蔡美穗

（福建省厦门市同安区中医医院妇科，福建 厦门　361100）

从瘀论治结合调周法治疗子宫内膜增厚50例

蔡美穗

（福建省厦门市同安区中医医院妇科，福建 厦门361100）

子宫内膜增厚的病机本质是瘀血阻滞，渐成癓积。子宫内膜增厚多发于无排卵周期中。由于不排卵，子宫内膜受单一雌激素的刺激，而无孕激素的拮抗作用，致使子宫内膜增生增厚。治疗以活血化瘀为大法，结合调周法治疗。活血祛瘀，以失笑散为基本方，使瘀去癓消，达到治愈。调周治疗，通过调控肾-天葵、冲任-胞宫轴，使患者恢复排卵。本人从瘀论治结合调周法治疗子宫内膜增厚病例50例，每1疗程为1个月经周期，3个疗程治愈率88%，4个疗程治愈率100%，无不良反应，停药后半年内未见复发，疗效显著。

调周法；子宫内膜增厚；月经周期

［Abstract］The nature of the disease of endometrial thickening is that the blood which is deposited and blocked results in abdominal mass gradually. The endometrial thickening most occurs in anovulatory menstrual cycle. Lack of ovulation， to be stimulated for the single estrogen， no antagonistic effect of progesterone， the endometrial will be resulted in hyperplasia and thickening. The treatment is to promote blood circulation to remove blood stasis as the main method， combined with the regulating menstrual cycle. Shixiaosan， as the basic prescription， is used for promoting blood circulation and removing blood stasis， to achieve to a cure. The method of regulating menstrual cycle is to adjust Kidney-Tiankui and Chongren-Uterus axis to restore ovulation.There are 50 patients who were treated with the method of promoting blood circulation combined with regulating menstrual cycle for their endometrial thickening， one menstrual cycle as a treatment course， after 3 courses the cure rate was 90%， after 4 courses the cure rate was 100%， no adverse reactions， no recurrence was observed in the follow up of 6 months. The rative effect is obvious.

［Key words］Regulating menstrual cycle； Endometrial thickening； Menstrual cycle

正常的子宫内膜在增殖早期厚为0.1～0.2 cm，增殖晚期厚为0.3～0.5 cm；分泌期内膜逐渐增厚，到分泌晚期，内膜可达1 cm［1］。在无排卵性的功血中，由于反复无排卵周期子宫内膜增殖，使子宫内膜增厚，反复出血，中医谓之“崩漏”。持续无排卵亦可导致“闭经”。增厚的子宫内膜虽不像癓瘕一样是盆腔包块，但是增殖出的多余之物，也归于“癓瘕”范畴，多与瘀血阻滞有关［2］。

调周法，将月经周期分为4个阶段：月经期、经后期（卵泡期）、经间期（排卵期）和经前期（黄体期）。根据四个阶段的不同生理特点来设计中药调周治疗，是一种中药序贯调经疗法。调周法治疗既有固定的周期性特点，又需要医师根据患者的实际情况进行辨证处理，亦即是一种中医辩证与辨病、整体与局部相结合的中医中药调经方法，主要是根据月经周期中的生理变化特点而制定［3］。……