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中医古籍中的智慧——论治痛经精彩选段-

中医古籍中的智慧——论治痛经精彩选段

医宗金鉴·妇科心法要诀》:“腹痛经后气血弱,痛在经前气血凝,气滞腹胀血滞痛,更审虚实寒热情。 (注)凡经来腹痛,在经后痛,则为气血虚弱;经前痛,则为气血凝滞。若因气滞血者,则多胀满。  因血滞气者,则多疼痛。更当审其凝滞作胀痛之故,或因虚,因实,因寒,因热而分治之也。

  • 景岳全书·妇人规》曰:“经行腹痛,证有虚实。实者或因寒滞,或因血滞,或因气滞,或因热滞;虚者有因血虚,有因气虚。”
  • 《医宗金鉴·妇科心法要诀》中说:“凡经来腹痛,在经后痛,则为气血虚弱;经前痛,则为气血凝滞。
  • 四圣心源》曰:“经行腹痛,肝气郁塞而刑脾也。缘其水土湿寒,乙木抑遏,血脉凝涩不畅。月满血盈,经水不利,木气壅迫,疏泄莫遂,郁勃冲突,克伤脾藏,是以腹痛。中气不运,胃气上逆,则见恶心呕吐之证。血下以后,经脉疏通,木气松和,是以痛止。此多绝产不生。温燥水土,通经达木,经调痛去,然后怀子。其痛在经后者,血虚肝燥,风木克土也。以经后血虚,肝木失荣,枯燥生风,贼伤土气,是以痛作也。”
  • 《景岳全书》:“经行腹痛,证有虚实。实者,或因寒滞,或因血滞,或因气滞,或因热滞;虚者,有因血虚,有因气虚。然实痛者,多痛于未行之前,经通而痛自减;虚痛者,于既行之后,血去而痛未止,或血去而痛益甚。大都可按可揉者为虚,拒按拒揉者为实。有滞无滞,于此可察。但实中有虚,虚中亦有实,此当于形气禀质,兼而辩之,当以意察,言不能悉也。”
  • 女科证治准绳》:“妇人经来腹痛,由风冷客于胞络冲任,或伤手太阳、少阴经,用温经汤、桂枝桃仁汤。若忧思气郁而血滞,用桂枝桃仁汤、地黄通经丸。若血结而成块,用万病丸。”
  • 女科指要》曰:“寒凝紧盛,迟细虚寒,热结于血或洪或数,血少挟热弦数涩芤,水停沉细,滑必痰凝,风冷脉浮,沉则气滞。经前腹痛,气血之滞。经后刺疼,血室之虚。
  • 痛经在表主以趁痛散,在里主以八物汤,血滞换赤芍,挟瘀加桃仁,血热加栀丹,血寒加姜桂,血虚四物汤,肝郁逍遥散,肾虚地黄汤。”

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