Liu Xiao-Qian, Ma Kun, Zhang Xiao-Yu, Yin Yun-Dong
Tianjin University of Traditional Chinese Medicine Tianjin 301617, China.
China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2022 Mar;47(6):1694-1699. doi: 10.19540/j.cnki.cjcmm.20211208.502.
This paper discussed the guiding significance of "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) for dealing with ovulation disorder infertility caused by hyperprolactinemia(HPRL). FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) concentrates on the disease entities, main symptoms, pathogenesis, and syndrome differentiation, based on which the prescriptions are prescribed. This reflects the "disease-syndrome-symptom" mode, with the core lying in the "combination of disease with syndrome". The contained Discussion on Menstruation Regulation(Tiao Jing Pian) and Discussion on Getting Pregnant(Zhong Zi Pian) have important reference significance for later doctors in the diagnosis and treatment of inferti-lity, and many prescriptions are still in use due to good effects. It is believed in traditional Chinese medicine(TCM) that HPRL results from kidney deficiency and liver depression, among which kidney deficiency is the main cause. Liver depression accelerates the onset of HPRL, so the kidney-tonifying and liver-soothing herbs were mainly selected. The "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) sheds enlightenment on the diagnosis and treatment of ovulation infertility caused by HPRL, in that it is not confined to disease entity and syndrome type. The integration of "disease-syndrome-symptom" highlights the main complaint of patients and emphasizes the main pathogenesis, thus giving full play to the overall advantage of syndrome differentiation. For multiple diseases in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) such as infertility due to liver depression, infertility due to obesity, delayed menstruation, and irregular menstruation, although the typical lactation symptom of HPRL is not mentioned, the medication can still be determined according to the chief complaint, syndrome type, and symptoms and signs, making up for the defects of excessive reliance on serum biochemical indicators in modern Chinese medicine. We should learn its diagnosis and treatment thoughts of paying attention to liver, spleen, kidney, and heart, holism, and strengthening body resistance to eliminate pathogenic factors.
本文探讨了《傅青主女科》中“病-证-症”模式对处理高催乳素血症(HPRL)所致排卵障碍性不孕症的指导意义。《傅青主女科》专注于疾病实体、主要症状、发病机制和辨证,在此基础上开方用药。这体现了“病-证-症”模式,其核心在于“病证结合”。其中所载的《调经篇》和《种子篇》对后世医家诊治不孕症具有重要的参考意义,许多方剂因疗效良好至今仍在使用。中医认为,HPRL由肾虚肝郁所致,其中肾虚是主要原因。肝郁加速了HPRL的发病,故主要选用补肾疏肝之药。《傅青主女科》中的“病-证-症”模式对HPRL所致排卵性不孕症的诊治具有启示作用,即不拘泥于疾病实体和证型。“病-证-症”的结合突出了患者的主诉,强调了主要病机,从而充分发挥了辨证论治的整体优势。对于《傅青主女科》中的多种病症,如肝郁不孕、肥胖不孕、月经后期、月经不调等,虽未提及HPRL典型的泌乳症状,但仍可根据主诉、证型及症状体征来确定用药,弥补了现代中医过度依赖血清生化指标的缺陷。我们应学习其重视肝、脾、肾、心,整体观念以及扶正祛邪的诊治思路。