英文课件5带下病-完成

1、带下病【概说】带下，是指妇女从阴道中流出稠粘液体，如涕如睡，绵绵不断的一种病证。因带下的颜色不同，有白带、黄带、赤带及赤白带、五色带等名称。根据临床观察，以白带和黄带最为常见。Morbid LeukorrheaMorbid leukorrhea is a disease symptomized by persistent excessive mucous vaginal discharge.Based on different colors, the condition is classified by its colors into white, yellow, red, red-white

2、 and multicolored leukorrhea, among which white and yellow leukorrhea are commonly seen in clinic.【病因病机】（一）脾虚湿盛-饮食不节，劳倦过度，损伤脾气，运化失常，则水谷之精微不能上输，反聚而为湿，流于下焦，而为带下。（二）肾气亏虚-素体肾气不足，下元亏损，或孕育过多，伤及肾气，而使带脉失约，任脉不固，遂成带下。（三）湿热下注-脾虚湿盛，郁而化热，或肝气郁结，郁久化热，热与湿搏，湿热下注，而成带下。Etiology and Pathogenesis1. deficiency in the spl

3、een: improper diet and overstrain hinder the spleen qi from transforming and transporting nutrient particles, which accumulate in the lower energizer and turn to damp and finally leukorrhea appears.2. deficiency in the kidney: constant deficiency of kidney qi, grand multipara, dysfunctions of the Be

4、lt and Conception vessels lead to leukorrhea. 3. damp heat: the presence of excessive damp due to deficiency in the spleen, changes into heat. Prolonged stagnated liver qi may transform into heat and amalgamate with the damp. The downward infusion of damp heat turns out to be leukorrhea.【辨证】（一）脾虚证主证

5、：带下量多，色白或淡黄，面色萎黄，精神疲倦，舌腻，脉缓弱。质粘稠，无臭，如涕如唾，连绵纳少便溏，下肢浮肿，舌淡苔白。 征候分析：脾虚失运、水湿下陷则为带下；脾虚中阳不振，则纳少便溏，下肢浮肿，面色不荣而呈咣白或萎黄，四肢不温，精神疲乏；舌淡苔白腻，脉缓，均为脾虚之征。 Differentiation 1. deficiency in the spleenMain manifestations: profuse thick, white or light yellow vaginal discharge without smell, pale or sallow complexion, lass

6、itude, poor appetite and loose stools, edema in the lower limbs, pale tongue with white sticky coating, slow weak pulse.Analysis: on account of deficiency in the spleen, the downward infusion of water and damp form leukorrhea. With deficiency in the spleen, the sapped yang qi in the middle energizer

7、 gives rise to poor appetite, loose stools and edema in the lower limbs, lusterless and pale or sallow complexion, cold extremities and lassitude. Pale tongue with white sticky coating and slow pulse are signs of deficiency in the spleen. 【辨证】（二）肾虚证主证：带下量多，质靖而稀，淋漓不断，腰如折，小腹发冷，小便频数清长，大便溏薄，舌淡苔薄白，脉沉。 证候

8、分析：肾阳不足，带脉失约，任脉不固，带下清冷，淋漓不断；命门火衰，不能下暖膀胱，上温脾土，故小便清长大便溏薄；腰为肾之府，肾虚失荣，则腰痰如折；肾阳虚衰，不能温暖胞宫，则小腹有冷感舌淡；苔薄白，脉沉，为肾阳不足之征。 Differentiation2. deficiency in the kidneyMain manifestations: profuse and continuous discharge of thin and transparent whites, severe soreness of the lower back, cold sensation in the lower

9、abdomen, frequent and excessive urine, loose stools, pale tongue with thin coating, and deep pulse.Analysis: deficiency kidney yang causes Belt and Conception vessels to slacken its restriction of essence, resulting in the continuous vaginal discharge. The dimmed fire in the Mingmen is too weak to w

10、arm up the bladder and spleen and brings on frequent urine in large volume and loose stools. Sore lower back is due to a weakened kidney that is situated here. When the weak kidney yang fails to keep the uterus warm, there appears a cold sensation in the lower abdomen. Pale tongue with thin white co

11、ating and deep pulse are signs of deficiency of the kidney yang. 【辨证】（三）湿热证 主证：带下色黄量多，质粘稠，其气秽臭，阴中瘙痒，大便于结，小便短赤，脉象濡数；舌苔黄腻；或带下色黄兼赤，口蓑咽干，烦热，心悸失眠，情绪急躁易怒，苔黄，脉象弦数。 证候分析：湿热下注，带脉失约而致带下；湿邪挟热，故带下色黄稠粘且臭，阴部搔痒；湿热内蕴，则大便干结，小便短赤；脉濡数，苔黄腻，均为湿热之征。肝郁化热，则急躁易怒，口苦咽干；热扰营血，血不循经，随带而下，故带下赤色；热扰心神，故烦热，心悸、失眠；脉弦数，苔黄，为肝经郁热之象。Differ

12、entiation3. Damp heatMain manifestations: sticky, viscous and stinking yellow leukorrhea in large quantity, itching in the vulva, dry stool, scanty and yellow urine, soft and rapid pulse, sticky yellow coating, or leukorrhea in reddish yellow color, bitter taste in the mouth, dry throat, irritabilit

13、y with feverish sensation, palpitation, insomnia, yellow coating, string-taut and rapid pulse.Analysis: The downgoing damp and heat hurt the Conception and Belt vessels. The pathogenic heat amalgamated with damp gives rise to the yellow color, visicosity and stench of the whites and the itching in t

14、he vulva. The internal accumulation of the pathogenic damp is the cause of dry stools and scanty yellow urine. Soft rapid pulse and yellow sticky tongue coating are signs of damp and heat. There appear irritability, bitter taste in the mouth and dry throat, when the pathogenic heat is transformed fr

15、om the stagnated liver qi. Heat in the blood causes reddish leukorrhea. When heat disturbs the mind there present irritability, feverish sensation, palpitation and insomnia. The string-taut rapid pulse and yellow coating imply accumulated heat in the Liver Meridian. 【治疗】（一）脾虚证 治法：取任脉、足太阴、阳明经穴为主。针刺用补

16、法，并用灸法。以健脾利湿，调任固带。 处方：带脉(胆26) 气海（任6） 白环俞(膀胱30) 阴陵泉（脾9） 足三里(胃36) 方义：阴陵泉、足三里-健脾利湿，为主穴。带脉-固摄带脉，主治带下；气海-理气化湿，调任固带； 白环俞-邻近取穴，功于止带； Treatment 1. deficiency in the spleenMethod: main points are selected from the Conception Vessel, Foot-Taiyin and Yangming Meridians. Acupuncture with the reinforcing method

17、and moxibustion is used to build up the spleen and remove damp, regulate Conception Vessel and stabilize Belt Vessel.Prescription: Daimai (GB 26), Qihai (CV 6), Baihuanshu (BL 30), Yinlingquan (SP 9), Zusanli (ST 36).Explanation: Daimai (GB 26), an intersecting point of the Belt Vessel and Foot-Shao

18、yang Meridians stabilizes the Belt Vessel and is a cure for leukorrhagia. Qihai (CV 6) regulates qi, resolves damp, adjusts the Conception Vessel and stabilizes the Belt Vessel. Baihuanshu (BL 30) is selected as an adjacent point to check leukorrhagia. Yinlingquan (SP 9) and Zusanli (ST 36), major p

19、oints in this prescription, are paired to build up the spleen and remove damp. 【治疗】（二）肾虚证 治法：取任脉、足少阴经穴为主。针刺用补法，并用灸法。以助阳补肾，固摄任带。 处方：肾俞(膀胱23) 关元（任4） 大赫(肾12) 带脉(胆26) 复溜(肾7)。 方义：肾俞、关元、大赫、复溜-助阳补肾，使肾能闭藏，任固带约，则带下可止；带脉穴有止带的作用。 Treatment2. deficiency in the kidneyMethod: select points mainly from the Concept

20、ion Vessel and Foot-Shaoyin Meridian. Acupuncture with the reinforcing method and moxibustion are used to promote yang qi, tonify the kidney and stabilize the Conception and Belt vessels.Prescription: Shenshu (BL 23), Guanyuan (CV 4), Dahe (KI 12), Daimai (GB 26), Fuliu (KI 7).Explanation: Shenshu (

21、BL 23), Guanyuan (CV 4), Dahe (KI 12), Daimai (GB 26), are applied together to promote yang qi and tonify the kidney so as to restore its strong function, and stabilize the Conception and Belt vessels, and finally check leukorrhagia. Daimai (GB 26) is selected aiming at leukorrhagia. 【治疗】（三）湿热证 治法：取

22、任脉、足太阴经穴为主。针刺宜用泻法，以清热利湿，调任固带。 处方：中极（任3） 次髎(膀胱32) 三阴交（脾6） 太冲(肝3) 随证配穴；阴部搔痒：蠡沟（肝5） 带下色赤：血海(脾10) 热重者：曲池（大肠11） 方义：中极-泻之可清利下焦湿热；次髎可清热利湿，功于止带；三阴交-健脾利湿；诸穴相配可达清热利湿，调任固带的作用。蠡沟-清泻肝经湿热，治疗阴部搔痒；血海-清泻血热，治疗带下色赤；曲池-清热。Treatment3. damp heatMethod: mainly select points from the Conception Vessel and Foot-Taiyin Meridian. Acupuncture with the reducing method is employed to clear heat, remove damp, adjust the Conception Vessel and stabilize the Belt Vessel.Prescription: Zhongji (CV 3), Ciliao (BL 32), S