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基于"寒气生浊"理论的子宫内膜异位症相关纤维化辨治思路探析OA北大核心CSTPCD

Diagnosing and treating endometriosis-related fibrosis based on the perspective of the traditional Chinese medicine theory of "coldness produces turbid yin"

中文摘要英文摘要

子宫内膜异位症具有易长难消、广泛受累、病情缠绵等特点,是导致患者生活质量降低的常见妇科疾病.异位内膜组织的纤维化既是本病的主要病理特征,也是导致患者痛经、不孕及慢性盆腔痛的主要原因之一.中医学认为,血瘀为子宫内膜异位症的病理基础及病机核心所在,且以活血化瘀之法贯穿疾病治疗始终."寒气生浊"源自《素问·阴阳应象大论篇》,寒为阴邪,其性凝滞且易伤阳气,痰湿瘀血等浊邪则内生而为患.基于此,本文分阶段探析子宫内膜异位症的病因病机,初始期以"寒气盛、凝血为瘀,浊邪生、癥之所结"为主,进展期则为"阳气虚、寒瘀难解,纤维化、癥久而成";针对不同阶段的病机特点,提出散寒化浊、温阳消癥、分阶段施治的理念.未病及初病之时以散寒活血、化浊通络为主;久病难解则重在温阳化浊、软坚消癥,扶正与祛邪并举以消久癥.寒气消散,瘀血浊邪得清,则病势可缓;阳气充盛,纤维化得解,则久癥渐除.

Endometriosis is a prevalent disease in gynecology. The symptoms of endometriosis are challenging to treat,affect various organs,and persist in the body,adversely impacting patients' quality of life. Endometriosis-related fibrosis is a primary cause of dysmenorrhea,infertility,and chronic pelvic pain,which represents the main pathological feature of endometriosis. Traditional Chinese medicine identifies blood stasis as the primary pathological basis of endometriosis,emphasizing the use of treatments to promote blood circulation and resolve stasis. The traditional Chinese medicine theory,"coldness produces turbid yin",suggests that coldness plays a crucial role in the formation of blood stasis and damp phlegm. Coldness is harmful to yang qi,leading to the accumulation of blood stasis and damp phlegm in the body,which can cause endometriosis. Based on this theory,the etiology and pathogenesis of endometriosis were discussed in stages. "Strong coldness coagulation is blood stasis,turbidity generating abdominal masses" is the first etiological factor. The progress stage is "yang qi deficiency is difficult to resolve cold blood stasis,and fibrosis is formed over a long period". According to the pathogenesis characteristics at different stages,the treatment concept for endometriosis is warming yang to resolve turbidity and blood stasis. During the initial stage of disease treatment,the treatment principle is primarily based on dispersing cold,activating blood circulation,and removing damp phlegm and blood stasis. The primary treatment is to improve yang qi to dissipate turbidity and circulate blood,and eliminate stasis to reduce abdominal masses if endometriosis is challenging to treat over a long period. In conclusion,endometriosis can be treated when blood stasis and damp phlegm are dissipated,and endometriosis-related fibrosis can be treated to clear abdominal masses when yang qi is filling the body.

强若男;刘雁峰

北京中医药大学东直门医院 北京 100700

中医学

子宫内膜异位症纤维化寒气生浊阳虚寒凝

endometriosisfibrosiscoldness produces turbid yinyang deficiencycold coagulation

《北京中医药大学学报》 2024 (009)

1185-1190 / 6

国家自然科学基金项目(No.82274567,No.82074480)National Natural Science Foundation of China(Nos.82274567 and 82074480)

10.3969/j.issn.1006-2157.2024.09.001

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