赵瑞华治疗子宫腺肌症痛经验案一则
ZHAO Ruihua's experience in treating Adenomyosis pain
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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 广安门医院妇科,北京 100053
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李田田, 赵瑞华. 赵瑞华治疗子宫腺肌症痛经验案一则[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539517&Fpath=home&index=0
LI Tiantian, ZHAO Ruihua. ZHAO Ruihua's experience in treating Adenomyosis pain[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539517&Fpath=home&index=0
李田田, 赵瑞华. 赵瑞华治疗子宫腺肌症痛经验案一则[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539517&Fpath=home&index=0 DOI:
LI Tiantian, ZHAO Ruihua. ZHAO Ruihua's experience in treating Adenomyosis pain[DB/OL].(2023-04-28)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36539517&Fpath=home&index=0 DOI:
病史摘要,2,患者主因“痛经5年伴月经量多4个月”就诊。患者2015年出现经行腹痛,于北京友谊医院超声提示子宫腺肌症,后痛经渐进加重,经期前3天小腹坠胀、刺痛,VAS:8~10分。近4个月月经量较前增加1倍,继发贫血。LMP:4月22日,6天干净,月经量多,PBAC:120分,有大血块,经期前3天小腹坠胀痛,VAS:8分,每天需服1片止痛药。平素性急,乏力,纳眠可,平素易感冒,畏寒、脚凉,偶有非经期小腹隐痛不适,受凉后易诱发和加重,大便正常。舌淡红,有齿痕,苔白略厚,脉弦滑。既往乙肝小三阳15年。清开灵过敏史。孕4产2,人工流产2次,自然分娩2次。家族史:妹妹有子宫腺肌症病史。专科检查子宫增大如孕7~8周。广安门医院超声:子宫8.2×7.5×7.5 cm,肌层回声不均,前壁厚2.4cm,后壁4.2厚cm。提示:子宫腺肌症,合并腺肌瘤不除外。中医诊断 痛经,癥瘕,月经过多 辨证属气滞血瘀兼寒凝证。中医治法 理气活血散瘀,温阳散寒消癥。西医诊断 子宫腺肌症。干预措施 以“执中致和”“治未病”思想并举,辨病与辨证论治相结合,中药处方以逍遥散、桂枝汤、四逆汤加减,或六合定中汤、桂枝汤、四逆汤加减,同时调摄生活,情志管理。疗效转归 随诊10月余,患者痛经基本缓解,月经量正常,体质改善,症状未复发。
Summary of case history, The main reason of the patient was " Dysmenorrhea for 5 years and more menstruation for 4 months". In 2015, the patient suffered from menstrual abdominal pain. Ultrasound at Beijing Friendship Hospital suggested adenomyosis, and then the dysmenorrhea gradually worsened. The lower abdomen was swollen and painful 3 days before the menstrual period. VAS: 8-10 points. The menstrual volume in recent 4 months doubled compared with the previous one, secondary to anemia. Menstrual pain should be relieved by taking tablets every day for more than 3 days, and vas should be taken for more than 4 days before menstruation,. She is usually impatient, weak and sleepy. She is usually prone to colds, chills and cold feet. Occasionally, she has hidden pain and discomfort in the lower abdomen during the non-menstrual period. she is easy to induce and aggravate after catching cold, and her stool is normal. The tongue is light red, with tooth marks, the moss is white and slightly thick, and the pulse string is smooth. Past hepatitis B mistress for 15 years. Qingkailing allergy history. 4 pregnancies, 2 births, 2 induced abortions and 2 spontaneous births. Family history: her sister has a history of adenomyosis. Specialized examination showed that the uterus was enlarged and plump. Guang'an hospital Ultrasound: uterus 8.2×7.5×7.5 cm, uneven echo of muscular layer, 2.4cm thick anterior wall and 4.2cm thick posterior wall. It is suggested that adenomyosis with adenomyoma is not excluded.,TCM diagnosis, Dysmenorrhea, Zhengjia, Menorrhagia Qi stagnation, blood stasis and cold coagulation. TCM treatment Regulating Qi, activating blood circulation and dispersing blood stasis, warming Yang, dispersing cold and eliminating symptoms.,Western medicine diagnosis, Adenomyosis.,Therapeutic methods, The intervention measures are based on the ideas of "sticking to the middle and causing harmony" and "treating diseases before they are cured", combining disease differentiation with syndrome differentiation and treatment. The traditional Chinese medicine prescriptions are Xiaoyao Powder, Guizhi Decoction and Sini Decoction, or Liuhe Dingzhong decoction, Guizhi Decoction and Sini decoction. At the same time, they adjust life and emotional management.,Clinical outcomes, After more than 10 months of follow-up, the patient's dysmenorrhea was basically relieved.The amount of menstruation was normal, the physique was improved, and the symptoms did not recur.
子宫腺肌症痛经执中致和治未病
AdenomyosisDysmenorrheaInsisting on harmonyPrevention of disease
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