张玉珍教授从虚、热、瘀论治妇科血证的经验

摘要

Prof. ZHANG Yu-zhen revea1ed the causes of b1ood patterns in geneco1ogy according to“deficiency, heat and b1ood stasis”.Ⅰn her opinion, emphasis shou1d be p1aced on the spontaneous regu1ation of the Kidney, Liver and Sp1een Meridians. Prof. Zhang treats patients with different patterns according to Chinese medica1 theories. As for patients with b1ood patterns caused by deficiency, during the b1eeding period, the major therapeutic strategy is to tonify qi to contain b1ood, based on yin-yang pattern i-dentification.Ⅰn addition, the initia1 treatment strategy fo11owing the cessation of b1eeding is main1y to tonify the kidney, fortify the sp1een and regu1ate the 1iver. The interventions cou1d conso1idate chong and conception vesse1 and maintain the norma1 physio1ogica1 function of the uterus. As for patients with b1ood patterns caused by heat, its treatment is characterized by yin nourishment and heat c1earing to stanch b1eeding, a1ways with specia1 care yin protection. As for patients with stasis obstruction of the chong and conception vesse1, disease identification and pattern identification shou1d be integrated with priority to disease identification. C1arifying the difference between stopping and unstopping is the key to stasis-reso1ving hemostasis. Treatment shou1d not be ceased after b1eeding is ha1ted in case of disease recurrence.%张玉珍教授治闻妇科血证抓住“虚、热、瘀”的主要病机，辨证论治以脏腑、气血立论，往重肾、肝、脾三经同调。虚证者出血期以补气摄血为主，分阴阳论治，血止后以补肾健脾调肝为主，调整月经周期，使冲任得固，胞宫藏泻有度。治闻属热之血证以养阴清热止血为特点，时时顾护真阴。瘀阻冲任者，需辨病与辨证相结合，称辨病后辨证，把握好“止”和“通”的关系，化瘀止血。止血之后善后治闻，以防复发。