological color Doppler ultrasound also indicated overall effective treatment.During the three-month treatment process,Professor LI Jian started from the principle of pain due to blockage and pain due to deficiency,first identified the deficiency and excess,then identified the cold and heat,and strictly followed the treatment methods of promoting blood circulation and removing blood stasis,and regulating Qi and relieving pain.Professor LI Jian applied these methods to the four stages of menstruation,post menstruation,intermenstrual period,and premenstrual period,and took into account the therapies of soothing the liver and spleen,warming and nourishing the liver and kidney,and nourishing Yin(阴)and promoting bowel movements,with a rich harvest.At the same time,Professor LI Jian also proposes to pay attention to the long-term management of patients with endometriosis,follows up once every 1 to 3 months,carries out health education to timely understand the patient's condition and eliminate patients'negative psychological emotions.At present,although there are many reports on the treatment experience of endometriosis,the author still hopes to provide a diagnostic and treatment idea for medical personnel to alleviate the pain of patients.

EndometriosisDysmenorrheaTCM gynecologyExperience sharing

白志慧、吴丽梅、厉健

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山西中医药大学研究生院,山西 太原,030024

山西中医药大学附属医院,山西 太原,030024

子宫内膜异位症 痛经 中医妇科学 经验分享

邢维萱省级名中医工作室项目

SXSMZYGZS030

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(20)