沈鹤峰医师处方妇科部分①

Gynecologic Conditions

神经系统紧张导致的闭经

Hamilton Rotte： Nervous tension compromises the liver function of regulating the menses. It causes stagnation of qi and blood. This formula, which bears some similarity to Dr. Shen’s “Nervous System Tense” formulas, is aimed at regulating qi and blood. Ingredients that are commonly included in Dr. Shen’s “Nervous System Tense” formulas include shi chang pu, chuan xiong, and lu lu tong.

Hamilton Rotte：神经系统紧张会影响肝脏调节月经的功能，导致气血淤滞。此方调理气血，与沈医生的“神经系统紧张方”有类似之处。处理此类疾病沈医生经常用石菖蒲、川芎和路路通，这三味药曾出现在“神经系统紧张方”中。

Other than these ingredients, his formula contains mostly blood-invigorating ingredients. These include dang gui,dan shen, niu xi, yan hu suo, and yi mu cao. Dang gui, niu xi, and yi mu cao are widely used in gynecology. Dr. Shen also especially liked to use dan shen and yan hu suo for moving blood in gynecologic conditions. Niu xi is strongly descending and therefore especially indicated for amenorrhea.Sheng di huang and dang gui are included to offset drying tendencies of other herbs in the formula.

除了这三味药，本处方中大多为活血药，包括当归、丹参、牛膝、延胡索和益母草。当归、怀牛膝和益母草被广泛应用于妇科疾病的治疗中。沈医生还善用丹参和延胡索活血。怀牛膝或者川牛膝（怀牛膝偏于补肝肾，川牛膝偏于散淤血，并能祛风治痹。译者注）有很强的引血下行的作用，尤其适用于闭经的病人。生地黄和当归养血，同时可以反佐方中其它药物的燥性。

乳房气血阻滞伴有淋巴结肿大

Hamilton Rotte： This formula, which bears significant resemblance to “Move Qi in the Chest,” is strongly moving to both qi and blood and targets the upper burner and breasts. Circulation of qi and blood in the breasts mainly depends on circulation in the upper burner (heart and lungs) as well as the liver.

Hamilton Rotte：此处方对上焦和乳房有很强的行气活血作用，与“宽胸理气方”极为相似。乳房中的气血循行主要靠上焦心肺的推动和肝脏的疏泄。

Qi-moving herbs in this formula include xiang fu, hou po, mu xiang, and yu jin. The focus is on the liver (xiang fu, mu xiang, yu jin), lungs (hou po), heart (yu jin), and triple burner (xiang fu and mu xiang). Swelling of the lymph nodes is associated with a disturbance of the triple burner’s ability to circulate fluids throughout the body.

方中香附、厚朴、木香和郁金理气。香附、木香、郁金作用于肝，厚朴作用于肺，郁金作用于心。香附与木香还作用于三焦，淋巴结肿大与三焦在全身通调水道功能失调有关。

Blood-invigorating ingredients include dang gui, hong hua, si gua lou, niu xi, yu jin, and chi shao. These herbs all treat the liver. Hong ahua is light, ascending, and affects the upper burner. Niu xi and yu jin are descending, very important in the treatment of stagnation in the upper burner. Si gua lou opens channels and collaterals and is especially indicated for stagnation in the breasts.

方中的活血药皆作用于肝脏，其中包括当归、红花、丝瓜络、牛膝、郁金和赤芍。红花轻而上浮以调理上焦；牛膝和郁金主降，在疏通上焦阻滞中尤为重要；丝瓜络通经活络，对乳房阻滞有特效。

Dang gui and bai shao tonify blood. It is essential to include blood tonics along with blood-moving herbs in order not to damage the blood.

此方在活血的同时配合了补血养血的当归和白芍，以避免破血。

 月经延迟  

宫寒导致的月经延迟方

Hamilton Rotte：Excess cold easily lodges in the uterus from exposure to cold or ingesting cold foods, especially during menses when the uterus is open. This causes pain and delayed menses because of the effect that cold has in slowing down circulation. The excess cold causes stagnation of qi and blood. This formula removes cold from the uterus and moves qi and blood in the uterus.

Hamilton Rotte：暴露在寒冷环境下或者进食生冷，尤其是月经期间宫口敞开时，子宫很容易受到寒邪侵袭。寒邪会使子宫的血液循环减慢，导致疼痛和月经推迟，同时寒邪还会导致气血瘀滞。本方驱除宫寒，同时疏通局部气血。

The herbs that expel cold from the uterus include gan jiang (Dr. Shen especially liked ginger products for menstrual problems), ai ye, and rou gui. Herbs that move blood include dang gui, dan shen, huai niu xi, and rou gui. Huai niu xi exerts a particularly descending effect, especially for unblocking menstruation. Dang gui may also be included to offset the drying effects of the warming ingredients. Qi regulators include xiang fu and mu xiang, both targeting the liver channel and descending qi.

方中干姜（对月经问题沈医生尤其喜欢用姜）、艾叶和肉桂用以驱除宫寒。当归、丹参、怀牛膝和肉桂活血。引血下行的怀牛膝还可用以通经。当归在此还可以佐制方中热药的燥性。理气药香附和木香，皆作用于肝经以行气降气。

Delayed menses is also commonly caused by deficiency of kidney yang essence and liver blood. In such a case a tonic formula would be indicated.

月经延迟的常见原因还有肾阳虚、肾精虚和肝血虚，治疗上则需使用一些补益类的方剂。