中医临床研究2025，Vol.17Issue(25)：114-119,6.DOI:10.3969/j.issn.1674-7860.2025.25.017
基于"甘守津还"理论探讨围绝经期汗证的病机与辨治
The pathogenesis and syndrome differentiation and treatment of perimenopausal sweating disorders based on the theory of"promoting body fluid restoration with sweet medicines"
摘要
Abstract
Perimenopause,as a critical transitional phase in the female physiological cycle,is characterized by the progressive decline of ovarian function,with clinically prevalent symptoms including paroxysmal hot flashes with sweating,palpitations,depression,irritability,insomnia,and particularly common spontaneous sweating and night sweats.Modern medicine defines sweating syndrome that occurs during perimenopause as vasomotor symptoms.The therapeutic principle of"promoting body fluid restoration with sweet medicines"originates from YE Gui's Wenre Lun(《温热论》).Based on this theoretical foundation,in this study,the pathogenesis evolution and diagnostic treatment system for perimenopausal sweating disorders are elucidated,and the core pathogenesis is proposed as follows:first,the deficiency of kidney essence and the imbalance of Yin(阴)-Yang(阳).Secondly,the spleen is affected by kidney deficiency and fails to transport body fluid.Thirdly,blood deficiency in the heart and liver manifesting as persistent Yin insufficiency.In response to this complex pathogenesis,based on the theory of"promoting body fluid restoration with sweet medicines"from YE Gui,the therapeutic principle of taking sweet medicines as the core of the prescription is established.By thoroughly studying the medicinal property and taste characteristics of sweet medicines and the principles of their compatibility and synthesis,the synergistic effect of prescriptions and medicines can be strengthened to fully exert their effects of tonifying,soothing,and harmonizing.In clinical practice,according to the specific etiological and pathogenetic evolution,various basic treatment methods are selected flexibly:sweet-warm medicines are used to replenish Qi(气)and secure the exterior,sweet-bland medicines are used to promote urination and strengthen the spleen,sweet-bitter medicines are used to drain fire and alleviate vexation,sweet-sour medicines are used to constrain Yin(阴)and arrest sweating,and sweet-moistening medicines are used to nourish the kidneys and replenish essence.Additionally,the treatment is based on the diagnosis.This integrated approach can nourish systemic Yin fluids while effectively regulating fluid distribution,transportation,and excretion,thereby normalizing sweat production.Significant therapeutic efficacy observed clinically demonstrates that this integrated approach not only provides a novel perspective for syndrome differentiation and treatment but also enriches the theoretical framework and practical application system for perimenopausal sweating disorders,establishing substantial guiding significance for clinical practice.关键词
甘守津还/围绝经期/汗证/甘味药物Key words
Promoting body fluid restoration with sweet medicines/Perimenopausal period/Sweating disorders/Sweet medicine分类
医药卫生引用本文复制引用
余科伟,陆嗣标,马黎倩,陈芊樾,孟杭淇,林咸明..基于"甘守津还"理论探讨围绝经期汗证的病机与辨治[J].中医临床研究,2025,17(25):114-119,6.基金项目
浙江省级名中医工作室建设项目(浙卫发[2018]69号) （浙卫发[2018]69号）
国家中医优势专科(针灸科)(国中医药医政函[2024]90号). （针灸科）
