赵瑞华治疗经前期综合征验案一则
增强出版ZHAO Ruihua's Experience in Treating Premenstrual Syndrome
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1.北京市回民医院妇科,北京 100054
2.中国中医科学院广安门医院,妇科,北京 100053
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李田田, 赵瑞华. 赵瑞华治疗经前期综合征验案一则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32156540&Fpath=home&index=0
LI Tiantian, ZHAO Ruihua. ZHAO Ruihua's Experience in Treating Premenstrual Syndrome[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32156540&Fpath=home&index=0
李田田, 赵瑞华. 赵瑞华治疗经前期综合征验案一则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32156540&Fpath=home&index=0 DOI:
LI Tiantian, ZHAO Ruihua. ZHAO Ruihua's Experience in Treating Premenstrual Syndrome[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=32156540&Fpath=home&index=0 DOI:
病史摘要,2,安某,女,28岁,主因“经行乳痛4年,经行头痛1年”就诊。患者平素月经规律,痛经VAS:4~5分,2017年始伴经前乳房胀痛、刺痛,VAS:7分,月经来潮后减轻。近1年出现经前及经期头部胀痛、跳痛,两侧太阳穴尤甚,VAS:10分,服用止痛药无效,伴恶心,压力大、情绪不佳时加重,经后缓解。2021年3月始出现经间期少量出血。LMP:6月12日。患者欲调理经期不适症状以备孕。平素情绪低落,易焦虑,余无不适。舌淡红,有瘀点,苔白厚,脉弦涩。既往:荨麻疹病史10年,双侧乳腺结节9年;焦虑状态3个月,抑郁状态3个月。否认过敏史。已婚,孕0产0。否认家族史。广安门医院检查:2021年6月15日性激素:未见明显异常。2021年6月18日乳腺超声:双乳腺多发低回声结节。2021年6月25日盆腔超声:子宫及双附件未见异常。中医诊断 月经前后诸证;经间期出血;乳癖;(肝郁气滞;痰瘀互结)。中医治法 燮理气机,化痰散瘀,调和气血。西医诊断 经前期综合征,围排卵期出血,乳房结节。干预措施 始终坚持祛邪不伤正,顾护中焦脾胃为原则,切中病机,合方应用,使用药对,中药处方予柴胡疏肝散合。桂枝汤合四君子汤加减,同时调摄生活,情志管理,指导同房,受孕后积极保胎。疗效转归 患者月经前后诸证明显减轻,成功受孕,保胎后足月分娩。
Summary of case history ,Miss An, 28 years old, was hospitalized for menstrual pain of breasts for 4 years and menstrual headache for 1 year. The patient usually has regular menstruation, dysmenorrhea, vas: 4~5 points, with premenstrual breast swelling and tingling since 2017, vas: 7 points, which is relieved after menstruation. In the past 1 year, there has been swelling pain and jumping pain in the head before and during menstruation, especially in the temples on both sides. Vas: 10 points accompanied by nausea, aggravation in case of high pressure and poor mood, and remission after menstruation, Taking painkillers is ineffective. A small amount of interpenstrual bleeding began in March 2021. Last menstruation (LMP): June 12,2021. The patient wants to relax the symptoms of menstrual discomfort for pregnancy. Usually low mood, easy to anxiety,and no other discomfort. The tongue is light red, with ecchymosis, white and thick moss and astringent pulse string. Past history:The history of urticaria of breast nodules was 10 years, and bilateral breast nodules were 9 years; Anxiety for 3 months and depression for 3 months. Denied allergy history. Married. no pregnancy history. No family history. Examination of Guang'anmen Hospital on June 15, 2021, sex hormone showed no obvious abnormality. June 18, 2021 breast ultrasound results showed multiple hypoechoic nodules in both breasts. Pelvic ultrasound on June 25, 2021, no abnormality was found in uterus and double accessories.,TCM diagnosis , Premenstrual syndrome, Intermenstrual bleeding, Mastophilia Syndrome differentiation belongs to liver depression and qi stagnation, phlegm and blood stasis.,Western medicine diagnosis ,Premenstrual Syndrome, Periovulation spotting; Breast nodule,Therapeutic methods ,Adhere to the principle of eliminating pathogenic factors without harming the health, and taking care of the spleen and stomach in the middle energizer. We cut the pathogenesis, apply the combination of prescriptions, and use drug pairs. We prescribe ,Chaihu Shugan, Powder,Guizhi Decoction, and ,Sijunzi Decoction,. At the same time, we regulate their lives, manage their emotions, guide sexual intercourse, and actively protect the fetus after pregnancy.,Clinical outcomes ,The symptoms of the patient before and after menstruation were significantly reduced, successful pregnancy, and full-term delivery after pregnancy protection.
经前期综合征月经前后诸证燮理气机赵瑞华
Premenstrual syndromeSyndrome before and after menstruationregulate QiZhao Ruihua
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