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从心肾论治经间期出血

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经间期出血又称排卵期出血,属于"排卵障碍性异常子宫出血"的范畴,为妇科多发病、疑难病,严重危害女性的身心健康.《素问》记载:"胞脉者属心而络胞中".夏桂成提出"心(脑)-肾-子宫轴",指出女子排卵取决于心(脑)的功能,必须在动态的"心"的指导下方能顺利排卵.胞宫主月经藏泻,心主血脉、主神明,心脉与胞脉相连,心神调节胞宫藏泻;肾主生殖、主天癸盛衰,天癸至,则月事以时下,又因胞络者,系于肾,胞胎上系于心包,下系于命门,所以胞宫与心肾关系尤为密切.心肾为水火两极,正如太极图中子午两极,为阴阳转化的关键节点,经间期是重阴转阳的时期,经间期出血由阴阳转化失调导致,因此调节心肾关系是调节阴阳转化失调、治疗经间期出血的关键.调节心肾关键在于恢复和维持心肾相交,治法主要有交通心肾、补肾宁心、补肾疏心养心,从而使得心肾相交,君火以明,相火以位,气机升降有序,阴阳平调,转化正常,血随气行,如环无端,畅行无阻,则经间期出血可愈.从心肾论治经间期出血既兼顾了本病的核心病机,也重视患者的情绪,达到身心同治,方能取得良好的效果.
Treatment of intermenstrual bleeding from the perspective of heart and kidney
Intermenstrual bleeding,also known as ovulation bleeding,belongs to the category of abnormal uterine bleeding with ovulation disorders,and is a common and difficult disease in gynecology,which seriously endangers women's physical and mental health.Suwen(《素问》)records that"The blood vessel belongs to the heart,and the heart is in collaterals".XIA Guicheng proposes the"heart(brain)-kidney-uterus axis",pointing out that female ovulation depends on the function of heart(brain),and must be guided by the dynamic"heart"in order to successfully ovulate.Uterus is in charge of menstruation,the heart rules the blood and the mind,the heart meridian is connected with the uterus collaterals,and the mind regulates uterus menstruation.Kidney is in charge of reproduction,and regulates the rise and fall,of substances that sustain reproductive function;menstruation comes at the appointed time when substances that sustain reproductive function are normal.And because the uterus collaterals are connected with the kidney,and the uterus is tied to the pericardium above and tied to the life gate in the lower,so the relationship between the uterus and the heart and kidney is particularly close.The heart and kidney are the two poles of fire and water,just as the meridian pole of the Taiji(太极)diagram is the key node of Yin(阴)and Yang(阳)transformation.The intermenstrual period is the period when heavy Yin turns to Yang,and the intermenstrual bleeding is caused by the imbalance of Yin and Yang transformation,so regulating the relationship between the heart and kidney is the key to regulating the imbalance of Yin and Yang transformation and treating the intermenstrual bleeding.The key to regulating the heart and kidney is to restore and maintain the intersection of the heart and kidney,the treatment methods mainly includes connecting heart and kidney,tonifying kidney and calming heart,tonifying kidney and clearing the heart,so that the heart and kidney intersect,the monarch fire regulates Yang and the ministerial fire is in position,Qi(气)rise and fall orderly,Yin and Yang are in harmony,and there are normal transformation of blood and Qi,which is cyclic without end,then the intermenstrual bleeding can be healed.Treating intermenstrual bleeding from the perspective of heart and kidney not only takes into account the core pathogenesis of the disease,but also attaches importance to the patients'emotions,and achieves the simultaneous treatment of body and mind,in order to obtain good results.

Intermenstrual bleedingTreatment from the perspective of heart and kidneySuwen

林雯雯、李兰兰

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安徽中医药大学,安徽 合肥,230012

安徽中医药大学附属铜陵市中医医院,安徽 铜陵,244000

经间期出血 从心肾论治 《素问》

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(24)