1.广州中医药大学第一临床医学院,广东省广州市白云区机场路12号,501405
2.广州中医药大学第一附属医院
zenglei@gzucm.edu.cn
收稿:2024-04-09,
修回:2024-06-18,
纸质出版:2024-11-02
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陆希婧,罗颂平,黎佩银等.岭南罗氏妇科术后“消癥助孕”思想钩玄[J].中医杂志,2024,65(21):2205-2210.
LU Xijing,LUO Songping,LI Peiyin,et al.The Treatment Idea for Postoperative "Eliminating Abdominal Mass to Help Pregnancy" in Lingnan LUO's Gynaecology[J].Journal of Traditional Chinese Medicine,2024,65(21):2205-2210.
陆希婧,罗颂平,黎佩银等.岭南罗氏妇科术后“消癥助孕”思想钩玄[J].中医杂志,2024,65(21):2205-2210. DOI: 10.13288/j.11-2166/r.2024.21.007.
LU Xijing,LUO Songping,LI Peiyin,et al.The Treatment Idea for Postoperative "Eliminating Abdominal Mass to Help Pregnancy" in Lingnan LUO's Gynaecology[J].Journal of Traditional Chinese Medicine,2024,65(21):2205-2210. DOI: 10.13288/j.11-2166/r.2024.21.007.
岭南罗氏妇科根据妇科术后病机特点,总结出“消癥助孕”思想,将消法运用于妇科术后促进康复、预防复发、序贯调经等治疗环节中,并分为三阶段进行论治。术后康复第一阶段(术后2周)病机以多虚、多瘀、易留邪为主,治疗应着重补益正气,兼以消癥,常用四君子汤合生化汤加减。术后康复第二阶段(术后2周至术后2~3个月)病机以肾虚血瘀为主,治疗应补肾填精、化瘀消癥,常用归肾丸配伍活血化瘀通络之品。术后序贯调经助孕阶段(术后康复阶段结束,宫腔及盆腔正常解剖结构基本恢复后)采用周期序贯疗法,根据月经不同时期的病机特点分期调治,总以补肾调经、消癥散结之法贯穿始终,并重视活血化瘀、行气解郁、化痰祛湿、消积导滞四种消癥之法的运用。
Based on the characteristics of postoperative gynaecological diseases, Lingnan LUO's Gynaecology has summarized the idea of "eliminating abdominal mass to help pregnancy", and applied the elimination method in the postoperative gynaecological treatment to promote rehabilitation, prevent recurrence, and regulate menstruation in a sequential manner, which is divided into three phases of diagnosis and treatment. The first stage of postoperative rehabilitation (2 weeks after surgery) is based on the pathogenesis of profuse deficiency, profuse stasis, and easy to retain pathogens, and the treatment should focus on tonifyi
ng the positive
qi
and eliminating abdominal mass at the same time, commonly used in modified
Sijunzi Dcoction
(四君子汤) and
Shenghua Dcoction
(生化汤). In the second stage of postoperative rehabilitation (2 weeks to 2-3 months after surgery), the pathogenesis is mainly kidney deficiency and blood stasis, which should be treated by tonifying kidney and supplement essence, eliminate blood stasis and eliminate abdominal mass, and commonly use the
Guishen Pill
(归肾丸) with herbs that invigorating blood, dissolving stasis, and clearing the collaterals. Postoperative sequential menstrual regulation and fertility promotion stage (after the end of the postoperative rehabilitation stage, the normal anatomy of the uterine cavity and pelvis is basically restored) adopts cyclic sequential therapy, according to the characteristics of the pathogenesis of the different periods of menstruation in phases, always tonifying kidney and regulating menstruation, eliminating abdominal mass, and attaches importance to the application of four methods of eliminating abdominal mass, including invigorating blood and dissolving stasis, moving
qi
to resolve constraint, dissolving phlegm and dispelling dampness, resolving accumulation and removing stagnation.
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