升阳益胃汤治疗绝经前后诸证医案举隅

Shengyang Yiwei Decoction in Treating Perimenopausal Syndromes: A Case Series

摘要: 绝经前后诸证为更年期女性常见病症，临床常表现为潮热面赤、烘热汗出、心烦易怒，同时存在失眠健忘、神疲体倦、头晕耳鸣、五心烦热等症状。临床多从肾虚辨证论治，极易忽略脾胃气虚，气机失调，阴火内炽的发病机理。本文列举临床病案，介绍马莉教授结合李东垣升阳健脾学术理念，阐述围绝经期综合征运用升阳益胃汤加减辨证施治，益气升阳、健脾化湿、清泄阴火、调和冲任，此法标本兼顾，疗效显著。

Abstract: Perimenopausal syndromes are common in menopausal women, with clinical manifestations including hot flushes, facial flushing, sweating, irritability, insomnia, amnesia, fatigue, dizziness, tinnitus, and feverish sensation in the palms, soles, and chest. Clinical treatment often focuses on kidney deficiency pattern differentiation, while the pathogenesis of spleen-stomach qi deficiency, qi imbalance, and internal blazing of yin fire is easily overlooked. This paper presents clinical cases and introduces Professor Ma Li’s academic approach of raising yang and invigorating the spleen. It elaborates on the treatment of perimenopausal syndrome using modified Shengyang Yiwei Decoction based on syndrome differentiation, aiming to tonify qi and raise yang, invigorate the spleen and eliminate dampness, clear yin fire, and regulate the Chong and Ren meridians. This method addresses both the symptoms and the root cause, achieving remarkable therapeutic effects.