从瘀论治围绝经期汗证

Treating Menopausal Sweating from the Perspective of Blood Stasis

摘要: 围绝经期女性多有烘热、汗出、失眠、月经不规则等症状，为妇科常见疾病，此阶段女性常见有汗出异常的问题。血瘀型围绝经期汗证还会伴有舌质紫暗、脉涩等血瘀征象。本文从血瘀的角度分析，并根据血汗同源，津血同源，以及与五脏、经络、气血等影响血行的方面进行阐述。女性进入围绝经期，先天肾气渐衰、天癸渐竭，五脏功能整体失调，导致气血生化乏源。气血为人体津液输布与阴阳调和之本，气虚则无力推动血行，阴虚则脉络失于濡养，进一步加重血行迟缓。五脏失职，气血失和，形成血瘀，瘀血内停阻滞周身经络，使气血津液循行通路闭塞，营卫之气失和，腠理开阖失司，卫外不固进而津液外泄为汗。本病以五脏亏虚为本，气血失调为中介，经络瘀阻为通路，血瘀贯穿病情始终。临床调理应注重标本兼顾，五脏功能正常，经络舒达通畅，气血充盈调达，血汗可正常运行。为临床使用活血化瘀药治疗因瘀导致的围绝经期汗证提供有效思路。

Abstract: Perimenopausal women often experience symptoms such as hot flashes, sweating, insomnia, and irregular menstruation, which are common gynecological disorders. Abnormal sweating is a frequent issue during this period. Women with blood stasis type perimenopausal sweating also present with signs of blood stasis such as a dark purple tongue and a sluggish pulse. This article analyzes from the perspective of blood stasis and elaborates based on the principles of blood and sweat sharing the same origin, body fluids and blood sharing the same origin, as well as the aspects that affect blood circulation such as the five internal organs, meridians, and qi and blood. When women enter the perimenopausal period, their innate kidney qi gradually declines, and the essence of the kidney gradually depletes, leading to overall dysfunction of the five internal organs and a lack of sources for the generation of qi and blood. Qi and blood are the basis for the distribution of body fluids and the balance of yin and yang in the body. Qi deficiency results in an inability to promote blood circulation, while yin deficiency leads to insufficient nourishment of the meridians, further exacerbating the sluggishness of blood circulation. Dysfunction of the five internal organs and disharmony of qi and blood result in blood stasis. The accumulation of stasis blocks the meridians throughout the body, causing the pathways for the circulation of qi, blood, and body fluids to be blocked, disrupting the harmony of the protective and nutritive qi, and causing the pores to lose their ability to open and close properly, leading to the leakage of body fluids as sweat. This disease is characterized by deficiency of the five internal organs as the root cause, disharmony of qi and blood as the intermediary, and obstruction of the meridians as the pathway, with blood stasis running through the entire course of the disease. Clinical treatment should focus on addressing both the symptoms and the root cause, ensuring normal function of the five internal organs, unobstructed meridians, and abundant and harmonious qi and blood, so that blood and sweat can circulate normally. This provides an effective approach for the clinical use of blood-activating and stasis-resolving drugs to treat perimenopausal sweating caused by stasis.