佀雪平教授运用宣郁通经汤治疗痛经的经验举隅

Professor Xueping Si’s Experience in Treating Dysmenorrhea with Xuanyu Tongjing Decoction: A Case Study

摘要: 痛经为女性常见病，病机多因冲任失调、气血不和，其中以肝郁化火、气滞血瘀型最为多见。佀雪平教授在临床中强调“调肝为本、补肾为要”，主张辨证施治、标本兼顾。宣郁通经汤源于《傅青主女科》，方中疏肝解郁、清热泻火、活血化瘀、调经止痛并重，历代医家多用于治疗肝郁化火、气滞血瘀型痛经。临床医案与随访结果亦证实，宣郁通经汤对原发性痛经及子宫内膜异位症、子宫腺肌症等继发性痛经疗效显著。本文结合现代药理学研究，论述宣郁通经汤的组成特点与作用机制，并通过1则典型医案举隅，展现佀雪平教授辨证施治、灵活运用经典名方治疗痛经的经验，为中医治疗本病提供理论参考与实践依据。

Abstract: Dysmenorrhea is a common condition in women, with pathogenesis often attributed to irregularities in the Chong and Ren meridians as well as disharmony between qi and blood. Among the various patterns, liver qi stagnation transforming into fire combined with qi stagnation and blood stasis is the most frequently observed. Professor Xueping Si emphasizes in clinical practice “taking the liver as the root in treatment and the kidney as the core,” advocating for pattern differentiation and simultaneous consideration of both root cause and symptoms. Xuanyu Tongjing Decoction, originating from Fu Qingzhu’s Treatise on Gynecology, integrates the functions of soothing the liver and relieving depression, clearing heat and purging fire, activating blood and resolving stasis, and regulating menstruation to alleviate pain. It has been widely used by physicians throughout history to treat dysmenorrhea of the pattern of liver qi stagnation transforming into fire combined with qi stagnation and blood stasis. Clinical case studies and follow-up results have also confirmed that Xuanyu Tongjing Decoction demonstrates significant efficacy in treating primary dysmenorrhea as well as secondary dysmenorrhea caused by conditions such as endometriosis and adenomyosis. This article, supported by modern pharmacological research, discusses the composition characteristics and mechanisms of Xuanyu Tongjing Decoction. By presenting one representative case study, it demonstrates Professor Xueping Si’s experience in applying pattern differentiation and flexibly utilizing classic formulas to treat dysmenorrhea, providing theoretical references and practical evidence for traditional Chinese medicine in treating this condition.