首页|基于"肺为水之上源"探讨血水同治治疗慢性盆腔炎型复发性流产

基于"肺为水之上源"探讨血水同治治疗慢性盆腔炎型复发性流产

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慢性盆腔炎型复发性流产属于中医"滑胎""数堕胎"范畴,临床多从肝、脾、肾论治,常忽略肺与本病的关系.然人体的三焦是相互关联、相互作用的整体,全身水液上下一体,气机升降相因,维持机体正常功能.慢性盆腔炎型复发性流产不只是胞宫局部的疾病,还是机体在致病因素作用下的整体反应,其治疗应从整体出发,重视脏腑、气血津液之间的相互影响,以明确病机所在.肺为水之上源,通调周身水道,肺源清洁,则水津上通下达,痰无以生,瘀无以成,水道通而脉络利,下焦之流自然通畅.慢性盆腔炎型复发性流产的主要病机为湿瘀互结阻络,血行不畅,胞宫灌溉不周,胎无所养,而致滑胎.湿、瘀同源且同病,故提出从肺通调水道入手血水同治治疗慢性盆腔炎型复发性流产.临证见平素无汗或少汗,汗出则舒,恶风怕冷,容易感冒,皮肤粗糙等肺气郁闭之证者,以麻黄剂为主方加减宣肺开郁,提壶揭盖,达邪外出,解气机之郁闭、胞脉之不通,令血行通畅,并结合血瘀、水湿之偏重及月经周期各阶段分期辨证论治,活血调周,预培其损,并辅以辛味之品驱散壅滞,疏通道路,宣行气液,上郁得开,津液得下,则表解里和,血海充盈,胎元稳固.最后以一则验案阐述从肺血水同治治疗本病的实际应用,以期为临床诊治提供新的思路.
Treating chronic pelvic inflammatory type recurrent miscarriage by the method of treating both blood and water based on the theory of"lung is the source of water"
Chronic pelvic inflammatory type recurrent miscarriage belongs to the slippery fetus and multiple abortions categories in traditional Chinese medicine,its clinical treatment is mainly from the aspects of liver,spleen,kidney,often ignores the relationship between lung and chronic pelvic inflammatory type recurrent miscarriage.However,the triple energizer of the human body are interrelated and interact with each other as a whole,the water and fluid of the whole body up and down are integrated,and the lifting and lowering of Qi(气)are mutually dependent to maintain the normal function of the body.Chronic pelvic inflammatory type recurrent miscarriage is not only a localized disease of the uterus,but also the overall response of the body under the action of pathogenic factors,its treatment should be based on the whole body,paying attention to the interactions among the internal organs,and Qi,blood,and body fluid,in order to clarify the pathogenesis of the disease.Lung is the source of water,and in charge of regulating the body waterways.When lung source is clean,the water and body fluid can be transported up and down,phlegm and blood stasis are not born,the waterways and meridians in the body are unobstructed,and the flow of the lower-jiao(下焦)is naturally smooth.The main pathogenesis of chronic pelvic inflammatory type recurrent miscarriage is dampness and blood stasis mutual obstruction to block meridians and collaterals,the blood does not flow smoothly,and the uterus and fetus can not be nourished,which lead to the miscarriage.Dampness and blood stasis have the same origin and the same diseases,so it is proposed to treat chronic pelvic inflammatory type recurrent miscarriage by the method of treating both blood and water from the aspect of lung is in charge of regulating the body waterways.Patients with symptoms of lung Qi depression such as no or little sweating,comfortable feeling after sweating out,aversion to cold,easy to catch a cold,rough skin,etc.,should be mainly treated with the prescriptions contained Mahuang(Herba Ephedrae),in order to disperse Qi stagnation,dispel evil,and solve vascular obstruction,so that the blood flow is smooth.Additionally,combined with the degree of blood stasis and water-dampness,and the stages of menstruation cycle,stage treatment is applied based on TCM syndrome differentiation to activate the blood to regulate menstruation and strengthen the damaged part,and supplemented with pungent products to disperse the congestion,so as to promote the unobstructed flow of Qi and body fluid,thus keep the fetus nourished and stable.Finally,one empirical case is presented to illustrate the practical application of the method of treating both blood and water in the treatment of this disease,in order to provide new ideas for clinical diagnosis and treatment of this disease.

Recurrent miscarriageChronic pelvic inflammatoryLung is the source of waterTreating both blood and water

程文静、刘彤鸥

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湖北中医药大学,湖北 武汉,430061

复发性流产 慢性盆腔炎 肺为水之上源 血水同治

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(29)