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全生妇科十讲10: 乳腺增生(11/21/2011)
全生妇科十讲9: 急性乳腺炎(11/9/2011)
全生妇科十讲8: 盆腔炎
全生妇科十讲7: 子宫内膜异位症(10/25/2011)
全生妇科十讲6: 功能性子宫出血(10/19/2011)

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全生妇科十讲8: 盆腔炎

 卢全生医师,北京中医药大学中医硕士,中国中医科学院中西医结合博士,美国乔治城大学医学院博士后,河南中医学院客座教授。

 编者按: 全生讲中医专栏的目的是普及中医知识, 弘扬中医文化, 介绍中医进展, 传授专家经验, 提高人们养生及防治疾病的能力. 如果你热爱健康, 喜欢养生, 那就静下心来, 和全生讲中医一起, 探索中医奥秘, 见证中医神奇, 分享名医经验, 寻找济世良方吧。 

盆腔炎是指盆腔内脏器及其周围组织的炎症病变,其中包括子宫、输卵管、卵巢、盆腔腹膜及盆腔结缔组织等炎性病变。其炎症可以局限于某一部分或几个部分同时发生。临床以输卵管炎较为多见。

根据发病的过程,可以分为急性、慢性盆腔炎。 引起急性盆腔炎的主要病因是产后或流产感染、宫腔内手术操作术后感染、经期卫生不良、邻近器官的炎症直接蔓延。 急性盆腔炎可使机体发生急性子宫内膜炎及急性子宫肌炎、急性输卵管炎、输卵管卵巢脓肿、急性盆腔结缔组织炎、急性盆腔腹膜炎、败血症及脓毒血症等。慢性盆腔炎常为急性盆腔炎未能彻底治疗,或患者体质较差,病程迁延所致。它可使机体发生慢性输卵管炎与输卵管积水、输卵管卵巢炎及输卵管卵巢囊肿、慢性盆腔结缔组织炎。  

在现实生活中,并不是所有的妇女都会患上盆腔炎,发病只是少数。这是因为女性生殖系统有自然的防御功能,在正常情况下,能抵御细菌的入侵,只有当机体的抵抗力下降,或由于其他原因使女性的自然防御功能遭到破坏时,才会导致 盆腔炎 的发生。 

 急性盆腔炎的症状特点是:起病急,病情重,可出现下腹疼痛、发烧、寒战、头痛、食欲不振。检查时发现病人呈急性病容,体温高,心率快,下腹部有肌紧张、压痛及反跳痛。慢性盆腔炎的症状特点是:起病慢,病程长。全身症状多不明显,可有低热,易感疲乏,伴下腹坠腰痛,常在劳累、性交后及月经前后加剧。由于盆腔瘀血,患者可有月经增多;卵巢功能损害时可有月经失调;输卵管粘连阻塞时可致不孕。不孕症是盆腔炎对妇女造成的最大危害。 

中医则认为本病与湿热蕴结、寒湿凝滞及气滞血瘀等有关。湿热蕴结者以下腹胀痛下坠,带下黄稠秽臭,尿黄为特征;寒湿凝滞者以少腹剧痛,得温则减,形寒畏冷,带下色白质稀为特征;气滞血瘀者以少腹刺痛较剧,入夜尤甚,腹痛腰酸,伴有痛经,闭经、月经不调为特征。 盆腔炎以腹痛为主证,临床多见实象、热象,辨证时当以腹痛的程度、伴有的症状及舌苔、脉象为依据,详加审证。本病除有发热及腹痛外,常兼见带下异常。但慢性盆腔炎,尚有寒湿凝滞,肝肾阴虚证型,不可不知。对急性盆腔炎患者,应给以积极、彻底的治疗,以防止炎症变为慢性。

中医针灸对盆腔炎患者,疗效很好。针灸结合中药,一般1-2月痊愈。 对急性期热毒炽盛型盆腔炎,可采用清热解毒,化瘀止痛。方用银翘红酱解毒汤:银花30g,连翘 30g,红藤30g,败酱草30g,丹皮9g,生山栀10g,赤芍10g,延胡索12g,川楝子10g。或用张仲景《金匮要略》大黄牡丹汤加减:生大黄9g,牡丹皮12g,赤芍12g,薏仁15g,银花15g,败酱草30g,蛇舌草30g。

另外,中药灌肠对盆腔炎的治疗有帮助。方一:红藤、败酱草、蒲公英、鸭跖草、紫花地丁各30g,上药浓煎成100mL,保留灌肠20分钟,每日一次,10次为一疗程。方二: 虎杖30g,红藤30g,乳香10g,没药10g,方法如上,煎药灌肠。

盆腔炎患者要注意自我保健,如多喝水以降低体温;避免不必要的妇科检查以免扩大感染;注意个人卫,避免受风寒,不宜过度劳累;经期避免性生活,以免感染;月经垫要注意清洁卫生,最好用消毒卫生纸;多吃清淡的食物和有营养的食物,如鸡蛋、豆腐、赤豆、菠菜等; 忌食生、冷和刺激性的食物。 

下期敬请关注全生妇科十讲9: 乳腺炎. 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301-340-1066,301-919-9898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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