從「二陽之病發心脾，有不得隱曲，女子不月」分析張景岳之調經種子法

Analysis of Zhang Jing-Yue's Thoughts on the Menses Regulation and Treatment for Infertility from ＂The Diseases of The Two Yang Originate from The Heart and Spleen, Resulting in Unmentionable Difficulties (Reproductive Related Disorders) and Amenorrhea.＂

10.30030/JTCGM.202106_(27).0001

陳慈玉(Tzu-Yu Chen)；許中華(Chung-Hua Hsu)；曾宣靜(Hsuan-Ching Tseng)

張景岳 ； 二陽之病 ； 調經 ； 不孕 ； Zhang Jing-yue ； The disease of two yang ； Menses Regulation ； Infertility

中醫婦科醫學雜誌

27期（2021 / 06 / 01）

1 - 9

繁體中文

張景岳詮釋「二陽之病發心脾，有不得隱曲，女子不月」，並貫穿於調經種子思想，「二陽心脾」供應衝脈月經，進而為命門精血之源，情志傷心、飲食勞倦傷脾，心脾病延及胃，依序損傷衝脈、腎氣、命門真陰，最終引起經亂、經閉、不孕。且對此提出治則與方藥，認同調經當理心脾。治應依序，病未甚宜解初病；病已劇必計所歸，培補脾腎。以「血盈」治經閉。思鬱過度致經亂者治心脾或心脾腎兼治。種子需調補命門、顧惜陽氣，調經種子均提出治療方藥，然養心健脾胃亦是滋養命門精血，強調紓解情志且情志飲食及起居應優先於調治經。

Zhang Jing-Yue interpreted the sentence ＂The diseases of the two yang originate from the heart and spleen, resulting in impotence and amenorrhea.＂ and run this concept through his thoughts on regulating the menses and treating infertility. The two yang and the heart and spleen supply the Chong Mai and menstruation and therefore serve as the source of life gate essence-blood. Improper emotions damage the heart and, improper diet and fatigue damage the spleen, and further impair the stomach, Chong Mai, kidney qi, life gate and true yin sequentially, finally resulting in irregular menstruation, amenorrhea, and infertility. To solve these problems, Zhang Jing-yue recommended many principles and formulas. Menstruation should be regulated by managing the heart and spleen, and a sequence of treating irregular menstruation was proposed: initially dealing with the cause, while the disease progressing, managing the spleen and kidney. Replenishing blood should be adopted to treat amenorrhea. The irregular menstruation caused by overthinking should be treated by managing the heart and spleen or kidney added. The infertility is treated by nourishing life-gate and preserving the yang qi. Besides, supplementing the heart, spleen and stomach can also nourish life gate and essence-blood. Zhang Jing-yue highly concerned emotions, diet, and daily life, emphasizing releasing emotions and managing the emotions, diet, and daily life has a high priority over regulating the menses.

1. 王哲,師偉(2008)。《景岳全書．婦人規》不孕證治導讀。中醫文獻雜誌，5，28-30。
2. 王新智(2004)。張景岳《婦人規》學術特點探究。中醫文獻雜誌，3，30-31。
3. 王豔,常惠(2013)。張景岳溫補法治療月經病。吉林中醫藥，33，579-577。
4. 李志庸(2015).張景岳醫學全書.北京:中國中醫藥.
5. 邱志淩(2014)。“二陽之病發心脾”之我見。江西中醫藥，45，13-15。
6. 孫紅,李暉,王祖龍(2020)。芻議“二陽之病發心脾，有不得隱曲，女子不月”。中醫研究，33，8-11。
7. 張介賓(1976).景岳全書.臺北:台聯國風.
8. 張暖,董尚樸(2004)。“二陽之病發心脾”釋評。河北中醫，26，316。
9. 許慧紅(2001)。“隱曲”詞義辨析。中醫文獻雜誌，3，21-22。
10. 陳貞如,陳建仲,王人澍(2014)。景岳全書婦人規經痛治病思想及處方用藥特點。中西整合醫學雜誌，16，11-16。
11. 陳榮洲(2000)。吳謙婦科心法學術思想之研究。中醫藥雜誌，11，65-77。
12. 陳榮洲(1998)。景岳婦人規調經理論之研究。中醫藥雜誌，9(4)，185-199。