[1]张晓宇,张大伟,李潇,等.基于“络病理论”探析张大伟教授崩漏学术思想与临证经验[J].陕西中医,2025,46(12):1682-1685.[doi:DOI:10.3969/j.issn.1000-7369.2025.12.020]
　ZHANG Xiaoyu,ZHANG Dawei,LI Xiao,et al.Analysis on professor ZHANG Dawei’s academic thought and clinical experience of metrorrhagia based on “Collateral disease theory”[J].,2025,46(12):1682-1685.[doi:DOI:10.3969/j.issn.1000-7369.2025.12.020]
点击复制

基于“络病理论”探析张大伟教授崩漏学术思想与临证经验

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年12期
页码:
1682-1685
栏目:
名中医经验
出版日期:
2025-12-05

文章信息/Info

Title:
Analysis on professor ZHANG Dawei’s academic thought and clinical experience of metrorrhagia based on “Collateral disease theory”
作者:
张晓宇1; 张大伟2; 李潇1; 张雪琳2; 马丽亚3
（1.河南中医药大学第二临床医学院，河南 郑州450000；2.河南中医药大学第三临床医学院，河南 郑州 450000；3.河南中医药大学教务部，河南 郑州 450000）
Author(s):
ZHANG Xiaoyu1; ZHANG Dawei2; LI Xiao1; ZHANG Xuelin2; MA Liya3
(1.Second Clinical Medical College of Henan University of Traditional Chinese Medicine， Zhengzhou 450000，China;2.Third Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450000，China;3.Academic Affairs Department of Henan University of Traditional Chinese Medicine，Zhengzhou 450000，China)
关键词:
络病理论; 张大伟教授; 崩漏; 湿热瘀结; 治崩三法; 学术思想
Keywords:
Collateral disease theory; Professor ZHANG Dawei; Metrorrhagia; Damp-heat stasis; Three methods for treating metrorrhagia; Academic thought
分类号:
R 271.12
DOI:
DOI:10.3969/j.issn.1000-7369.2025.12.020
文献标志码:
A
摘要:
崩漏作为临床妇科急重症之一，是育龄期女性常见多发病。张大伟教授认为崩漏本质为湿热、瘀血阻滞胞宫脉络，具有病情缠绵反复的特点，且本病属慢性迁延疾病，符合络病“久病入络”“久瘀入络”的病机演变。基于络病理论，张大伟教授结合“塞流、澄源、复旧”治崩三法，提出从湿热瘀、从肝脾肾、从虚综合论治崩漏，灵活运用逐瘀止血、清热燥湿、疏肝行气、健脾益气等治法，使得络脉通利，气血调和，临床疗效显著。本文基于临床跟师实践，系统收集整理病历，检索相关文献，对典型病案深入剖析，总结张大伟教授治疗崩漏的诊疗辨证思路。
Abstract:
Professor ZHANG Dawei thinks that metrorrhagia and metrostaxis is characterized by damp-heat and blood stasis blocking uterine meridian,and it belongs to chronic protracted disease,which accords with the pathogenesis evolution of collateral disease.Based on the theory of collateral diseases,Professor ZHANG Dawei combined with the three methods of “blocking flow,clearing source and recovering old” to treat metrorrhagia and metrostaxis,put forward the comprehensive treatment of metrorrhagia and metrostaxis from damp-heat stasis,liver,spleen and kidney,and flexibly applied the treatment methods of eliminating blood stasis to stop bleeding,clearing heat and drying dampness,soothing liver and promoting qi,invigorating spleen and replenishing qi,etc.,so that the collaterals can be unblocked and qi and blood harmonized,and the clinical effect is remarkable.Based on clinical practice,this paper systematically collected and sorted out medical records,retrieved relevant literature,analyzed typical medical records,summarized professor ZHANG dawei’s diagnosis and treatment of metrorrhagia.

参考文献/References:

[1]高山凤,陈燕霞,马堃.马堃从心肾论治围绝经期排卵障碍性异常子宫出血经验[J].中医杂志,2023,64(8):765-768.
[2]中华中医药学会,世界中医药学会联合会.国际中医临床实践指南崩漏(2019-10-11)[J].世界中医药,2021,16(6):870-877.
[3]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:100-114.
[4]于绍卉,姚璠,石荣坤,等.张海莹基于“肾-天癸-冲任-胞宫”生殖轴论治无排卵型异常子宫出血[J].吉林中医药,2025,45(6):658-662.
[5]JAIN V,MUNRO M G,CRITCHLEY H O D.Contemporary evaluation of women and girls with abnormal uterine bleeding:FIGO systems 1 and 2[J].International Journal of Gynecology & Obstetrics,2023,162(1):29-42.
[6]张杞苹,蓝茂铮,陈林兴.基于数据挖掘探讨陈林兴教授治疗多囊卵巢综合征的用药规律[J].云南中医中药杂志,2025,46(4):39-45.
[7]李萌,宋佳怡,夏天.夏天运用补肾调冲法治疗反复胚胎移植失败临床经验[J].辽宁中医杂志,2016,43(9):1826-1829.
[8]丁宁,姜秀新,徐世杰.基于“女子以肝为先天”思想论治围绝经期无排卵性异常子宫出血[J].中国实验方剂学杂志,2021,27(13):191-198.
[9]李勤,侯丽辉,张晗,等.明代不孕症诊疗特色的挖掘[J].中医杂志,2012,53(5):387-389.
[10]LEBDUSKA E,BESHEAR D,SPATARO B M.Abnormal uterine bleeding[J].Medical Clinics,2023,107(2):235-246.
[11]林茜,褚克昙,周坚红.米非司酮在围绝经期排卵障碍性异常子宫出血治疗中的研究进展[J].中国妇幼保健,2023,38(22):4513-4516.
[12]JEWSON M,PUROHIT P,LUMSDEN M A.Progesterone and abnormal uterine bleeding/menstrual disorders[J].Best Practice & Research Clinical Obstetrics & Gynaecology,2020,69(1):62-73.
[13]阮祥燕,杨欣.围绝经期异常子宫出血诊断和治疗专家共识[J].协和医学杂志,2018,9(4):313-319.
[14]孙冬岩,王燕,刘玉兰,等.诺舒阻抗控制系统治疗异常子宫出血合并严重内科疾病的临床研究[J].中国妇产科临床杂志,2017,18(3):263-264.
[15]PINKERTON J A V.Pharmacological therapy for abnormal uterine bleeding[J].Menopause,2011,18(4):459-467.
[16]赵月星,郑红凤,李普霞,等.归脾丸加减对围绝经期功血患者免疫功能的影响[J].世界中医药,2020,15(5):768-772.
[17]崔昊然,邹元君.基于知识图谱的中医药治疗崩漏研究可视化分析[J].中国中医基础医学杂志,2022,28(8):1304-1309.
[18]焦琳,陈日新.腧穴者-其态各异,动、敏为本[J].时珍国医国药,2018,29(1):143-145.
[19]朱玉莹，薛晓鸥.郭志强基于“络病学说”妙用虫类药治疗盆腔炎性疾病后遗症经验[J].中医药导报，2023,29(7):184-187.
[20]刘琴,苏丽清,刘金雪,等.探析从“久病入络”论治卵巢巧克力囊肿纤维化[J].陕西中医,2024,45(8):1083-1086，1090.
[21]李洁.络脉文献的整理与研究[D].成都：成都中医药大学，2006.
[22]李豪英.论胞络瘀阻是妇科病形成的病理基础[J].光明中医,2007,1(2):3-5.
[23]袁静云,武晓冬,牟东晓,等.基于络病理论的妇科癥瘕的诊治思路与方法[J].世界中医药,2024,19(2):191-195.
[24]马玉草,吕柳,胡杰,等.基于络病理论探讨干燥综合征的病机与治疗[J].陕西中医,2023,44(4):479-482.
[25]李东垣.兰室秘藏[M].北京：中国中医药出版社，2007:67-68.
[26]李晓萍.《内经》血瘀理论对临床的指导意义[J].长治医学院学报,2006,22(1):67-68.

相似文献/References:

[1]沙燕红,钟晓玲,郑月慧,等.从络病理论辨治女性慢性盆腔疼痛[J].陕西中医,2026,(3):370.[doi:DOI:10.3969/j.issn.1000-7369.2026.03.015]
　SHA Yanhong,ZHONG Xiaoling,ZHENG Yuehui,et al.Diagnosis and treatment of chronic pelvic pain in women based on the theory of collateral disease[J].,2026,(12):370.[doi:DOI:10.3969/j.issn.1000-7369.2026.03.015]

备注/Memo

备注/Memo:
国家自然科学基金资助面上项目（82074562）；河南省自然科学基金资助面上项目（242300420168）；河南省卫生健康委员会中医药科学研究专项课题重大课题（2023ZYZD09）；河南省科技攻关项目（232102310478）
更新日期/Last Update: 2025-12-08