张明明+王凤兰+陆雪秋+孙亮

摘要：《竹林寺女科证治》为竹林寺僧所撰。全书共4卷，主要记载了调经、安胎、保产、求嗣四部分内容。其中“调经病篇”根据月经周期异常分成数十证型，大体可概括为月经先期、月经后期、月经先后不定期等。其病因病机可归纳为阴盛阳衰、痰多气虚之月经后期；脾胃虚弱、气血不足之月经先期；脾土不盛之月经先后不定期。治疗上谨遵疏肝气、健脾胃、调气血、固冲任等法则。竹林寺僧治疗月经病的特色是肝脾为主论、善调气血及喜用四物汤等。

关键词：竹林寺女科；《竹林寺女科证治》；月经周期异常；月经病

中图分类号：R2-09；R271.1 文献标识码：A 文章编号：2095-5707（2016）04-0056-03

Primary Investigation of Zhu Lin Si Nv Ke Zheng Zhi for the Abnormal Cycle of Menopathy

ZHANG Ming-ming， WANG Feng-lan*， LU Xue-qiu， SUN Liang

（Institute for the History of Chinese Medicine and Medical Literature， China Academy of Chinese Medical Sciences， Beijing 100700， China）

Abstract： Zhu Lin Si Nv Ke Zheng Zhi was compiled by the monks in the Zhulin temple. The book contains four volumes， mainly recording the contents about regulating the menstrual function， miscarriage prevention， delivery production and the ways to get pregnant. The chapter of “regulate the menstrual function” can be divided into 10 syndromes according to the abnormal menstrual cycle. Human body can be concluded as preceded menorrhea， delayed menstrual cycle and irregular menstruation， etc. Etiology and pathogenesis can be summarized as excessive yin causing yang deficiency， much phlegm and qi deficiency in the delayed menstrual cycle； weakness of the spleen and the stomach and qi-blood deficiency in preceded menorrhea； spleen deficiency in irregular menstruation. Treatment should follow the rules of soothing liver qi， strengthening the spleen and stomach， regulating qi and blood， and strengthening Chong and Ren meridians. The treatment features of the monks in the Zhulin temple for menopathy focus on liver and spleen， regulating qi and blood， and using Siwu Deccotion.

Key words： Zhulin temple gynecology； Zhu Lin Si Nv Ke Zheng Zhi； abnormal menstrual cycle； menopathy

1 月经周期异常病症

1.1 月经后期

《竹林寺女科证治》将月经后期详细划分为过期经行、形瘦过期经行、形肥过期经行、数月行经等不同类型。论其病因，不外乎虚实两端。

“月经后期”由阴不足而经退后一月，忽迟一月，临床表现为月经形色不鲜或涩滞而少、喜暖恶寒等症状。可知此处所言“阴不足”指由于素体阳虚致使寒凝日久而血瘀不能正常运行，最终导致体内阴血不足。方用正经养血汤以温阳散寒调经。组方中茯苓、白术、人参、甘草乃四君子汤，健脾补气以生阴血，气生则血生；白芍、当归、阿胶重在补血，兼顾活血；性温味辛之川椒，温阳散寒止痛；柴胡条畅气机，气行则血行。是方所用之药补中有行，散中有补，补血而不壅滞，理气而不伤正。该证属于月经后期常见类型之一。《景岳全书·妇人规》中写道，“凡血寒者，经必后期而至。……