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全生妇科十讲10: 乳腺增生(11/21/2011)
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全生妇科十讲1: 痛经(9/12/2011)

   痛经,是指在行经前后或月经期,出现小腹疼痛,或痛引腰骶,甚至剧痛晕厥的病证,亦称“经行腹痛”,尤以青年女性为多见。痛经分为原发性和继发性两类,前者是指生殖器无器质性病变的痛经,后者系指由于盆腔器质性疾病如盆腔炎、子宫内膜异位症,或肿瘤等所引起的痛经。
 
       痛经临床上除表现为在经期或行经前后,小腹及腰部疼痛,甚至剧痛难忍外,常可伴面色苍白,冷汗淋漓,手足厥冷,恶心呕吐,随着月经周期而持续发作。痛经是妇科常见病和多发病,病因多,病机复杂,反复且痛苦大,严重影响了广大妇女的工作和学习,降低了生活的质量。原发性痛经的共同特点是子宫肌层活性过强,由于过度收缩引起子宫局部缺血,与前列腺素(PGs)的关系密切。继发性痛经则由于生殖器官有明显病变所致。
 
       中医认为,本病的主要机理是经期受寒饮冷,寒邪客于冲任, 致气滞、寒凝,经脉运行不畅,或气血虚弱,肝肾虚损,经脉失养所致。气滞血瘀者每于经前一二日或经期中小腹胀痛,拒按,经量少或经行不畅,经色紫黯有块,血块排出时疼痛减轻,经净后疼痛自消,常伴胸胁、乳房作胀;寒湿凝滞者于经前数日或经期小腹冷痛,得热痛减,按之痛甚,以量少,经色黯黑有块,伴畏寒身冷;气血虚弱者于经后1~2天或经期小腹隐隐作痛,或小腹部及阴部空坠,喜揉按,经量少,色淡,伴神疲乏力,面色无华,纳少便溏;肝肾虚损者于经后1~2天内小腹绵绵作痛,腰部酸胀。经色黯淡,量少,质稀薄,伴耳鸣,头晕,目眩。
 
        北京中医药大学名老中医程士德教授,全国百名名老中医之一,积70余年临床经验,对关节痹痛、咳嗽、胃脘痛、闭经、、不孕不育、失眠、抑郁等精神情志失调性疾病和过敏性疾病等疑难杂证有丰富的理论和经验。下面抄录当时作者跟随程老坐诊时病例一则.
 
        一刘姓女子,25岁,贵州人。症见经行痛经,月经不调,手足有时冷,有时汗出,小腹冷,睡眠差。程老根据辨证,方药如下:柴胡10g,白芍20g,枳实10g,桂枝10g,吴萸10g,元胡10g,干姜10g,香附10g,益母草30g,艾叶15g,细辛3g,炒枣仁30g,炙甘草10g。
 
        针灸对于痛经的防治,疗效很好。但首需辨别寒热虚实;然后根据兼症,采用不同组穴,方可取得满意效果。最近澳大利学者发表了一篇针灸治疗痛经的随机对照研究报告。14-25岁的92例痛经病人随机分为针灸组和假针灸对照组。主穴选用公孙、归来、中极、次髎、地极、三阴交,同时根据寒凝、气滞血瘀、湿热、气血虚、肝肾虚不同证型,配以不同穴位。经过3个月9次的针灸治疗,针灸组痛经症状明显改善,而对照组无改变。
 
        另外,一个小方,对缓解痛经有帮助。玄胡益母草煮鸡蛋:玄胡20克,益母草50克,鸡蛋1个。将以上3味加水同煮,待鸡蛋熟后去壳,再放回锅中煮20分钟左右即可饮汤,吃鸡蛋。本方具有通经、止痛、补血、悦色、润肤美容功效。
 
     下期敬请关注全生妇科十讲2: 月经不调. 更多全生讲中医, 敬请访问卢全生中西医结合博士的网站www.wholelifeherb.com,或直接拨打中文热线电话301-919-9898, 301-340-7682约诊. 全生中医针灸医疗中心地址:  416 Hungerford Dr, Suite 215, Rockville, MD 20850. 或 9801 Georgia Ave, Suite 337, Silver Spring, MD 20902.
 

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