痛經的中醫藥治療

| 06-08-2017

《痛經的中醫藥治療》


下葵涌中醫中心  鄧舜元註冊中醫師

           近年來婦女們在社會上的地位不斷提高,擔當了很多重要的角色,然而當中不少人卻受到每月經痛之苦,部份人因而情緒低落,嚴重影響她們的生活,導致工作及學習表現欠佳。很多婦女們經痛時未有認真處理,隨便只吃些止痛藥就以為已解決了問題,其實痛經是不可忽視的,應儘快尋找治療。近年臨床上,利用中醫藥治療痛經,療效是十分顯著的,且副作用較少。

何謂痛經

           痛經是指女性在經期或其前後,出現小腹疼痛,甚至痛及腰骶部,嚴重者可伴有面色蒼白、手足厥冷、惡心嘔吐、甚至暈厥等症狀。痛經屬中醫學中「經行腹痛」範疇。此病名乃張景岳《景岳全書‧婦人規》首次提出。

痛經種類

           現今臨床上將痛經分為原發性和繼發性兩種,其中約90%的痛經均為原發性痛經。原發性痛經是指生殖器官無器質性病變,常發生在初潮後不久,多見於未孕婦女。繼發性痛經是指由於生殖器官有器質性病變如盆腔炎症、子宮肌瘤病、子宮發育不良、子宮內膜異位症等等所引起的痛症,常發生於育齡期女性。建議此類病人應定期做婦科檢查,及早找出病因以作出治療。

原發性痛經之成因

           在經期或經期前後,血海由滿盈而瀉溢,胞宮內氣血由氣盛血旺至經後暫虛,變化急劇。此時,若致病因素如起居不慎、情感所傷或感受外邪等乘虛而作,使胞宮內氣血運行受阻,以致不通則痛,或沖任胞宮失於濡養而不榮而痛。

圖片來源:The Meta Picture

辨証施治

           中醫辨証是一個非常重要關鍵的部份,因為只有正確的辨証才能作出正確及有效的治療。故此,醫師們需要在問診時了解患者的疼痛性質、部位、程度、時間,再結合月經的期、色、量、質與兼証,舌脈等資料去判明寒熱虛實。

根據疼痛性質辨寒熱虛實
一般來說疼痛時若出現掣痛、絞痛、刺痛、拒按者屬實証;隱痛喜按者屬虛証。下腹冷痛,得溫痛減者多為寒証;若灼痛且得熱痛增者多為熱証。若脹甚於痛,矢氣出則舒屬氣滯。若痛甚於脹且經行血塊排出,腹痛減輕者,屬血瘀。
根據痛經發生的時間辨虛實
若疼痛發生於經前或經後首一至二天者多為實証;若疼痛發生在經後或月經將乾淨時多為虛証。
根據痛經的部位辨病位
若疼痛痛在兩側少腹者病多在肝;若疼痛痛在小腹引腰骶者病多在腎。

治療原則

         至於痛經的治療原則則以調理沖任氣血為主,經行疼痛發作時,重點在於調血止痛以治標;在非經期時則辨証求因,調整臟腑功能,或調肝,或益腎,或扶脾等以治本,故此痛經的治療時間,一般建議最少要有連續三個月經周期才能達到根治的目標。至於其他因器質性病變如盆腔炎症、子宮發育不良、畸形等所致的痛經,應當根據不同情況選擇治療方案。

針灸可處理痛經急症

         若患者經痛難忍時,可考慮採用針灸緩解疼痛。由於針灸對機體有一種良性刺激,能迅速改善氣血循環,達致通則不痛之效,可收明顯的止痛效果。常用的穴位有合谷、三陰交等。合谷穴乃手陽明經原穴,三陰交乃是足三陰經的交會穴,兩穴相配能起行氣調血止痛之功效。一般治療五至三十分鐘內,疼痛可得到緩解。除了針灸外,若結合穴位敷貼、推拿等,亦可增加止痛效果。

預防之道

         建議婦女們在月事期間,應時刻保持清潔及避免受寒,不應游泳,冒雨涉水或冷水洗澡等,以免受外邪入侵,使氣血凝滯,以致不通則痛而發生痛經。另在飲食上要少吃寒涼生冷之物,亦要起居有節,堅持做運動,保持心情輕鬆開朗,定期作婦科檢查,這樣便可及早找出痛經原因,從而可得到適當的治療。

益母草煮雞蛋

  • 益母草 15-30 克
  • 雞蛋 2個
  • 紅棗 (去核) 3粒
  • 少許紅糖
做法:將益母草、雞蛋與紅棗放入水中同煮,雞蛋熟時可剥去蛋殼,加入紅糖。適合所有痛經患者,具有活血袪瘀,通經止痛之功效。

文章內容僅供參考,不能作為診斷及治療的醫據。
如需獲得健康方面的幫助,請諮詢中醫師及醫護人員的專業意見。

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