方名:溫宮散結方
【功能主治】
功能溫經行血,祛瘀散結。主治子宮內膜異位癥見痛經劇烈、肛門墜痛等。
【處方組成】
當歸9克(ke)(ke)、赤芍9克(ke)(ke)、五靈脂9克(ke)(ke)、元胡9克(ke)(ke)、桃仁9克(ke)(ke)、紅花9克(ke)(ke)、沒藥6-9克(ke)(ke)、生(sheng)蒲黃12克(ke)(ke)、干姜(jiang)4.5克(ke)(ke)、小茴(hui)香屯5克(ke)(ke)、肉桂3克(ke)(ke),水(shui)煎服(fu)。
【辨證加減】
經期顯多腹(fu)痛加花蕊(rui)石(shi)30克(ke)(ke)(ke)(ke)(ke)、血(xue)竭6-9克(ke)(ke)(ke)(ke)(ke),口服七厘散(san)0.75克(ke)(ke)(ke)(ke)(ke)或云南白藥(yao)0.5克(ke)(ke)(ke)(ke)(ke),日(ri)2次;非行經期加海藻9克(ke)(ke)(ke)(ke)(ke)、昆布9克(ke)(ke)(ke)(ke)(ke)、夏枯草9克(ke)(ke)(ke)(ke)(ke)、牡蠣30克(ke)(ke)(ke)(ke)(ke);氣虛加黃芪12克(ke)(ke)(ke)(ke)(ke)、黨參12克(ke)(ke)(ke)(ke)(ke),瘀(yu)熱者(zhe)去肉桂、干姜、小(xiao)茴香,加丹(dan)皮9克(ke)(ke)(ke)(ke)(ke)、紅藤(teng)15克(ke)(ke)(ke)(ke)(ke)、敗(bai)醬(jiang)草15克(ke)(ke)(ke)(ke)(ke);惡心加吳茱萸4.5克(ke)(ke)(ke)(ke)(ke)。住院者(zhe)每日(ri)可渺脈滴(di)注丹(dan)參注射液8支(含生(sheng)藥(yao)24克(ke)(ke)(ke)(ke)(ke))。若病灶(zao)限(xian)于直腸窩者(zhe),可上方煎(jian)湯作肛內滴(di)注或取湯藥(yao)40毫(hao)升滴(di)入電(dian)極板,作離子透(tou)入療(liao)法(fa)。
【臨床療效】
12例患者均以上(shang)方作住(zhu)院治(zhi)療(liao)(liao)。其中顯(xian)效(xiao)(治(zhi)療(liao)(liao)期(qi)間癥狀(zhuang)消(xiao)失或減(jian)輕一半以上(shang),腫塊或結節變(bian)(bian)(bian)軟,觸痛(tong)消(xiao)失)3例,有(you)效(xiao)(治(zhi)療(liao)(liao)期(qi)間癥狀(zhuang)緩解,體征(zheng)無變(bian)(bian)(bian)化)5例,無效(xiao)(癥狀(zhuang)體征(zheng)無變(bian)(bian)(bian)化)4例。總(zong)有(you)效(xiao)率66.67%。
【處方來源】
上海中醫(yi)學院(yuan)附屬龍華醫(yi)院(yuan)王祖(zu)倩等。
【按語】
王氏觀察認為本方療效與病(bing)程無明顯(xian)對應關系(xi),外在型子宮內(nei)膜異位癥之療效優于內(nei)在型和混合(he)型。
臨(lin)(lin)床(chuang)(chuang)一般從(cong)以下(xia)(xia)幾型(xing)進(jin)行(xing)(xing)(xing)(xing)辨(bian)證(zheng)施(shi)治: (1)肝(gan)(gan)郁(yu)氣(qi)(qi)(qi)(qi)滯(zhi)(zhi):精神抑郁(yu)、心(xin)情(qing)沉(chen)悶、多愁(chou)善(shan)慮、情(qing)志不(bu)(bu)(bu)暢(chang)(chang)(chang);肝(gan)(gan)主(zhu)(zhu)疏泄,肝(gan)(gan)氣(qi)(qi)(qi)(qi)郁(yu)結(jie)(jie),肝(gan)(gan)之功(gong)(gong)能(neng)失(shi)(shi)常(chang)(chang)(chang),肝(gan)(gan)郁(yu)則(ze)(ze)氣(qi)(qi)(qi)(qi)滯(zhi)(zhi),氣(qi)(qi)(qi)(qi)滯(zhi)(zhi)致血(xue)(xue)(xue)(xue)(xue)瘀(yu)(yu)而(er)(er)(er)(er)發(fa)(fa)(fa)痛(tong)(tong)(tong)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)、癥(zheng)(zheng)(zheng)瘕(jia);氣(qi)(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)不(bu)(bu)(bu)和而(er)(er)(er)(er)致月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)失(shi)(shi)調(diao)、不(bu)(bu)(bu)孕(yun)等(deng)(deng)。情(qing)志因素(su)(su)能(neng)影響下(xia)(xia)丘(qiu)腦一垂體一卵巢軸的(de)變化而(er)(er)(er)(er)致神經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)內(nei)(nei)(nei)(nei)分(fen)(fen)泌改(gai)變,如果腹(fu)(fu)(fu)(fu)腔(qiang)液中(zhong)孕(yun)激素(su)(su)水(shui)平下(xia)(xia)降,不(bu)(bu)(bu)能(neng)抑制有(you)(you)活性的(de)子(zi)(zi)(zi)宮內(nei)(nei)(nei)(nei)膜,使子(zi)(zi)(zi)宮內(nei)(nei)(nei)(nei)膜易(yi)種植(zhi)于盆腔(qiang)而(er)(er)(er)(er)發(fa)(fa)(fa)生(sheng)(sheng)內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)癥(zheng)(zheng)(zheng)。臨(lin)(lin)床(chuang)(chuang)主(zhu)(zhu)證(zheng):下(xia)(xia)腹(fu)(fu)(fu)(fu)脹(zhang)痛(tong)(tong)(tong)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)痛(tong)(tong)(tong)劇(ju)、痛(tong)(tong)(tong)引(yin)(yin)腰(yao)骶、痛(tong)(tong)(tong)甚昏厥、腹(fu)(fu)(fu)(fu)痛(tong)(tong)(tong)拒按(an), 性交疼痛(tong)(tong)(tong) ,胸(xiong)(xiong)脅作脹(zhang)、乳房(fang)脹(zhang)痛(tong)(tong)(tong),經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)淋漓(li)、經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)色紫黯,夾有(you)(you)血(xue)(xue)(xue)(xue)(xue)塊,婚(hun)后(hou)不(bu)(bu)(bu)孕(yun),舌苔(tai)(tai)薄質(zhi)紫、邊尖有(you)(you)瘀(yu)(yu)點,脈(mo)(mo)弦。 治則(ze)(ze):理(li)氣(qi)(qi)(qi)(qi)活血(xue)(xue)(xue)(xue)(xue)、散結(jie)(jie)止痛(tong)(tong)(tong)。方(fang)藥(yao)(yao):血(xue)(xue)(xue)(xue)(xue)府逐瘀(yu)(yu)湯(tang)(《醫林改(gai)錯(cuo)》)加(jia)(jia)(jia)(jia)(jia)(jia)減(jian), 藥(yao)(yao)用(yong):當歸(gui)、川(chuan)(chuan)芎(xiong)、赤芍、生(sheng)(sheng)地黃(huang)(huang)(huang)、枳殼、柴(chai)胡、桃仁、紅花(hua)、牛膝(xi)、香(xiang)(xiang)附(fu)等(deng)(deng)。若(ruo)(ruo)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)不(bu)(bu)(bu)暢(chang)(chang)(chang)加(jia)(jia)(jia)(jia)(jia)(jia)益(yi)母草(cao)、失(shi)(shi)笑散;陰部墜(zhui)脹(zhang)加(jia)(jia)(jia)(jia)(jia)(jia)川(chuan)(chuan)楝子(zi)(zi)(zi)、柴(chai)胡;經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)發(fa)(fa)(fa)熱加(jia)(jia)(jia)(jia)(jia)(jia)紅藤、大(da)(da)黃(huang)(huang)(huang);乳房(fang)脹(zhang)痛(tong)(tong)(tong)加(jia)(jia)(jia)(jia)(jia)(jia)橘葉、橘核;經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)淋漓(li)加(jia)(jia)(jia)(jia)(jia)(jia)蒲黃(huang)(huang)(huang)、炒(chao)地榆。 (2)寒(han)濕凝滯(zhi)(zhi):經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)、分(fen)(fen)娩或(huo)(huo)(huo)(huo)產(chan)后(hou)受寒(han),或(huo)(huo)(huo)(huo)久(jiu)臥濕地,寒(han)濕之邪客于沖(chong)(chong)任(ren)(ren)(ren)胞脈(mo)(mo),血(xue)(xue)(xue)(xue)(xue)行(xing)(xing)(xing)(xing)不(bu)(bu)(bu)暢(chang)(chang)(chang)則(ze)(ze)痛(tong)(tong)(tong)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)或(huo)(huo)(huo)(huo)瘕(jia)瘕(jia);素(su)(su)體虛弱,臟腑功(gong)(gong)能(neng)減(jian)退,陽氣(qi)(qi)(qi)(qi)不(bu)(bu)(bu)振(zhen),沖(chong)(chong)任(ren)(ren)(ren)之脈(mo)(mo)失(shi)(shi)于溫煦,血(xue)(xue)(xue)(xue)(xue)失(shi)(shi)固攝,血(xue)(xue)(xue)(xue)(xue)不(bu)(bu)(bu)循(xun)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)而(er)(er)(er)(er)致月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)不(bu)(bu)(bu)調(diao)或(huo)(huo)(huo)(huo)癥(zheng)(zheng)(zheng)瘕(jia)。 目前研究發(fa)(fa)(fa)現,臟腑功(gong)(gong)能(neng)低下(xia)(xia),易(yi)導致免(mian)(mian)疫(yi)(yi)功(gong)(gong)能(neng)異(yi)(yi)(yi)(yi)(yi)常(chang)(chang)(chang)。免(mian)(mian)疫(yi)(yi)系(xi)統(tong)調(diao)節(jie)失(shi)(shi)控,由免(mian)(mian)疫(yi)(yi)細(xi)(xi)胞分(fen)(fen)泌的(de)一系(xi)列細(xi)(xi)胞因子(zi)(zi)(zi)、炎(yan)癥(zheng)(zheng)(zheng)介質(zhi)等(deng)(deng)參(can)(can)與,促進(jin)異(yi)(yi)(yi)(yi)(yi)位內(nei)(nei)(nei)(nei)膜進(jin)一步生(sheng)(sheng)長和增(zeng)殖而(er)(er)(er)(er)發(fa)(fa)(fa)生(sheng)(sheng)內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)癥(zheng)(zheng)(zheng)。 臨(lin)(lin)床(chuang)(chuang)主(zhu)(zhu)證(zheng):經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)常(chang)(chang)(chang)下(xia)(xia)腹(fu)(fu)(fu)(fu)冷痛(tong)(tong)(tong)、隱痛(tong)(tong)(tong)、得熱則(ze)(ze)舒(shu)、經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)(fu)痛(tong)(tong)(tong)加(jia)(jia)(jia)(jia)(jia)(jia)劇(ju),畏(wei)寒(han)肢冷,腰(yao)膝(xi)冷痛(tong)(tong)(tong),頭(tou)昏頭(tou)痛(tong)(tong)(tong),白(bai)帶(dai)較多,月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)不(bu)(bu)(bu)調(diao),大(da)(da)便溏薄,婚(hun)后(hou)不(bu)(bu)(bu)孕(yun),舌邊紫黯、苔(tai)(tai)薄白(bai),脈(mo)(mo)細(xi)(xi)緊(jin)。治則(ze)(ze):溫經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)通絡、活血(xue)(xue)(xue)(xue)(xue)化瘀(yu)(yu)。方(fang)藥(yao)(yao):溫經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)湯(tang)(《金(jin)匱要略》)加(jia)(jia)(jia)(jia)(jia)(jia)減(jian),藥(yao)(yao)用(yong):當歸(gui)、川(chuan)(chuan)芎(xiong)、白(bai)芍、桂枝、人參(can)(can)、生(sheng)(sheng)姜(jiang)、丹(dan)(dan)皮(pi)、甘草(cao)等(deng)(deng)。若(ruo)(ruo)下(xia)(xia)腹(fu)(fu)(fu)(fu)冷痛(tong)(tong)(tong)加(jia)(jia)(jia)(jia)(jia)(jia)艾(ai)葉、紫石英;小腹(fu)(fu)(fu)(fu)下(xia)(xia)墜(zhui)加(jia)(jia)(jia)(jia)(jia)(jia)黃(huang)(huang)(huang)芪(qi)(qi)、升麻;大(da)(da)便溏薄加(jia)(jia)(jia)(jia)(jia)(jia)炒(chao)扁豆、肉豆蔻;帶(dai)下(xia)(xia)增(zeng)多加(jia)(jia)(jia)(jia)(jia)(jia)芡(qian)實(shi)、雞冠花(hua)。 (3)腎(shen)虛瘀(yu)(yu)阻(zu)(zu)(zu):房(fang)事(shi)不(bu)(bu)(bu)節(jie)或(huo)(huo)(huo)(huo)產(chan)育(yu)過多傷(shang)及腎(shen)氣(qi)(qi)(qi)(qi),致沖(chong)(chong)任(ren)(ren)(ren)損(sun)傷(shang);因腎(shen)藏精,腎(shen)虧(kui)則(ze)(ze)精少,胞脈(mo)(mo)失(shi)(shi)于濡養,沖(chong)(chong)任(ren)(ren)(ren)氣(qi)(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)不(bu)(bu)(bu)足,使氣(qi)(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)運行(xing)(xing)(xing)(xing)不(bu)(bu)(bu)暢(chang)(chang)(chang),滯(zhi)(zhi)而(er)(er)(er)(er)瘀(yu)(yu)阻(zu)(zu)(zu)。腎(shen)虧(kui)沖(chong)(chong)任(ren)(ren)(ren)損(sun)傷(shang)者易(yi)致免(mian)(mian)疫(yi)(yi)功(gong)(gong)能(neng)異(yi)(yi)(yi)(yi)(yi)常(chang)(chang)(chang)而(er)(er)(er)(er)發(fa)(fa)(fa)生(sheng)(sheng)內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)癥(zheng)(zheng)(zheng);腎(shen)虧(kui)瘀(yu)(yu)阻(zu)(zu)(zu)者易(yi)導致內(nei)(nei)(nei)(nei)分(fen)(fen)泌紊亂,排(pai)卵障礙,發(fa)(fa)(fa)生(sheng)(sheng)未破(po)卵泡(pao)黃(huang)(huang)(huang)素(su)(su)化綜合征,內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)癥(zheng)(zheng)(zheng)屬腎(shen)虧(kui)瘀(yu)(yu)阻(zu)(zu)(zu)型(xing)致不(bu)(bu)(bu)孕(yun)患者中(zhong)79%是LUFS者。 臨(lin)(lin)床(chuang)(chuang)主(zhu)(zhu)證(zheng):經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)常(chang)(chang)(chang)腰(yao)酸(suan),頭(tou)暈耳鳴,經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)(fu)痛(tong)(tong)(tong)、痛(tong)(tong)(tong)引(yin)(yin)腰(yao)骶,肛(gang)門墜(zhui)脹(zhang),平時少腹(fu)(fu)(fu)(fu)隱痛(tong)(tong)(tong)或(huo)(huo)(huo)(huo)不(bu)(bu)(bu)痛(tong)(tong)(tong),月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)先(xian)后(hou)不(bu)(bu)(bu)定期(qi),經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)量多、經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)色黯紅,眼眶發(fa)(fa)(fa)黑,神疲乏力,孕(yun)后(hou)流產(chan),繼發(fa)(fa)(fa)不(bu)(bu)(bu)孕(yun),舌苔(tai)(tai)薄質(zhi)黯,脈(mo)(mo)細(xi)(xi)。治則(ze)(ze):活血(xue)(xue)(xue)(xue)(xue)化瘀(yu)(yu)、補(bu)腎(shen)調(diao)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)。方(fang)藥(yao)(yao):內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)消(經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)驗方(fang))加(jia)(jia)(jia)(jia)(jia)(jia)減(jian),藥(yao)(yao)用(yong):三棱、莪術(shu)、淫羊藿、肉蓯(cong)蓉、菟(tu)絲子(zi)(zi)(zi)、穿山(shan)甲、水(shui)蛭等(deng)(deng)。若(ruo)(ruo)月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)量多加(jia)(jia)(jia)(jia)(jia)(jia)阿膠、崗(gang)稔根;頭(tou)暈耳鳴加(jia)(jia)(jia)(jia)(jia)(jia)女貞子(zi)(zi)(zi)、墨旱蓮;繼發(fa)(fa)(fa)不(bu)(bu)(bu)孕(yun)加(jia)(jia)(jia)(jia)(jia)(jia)仙茅、胡蘆(lu)巴;神疲乏力加(jia)(jia)(jia)(jia)(jia)(jia)黨參(can)(can)、黃(huang)(huang)(huang)芪(qi)(qi)。 (4)瘀(yu)(yu)熱內(nei)(nei)(nei)(nei)阻(zu)(zu)(zu):素(su)(su)為內(nei)(nei)(nei)(nei)熱之體,或(huo)(huo)(huo)(huo)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)、產(chan)后(hou)復感熱邪,或(huo)(huo)(huo)(huo)情(qing)志過極(ji)化火,或(huo)(huo)(huo)(huo)過食辛辣燥熱之品(pin),或(huo)(huo)(huo)(huo)瘀(yu)(yu)血(xue)(xue)(xue)(xue)(xue)曰久(jiu)滯(zhi)(zhi)而(er)(er)(er)(er)化熱,邪熱阻(zu)(zu)(zu)內(nei)(nei)(nei)(nei)傷(shang)及沖(chong)(chong)任(ren)(ren)(ren),氣(qi)(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)不(bu)(bu)(bu)暢(chang)(chang)(chang)致內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)癥(zheng)(zheng)(zheng)。 臨(lin)(lin)床(chuang)(chuang)主(zhu)(zhu)證(zheng):下(xia)(xia)腹(fu)(fu)(fu)(fu)疼痛(tong)(tong)(tong)、腹(fu)(fu)(fu)(fu)部有(you)(you)灼熱感,常(chang)(chang)(chang)有(you)(you)低熱或(huo)(huo)(huo)(huo)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)發(fa)(fa)(fa)熱,大(da)(da)便干結(jie)(jie),口渴或(huo)(huo)(huo)(huo)口干不(bu)(bu)(bu)欲(yu)飲,月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)提前、經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)色紅夾血(xue)(xue)(xue)(xue)(xue)塊,帶(dai)下(xia)(xia)色黃(huang)(huang)(huang),舌質(zhi)紅、苔(tai)(tai)薄黃(huang)(huang)(huang),脈(mo)(mo)細(xi)(xi)數。治則(ze)(ze):活血(xue)(xue)(xue)(xue)(xue)化瘀(yu)(yu)、清熱散結(jie)(jie)。方(fang)藥(yao)(yao):清熱調(diao)血(xue)(xue)(xue)(xue)(xue)湯(tang)(《古今醫鑒》)加(jia)(jia)(jia)(jia)(jia)(jia)減(jian),藥(yao)(yao)用(yong):黃(huang)(huang)(huang)連(lian)、生(sheng)(sheng)地黃(huang)(huang)(huang)、丹(dan)(dan)皮(pi)、桃仁、紅花(hua)、丹(dan)(dan)參(can)(can)、香(xiang)(xiang)附(fu)、莪術(shu)、延胡索等(deng)(deng)。若(ruo)(ruo)伴低熱加(jia)(jia)(jia)(jia)(jia)(jia)地骨皮(pi)、青蒿;心(xin)煩(fan)易(yi)怒(nu)加(jia)(jia)(jia)(jia)(jia)(jia)郁(yu)金(jin)、川(chuan)(chuan)楝子(zi)(zi)(zi);月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)先(xian)期(qi)加(jia)(jia)(jia)(jia)(jia)(jia)黃(huang)(huang)(huang)芩、黃(huang)(huang)(huang)柏;濕熱重(zhong)加(jia)(jia)(jia)(jia)(jia)(jia)土茯(fu)苓、萆薜;月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)過多加(jia)(jia)(jia)(jia)(jia)(jia)炒(chao)槐花(hua)、陳棕炭。 (5)痰(tan)(tan)熱互(hu)結(jie)(jie):瘀(yu)(yu)阻(zu)(zu)(zu)可因氣(qi)(qi)(qi)(qi)滯(zhi)(zhi)而(er)(er)(er)(er)引(yin)(yin)起,如果肝(gan)(gan)氣(qi)(qi)(qi)(qi)失(shi)(shi)調(diao)、肝(gan)(gan)旺(wang)克脾,脾虛易(yi)致痰(tan)(tan)濕內(nei)(nei)(nei)(nei)生(sheng)(sheng),痰(tan)(tan)濕內(nei)(nei)(nei)(nei)阻(zu)(zu)(zu),影響腎(shen)之氣(qi)(qi)(qi)(qi)化,使水(shui)濕停聚(ju),氣(qi)(qi)(qi)(qi)血(xue)(xue)(xue)(xue)(xue)津液運行(xing)(xing)(xing)(xing)失(shi)(shi)常(chang)(chang)(chang),痰(tan)(tan)瘀(yu)(yu)互(hu)結(jie)(jie)而(er)(er)(er)(er)致內(nei)(nei)(nei)(nei)異(yi)(yi)(yi)(yi)(yi)癥(zheng)(zheng)(zheng)。 臨(lin)(lin)床(chuang)(chuang)主(zhu)(zhu)證(zheng):月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)量多或(huo)(huo)(huo)(huo)少,經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)期(qi)延長,肛(gang)門墜(zhui)脹(zhang),性交疼痛(tong)(tong)(tong),腰(yao)尻酸(suan)痛(tong)(tong)(tong)、經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)行(xing)(xing)(xing)(xing)加(jia)(jia)(jia)(jia)(jia)(jia)劇(ju),胸(xiong)(xiong)悶不(bu)(bu)(bu)舒(shu),喉中(zhong)痰(tan)(tan)結(jie)(jie),形體肥胖(pang),嗜睡(shui)乏力,平時帶(dai)多,婚(hun)后(hou)不(bu)(bu)(bu)孕(yun),舌黯、舌尖有(you)(you)瘀(yu)(yu)點,苔(tai)(tai)白(bai)膩或(huo)(huo)(huo)(huo)厚膩,脈(mo)(mo)細(xi)(xi)濡。治則(ze)(ze):軟堅化痰(tan)(tan)、活血(xue)(xue)(xue)(xue)(xue)止痛(tong)(tong)(tong)。 方(fang)藥(yao)(yao):血(xue)(xue)(xue)(xue)(xue)竭(jie)(jie)散(《增(zeng)效產(chan)乳備(bei)要》)加(jia)(jia)(jia)(jia)(jia)(jia)消瘰丸(《醫學心(xin)悟》)加(jia)(jia)(jia)(jia)(jia)(jia)減(jian), 藥(yao)(yao)用(yong):血(xue)(xue)(xue)(xue)(xue)竭(jie)(jie)、沒藥(yao)(yao)、丹(dan)(dan)參(can)(can)、赤芍、山(shan)慈姑(gu)、薏(yi)苡(yi)仁、竹(zhu)茹、象貝母等(deng)(deng)。若(ruo)(ruo)月(yue)(yue)(yue)經(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)(jing)不(bu)(bu)(bu)調(diao)加(jia)(jia)(jia)(jia)(jia)(jia)當歸(gui)、川(chuan)(chuan)芎(xiong);胸(xiong)(xiong)悶不(bu)(bu)(bu)舒(shu)加(jia)(jia)(jia)(jia)(jia)(jia)全(quan)瓜蔞(lou)、枳殼;痰(tan)(tan)濕重(zhong)加(jia)(jia)(jia)(jia)(jia)(jia)蒼術(shu)、石菖蒲;瘀(yu)(yu)阻(zu)(zu)(zu)重(zhong)加(jia)(jia)(jia)(jia)(jia)(jia)蟄蟲(chong)、夏枯草(cao);有(you)(you)包塊者加(jia)(jia)(jia)(jia)(jia)(jia)水(shui)蛭、莪術(shu)。
患上子宮(gong)內(nei)(nei)膜(mo)異(yi)位(wei)癥后主要(yao)表出(chu)來的(de)癥狀有月經不調、性交疼痛、尿頻(pin)、尿痛等癥狀,每一(yi)種(zhong)表現對(dui)女性的(de)傷害都(dou)非常大。面對(dui)子宮(gong)內(nei)(nei)膜(mo)異(yi)位(wei)癥疾病應該(gai)如何(he)治療(liao)呢(ni)?下面為您介紹(shao)幾種(zhong)治療(liao)辦法,相信能(neng)夠幫助到您。
輕度子宮內(nei)膜異位癥如(ru)何治療?可采用孕激素、口服避孕藥(yao)和中藥(yao)治療。
第一種方法、孕激(ji)(ji)素:輕度子宮內膜(mo)異(yi)位癥患者(zhe)可以選(xuan)擇孕激(ji)(ji)素或者(zhe)是少量雄激(ji)(ji)素來控制病情(qing)。
第二(er)種(zhong)方法(fa)、口服(fu)避(bi)(bi)孕(yun)藥:輕度子宮內膜(mo)異(yi)位癥患者可以使用一(yi)些口服(fu)避(bi)(bi)孕(yun)藥來進行控(kong)制(zhi)。口服(fu)避(bi)(bi)孕(yun)藥對輕度的(de)子宮內膜(mo)異(yi)位癥引起的(de)痛經(jing)月(yue)經(jing)量大等癥狀具有(you)一(yi)定的(de)緩解(jie)與(yu)控(kong)制(zhi)作用。
第三種(zhong)方法、中藥(yao)治(zhi)療(liao):輕(qing)度(du)子宮(gong)內(nei)膜異(yi)(yi)位癥患(huan)者也(ye)可以(yi)通過中藥(yao)進行調(diao)理,以(yi)達到活血化瘀、疏肝理氣、溫經(jing)(jing)止血等作用。中藥(yao)治(zhi)療(liao)對(dui)于輕(qing)度(du)子宮(gong)內(nei)膜異(yi)(yi)位癥患(huan)者的痛經(jing)(jing)、月經(jing)(jing)不調(diao)等癥狀也(ye)具有緩解及控(kong)制的效果(guo),但(dan)要注意(yi)的是,中藥(yao)的療(liao)程長、起效慢、治(zhi)療(liao)及緩解效果(guo)因人(ren)而異(yi)(yi)。
子宮內膜異位癥(zheng)(zheng)用中(zhong)醫治療效果是(shi)得到肯定的(de)(de),子宮內膜異位癥(zheng)(zheng)通常表現為繼發(fa)性的(de)(de)痛經、月經量(liang)的(de)(de)增多(duo)、不孕以(yi)及(ji)性交疼痛等等。中(zhong)藥(yao)治療子宮內膜異位癥(zheng)(zheng)需要(yao)(yao)(yao)辯證準確,確定是(shi)氣(qi)滯血瘀(yu)引起的(de)(de),還是(shi)氣(qi)虛血瘀(yu)導(dao)致(zhi)的(de)(de)或者是(shi)其他的(de)(de)原因,然后對癥(zheng)(zheng)用藥(yao);另(ling)外還可(ke)以(yi)配合中(zhong)藥(yao)外敷,效果明顯。平(ping)時要(yao)(yao)(yao)注意(yi)情緒,保(bao)持好心態(tai),經期要(yao)(yao)(yao)注意(yi)保(bao)暖,避免受寒,要(yao)(yao)(yao)避免經期性生(sheng)活。
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