运用国医大师朱良春教授辨证与辨病相结合理论治疗原发性闭经

国医大师朱良春教授认为,对于疑难杂症,首先要找到＂证＂的本质,始可辨＂疑＂不惑,治＂难＂不乱,自可得心应手。更早于1961年开始发表相关文章,叮嘱行医者临床时应该辨证与辨病相结合,灵活运用,方可提高效果。朱老认为,原发性闭经属疑难杂症之列,闭经不外虚实两端,临床所见实证居多,有血瘀、气滞、寒凝、痰阻之别,治之较易;虚证有脾虚、热涸、血枯之别,均较难治。故经闭之证当分虚实寒热,首当重要,但亦有无虚无实可辨,妇检正常者,则应辨病和辨证相结合。更指出,治疗虚证经闭,不用桃红、地鳖虫之类活血祛瘀药,冲脉得滋,血海渐满,血液流通,则经水自然来潮。不可擅用攻破通经之药,否则损伤血室,则月事闭而难行矣。

Using the method of combining syndrome differentiation with disease differentiation by master Zhu Liangchun in treating peimary amenorrhea

Chinese medicine master Zhu Liangchun said that, in treating complicated Diagnosis, we should find out the cardi- nal syndrome first to clarify the confused syndrome and treat difficulties orderly, and then you can handle any refractory dis- ease. Early in 1967, he inculcated the following in his essays that we must combine syndrome differentiation with disease dif- ferentiation and practice the theory flexibly to improve efficiency. Zhu considers primary amenorrhea as a refractory disease which has shi syndrome and xu syndrome. Shi syndrome is, as the common syndrome in clinic, include blood stasis, qi stag- nation, congealing cold and phlegm obstruction, which are relatively easy to cure. Xu syndrome include spleen deficient, in- ternal pathogenic heat and blood exhaustion, which are difficult to cure. Therefore, when treating amenorrhea, we should firstly differentiate the syndrome of shi and xu, of cold and hot. For those patients without obvious signs and whose women check result are normal, we should combine syndrome differentiation with disease differentiation. He told us that we should not prescribe any medicine with the effect of activating blood circulation to treat amenorrhea of xu syndrome, such as Tao Ren, Hong Hua, Di Biechong and so on. Once the Chong meridian is full and the blood sea is fully filled, then the blood cir- culation will be smooth and patient will have normal Menstruation cycle. Any medicine that would stimulate the menstrual flow should be used cautiously, or it may damage the blood chamber and result in amenorrhea.