崩漏之中醫治療一例

Treatment of Menorrhagia: A Case Report

10.7102/JTCIM.201406_12(1).0005

白詩伃(Shih-Yu Pai)；沈蘊之(Yun-Chih Shen)；廖麗蘭(Li-Lan Liao)；許中華(Chung-Hua Hsu)

崩漏 ； 月經過多 ； 芎歸膠艾湯 ； 清心蓮子飲 ； menorrhagia ； uterine bleeding ； Chiong Guei Jiau Ay Tang ； Ching Shin Lian Tzy Yinn

中醫內科醫學雜誌

12卷1期（2014 / 06 / 01）

42 - 49

繁體中文

月經量多是常見的婦科疾病，月經正常來潮最多可持續七天，而平均血量35至40毫升。而月經過多一般平均血量會大於80毫升。根據調查結果有10%-35%的婦女有月經過多的症狀。就已生殖年齡女性來說，常發生原因主要是子宮結構的改變，例如：子宮肌瘤、子宮腺肌症、子宮內膜息肉或甲狀腺異常均可造成月經過多。本文病例討論是一名51歲的女性病患，是屬於子宮腺肌症所導致月經過多，其表現症狀怕熱、心悸、眩暈、腹脹、便祕、眠差。依中醫的觀點來看乃虛實夾雜或本虛標實。經診斷後其本證為脾胃虛損，氣血兩虛，肝氣鬱結。治療方以芎歸膠艾湯來養血止血；歸脾湯來健脾養心。除了配合主要症狀，甚至還配合當時的氣候來給予清心蓮子飲來治療氣陰兩虛，清心涼血，經由4次門診治療病患症狀獲得明顯改善。

Chronic menorrhagia is a common gynecologic problem. The average menstrual cycle lasts up to seven days and the amount of menstrual blood loss is 35 to 40 mL per cycle. Menorrhagia is defined as menstrual blood loss greater than 80 mL. In population-based studies, approximately 10 to 35 percent of women report having menorrhagia. In reproductive age women with regular periods (suggesting ovulatory cycles), heavy or prolonged uterine bleeding is usually due to distortion of the endometrial architecture, such as Uterine leiomyomas, endometrial polyps, adenomyosis, or thyroid disorders, The case in this article is about 51-year-old women who experience heavy uterine bleeding due to adenomyosis. The symptoms are heat intolerance, palpitations, dizziness, flatulence, constipation and insomnia. According to the traditional Chinese medicine concept, the symptoms mainly belong to the mixture of asthenia and sthenia (虛實夾雜) or asthenia in the root and stheniain the branch (本虛標實). It resulted from the deficiencyin spleen (脾胃虛損), the dual deficiency of qi and blood (氣陰兩虛) and the accumulation of stagnation of liver-qi (肝鬱氣滯),. The prescription is mainly based on Chiong Guei Jiau Ay Tang (芎歸膠艾湯) to nourishe the blood and arrest bleed, Guei Pyi Tang (歸脾湯) to Nourishe the Heart and strengthen the Spleen. In addition to depending on patient's symptoms, the external condition should be considered. Therefore Ching Shin Lian Tzy Yinn (清心蓮子飲) was prescribed to treat deficiency of both qi and yin and to eliminate pathogenic heat from the blood. After four times outpatient treatment during one month, her symptoms were improved.

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