从"气-血-冲任"论治围绝经期崩漏OA

Based on the theoretical framework of"Qi-blood-chong and ren meridians",this paper explores the patho-genesis and stage-based treatment strategies for perimenopausal metrorrhagia,aiming to provide theoretical basis and prac-tical guidance for clinical practice.Perimenopausal metrorrhagia is a common endocrine disorder in gynecology.Its core pathogenesis lies in the gradual decline of kidney-Qi,leading to deficiency of both Qi and blood,as well as imbalance of the Cchong and ren meridians,clinically manifested as untimely uterine bleeding.This study proposes a three-stage treatment approach:in the acute profuse bleeding stage,the priority is to"supplement Qi to prevent collapse,and stop bleeding by blocking the flow",for which modified Siwu Decoction(Siwu Decoction plus Shengdihuang and Digupi)is used to stop bleed-ing and nourish blood.In the continuous spotting stage,the focus is on"invigorating the spleen and supplementing Qi,clear-ing the source and restoring normal function",with Guipi Decoction applied to harmonize Qi and blood.In the recuperation stage,the emphasis is on"tonifying the kidney and replenishing essence,regulating the chong and ren meridians",using Erxian Decoction combined with Liuwei Dihuang Pill to balance Yin and Yang.In modified Siwu Decoction,Shengdihuang and Digupi exert hemostatic effects by regulating the coagulation-fibrinolysis system and improving the endometrial micro-environment.Guipi Decoction effectively regulates the hypothalamic-pituitary-ovarian axis function.Meanwhile,Erxian De-coction combined with Liuwei Dihuang Pill modulates estrogen levels,thereby regulating the chong and ren meridians.This stage-based treatment embodies the principle of"regulating Qi before treating bleeding,and tonifying the kidney to stabilize the chong meridian",offering diagnosis and treatment ideas that integrate traditional Chinese medicine theory with modern medical evidence.