摘要
子宫内膜息肉为妇科常见疾病,是导致育龄期妇女异常子宫出血及不孕的主要原因之一。岭南罗氏妇科传承人廖慧慧教授认为,子宫内膜息肉病机特点为本虚标实,以脾肾阳虚为本,血瘀、痰湿为标;病证以虚实夹杂为特点,可分为痰瘀互结证、湿热瘀结证、肝郁肾虚证及脾虚痰湿证4种证型。治疗子宫内膜息肉应结合息肉大小、病机特性、患者需求等确定疗法:若患者子宫内膜息肉较小(<1 cm)、单发,伴有异常子宫出血,但不伴有子宫内膜增厚,以祛除癥瘕为首要目标,予脱花煎加味(由当归、肉桂、川芎、牛膝、车前子、红花等药物组成)温经活血、化瘀消癥,以祛除息肉;若患者息肉较大(>1 cm)、多发,或同时存在异常子宫出血严重、内膜增生等情况,则建议患者先行宫腔镜下内膜息肉摘除术。待息肉已去,则分经期与非经期两个阶段辨证论治,调理体质,预防复发,结合周期疗法调经助孕,临床可获良效。
Endometrial polyp is a common gynecological disease and is one of the main causes of abnormal uterine bleeding and infertility in women of childbearing age.Professor LIAO Hui-Hui believes that the pathogenesis of endometrial polyp is characterized by deficiency in the origin and excess in the superficiality,i.e.,the yang deficiency of the spleen and kidney being the root cause,manifested as the clinical symptoms of blood stasis and phlegm-damp.The syndrome is characterized by a mixture of deficiency and excess,and can be divided into four types of syndromes,namely phlegm blended with stasis,damp-heat and blood stasis accumulation,liverdepression and kidney-deficiency,and spleen-deficiency and phlegm-damp.Treatment of endometrial polyps should take the size of the polyps,the characteristics of the pathogenesis and the patients’demand into account.If the endometrial polyps are small(<1 cm)and solitary,and the patients are accompanied by abnormal uterine bleeding,but not accompanied by endometrial thickening,the treatment mainly aims to eliminating the abdominal mass,and the Flavored Tuohua Decoction(composed of Angelicae Sinensis Radix,Cinnamomi Cortex,Chuanxiong Rhizoma,Achyranthis Bidentatae Radix,Plantaginis Semen,Carthami Flos,etc.)is given to warm meridians and activate blood,resolve blood stasis and eliminate abdominal mass,so as to get rid of the polyps.If the endometrial polyps are large(>1 cm)or multiple,and the patients are accompanied by severe abnormal uterine bleeding or endometrial hyperplasia,the patients are advised to undergo hysteroscopic removal of the endometrial polyps.After the removal of the polyps,syndrome differentiation and treatment separately for the menstrual period and non-menstrual period can be performed for regulating the body constitution and preventing recurrence,and the combination of periodic therapy will be helpful for regulating menstruation and promoting pregnancy.Following the above therapeutic principles,satisfactory clinical efficacy will be obtained.
作者
陈怡
陈慕镟
曾蕾
廖慧慧(指导)
CHEN Yi;CHEN Mu-Xuan;ZENG Lei;LIAO Hui-Hui(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2023年第9期2347-2353,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家自然科学基金项目(编号:81804135)
国家中医药管理局全国中医学术流派传承工作室建设项目(国中医药人教函[2019]62号)
张玉珍全国名老中医药专家传承工作室建设项目(粤中医办函[2017]209号)
广州市优才项目课程研究项目。
关键词
岭南罗氏妇科
子宫内膜息肉
脾肾阳虚
血瘀
温经活血
化瘀消癥
脱花煎
周期疗法
廖慧慧
Lingnan LUO’s Gynecology
endometrial polyps
deficiency of spleen and kidney yang
blood stasis
warming meridians and activating blood
resolving blood stasis and eliminating abdominal mass
Tuohua Decoction
periodic therapy
LIAO Hui-Hui
