洪建三医师基于辨证论治女性更年期综合征的临床经验分析

Clinical Experience Analysis of Treating Female Climacteric Syndrome Based on Syndrome Differentiation by Dr. Hong Jiansan

摘要: 女性更年期综合征，中医多归属于“绝经前后诸证”“脏躁”等范畴，是女性生命周期中的重要生理与病理转折阶段。建德市中医院副院长洪建三医师，凭借多年临床实践，认为本病的核心病机在于肾气渐衰、天癸将竭，导致冲任二脉虚损，脏腑阴阳气血失调。洪医师根据临床表现，将本病主要分为肾阳亏虚、肾阴亏虚、肝郁气滞三型进行辨证论治。他强调以调补肾气为本，兼顾疏肝健脾，根据不同证型灵活运用温阳、滋阴、疏肝等治法，并常以经典方剂如二仙汤、麦斛地黄汤、柴胡疏肝散等为基础化裁，取得了显著的临床疗效。本文旨在系统总结洪建三医师的诊疗思路与用药经验，以期为临床治疗本病提供有益参考。

Abstract: Female climacteric syndrome, often classified in traditional Chinese medicine as “menopausal syndrome” and “visceral agitation”, represents a significant physiological and pathological turning point in a woman’s life cycle. Dr. Hong Jiansan, Vice President of Jiande Traditional Chinese Medicine Hospital, believes that the core pathogenesis of this disease lies in the gradual decline of kidney qi and the exhaustion of menstrual blood, leading to the deficiency of the Chong and Ren meridians and the imbalance of yin and yang, qi and blood in the internal organs. Based on clinical manifestations, Dr. Hong divides this disease into three main types: kidney yang deficiency, kidney yin deficiency, and liver qi stagnation for dialectical treatment. He emphasizes the importance of regulating and nourishing kidney qi, while also considering the soothing of the liver and strengthening of the spleen. He flexibly applies treatments such as warming yang, nourishing yin, and soothing the liver according to different syndrome types, often using classic formulas such as Er Xian Tang, Mai Hu Di Huang Tang, and Chai Hu Shu Gan San as a basis for modification, achieving significant clinical efficacy. This article aims to systematically summarize Dr. Hong Jiansan’s diagnostic and treatment ideas and medication experience, providing a useful reference for the clinical treatment of this disease.