黄新艳教授治疗尿道综合征伴焦虑的临证经验总结OA

Urethral syndrome(US)is a functional disorder characterized by frequent,urgent,and painful lower urinary tract stimulation symptoms,with no obvious organic abnormalities detected in routine examinations of the urinary system.It is more common in middle-aged and elderly women,with a prolonged course of illness and easy recurrence,making treatment quite challenging.Clinical observations have found that patients with US are generally accompanied by varying degrees of anxiety,tension,and other emotional disorders,which interact and exacerbate each other,forming a complex pathological state of physical and mental illness.Modern medicine lacks a unified and effective treatment plan for this,with unstable efficacy and easy recurrence.It is urgent to explore new diagnostic and treatment ideas from a holistic medical perspective of traditional Chinese medicine(TCM).TCM has traditionally focused on the dialectical treatment of kidney deficiency,damp heat,and Qi(气)stagnation.Although it can improve symptoms to a certain extent,the therapeutic effect is often not ideal for patients with significant emotional abnormalities.This article systematically summarizes the diagnosis and treatment experience of Professor HUANG Xinyan,a renowned TCM practitioner,and elaborates on her innovative theory of"Three-Axis Dysregulation"pathogenesis.This theory holds that the core pathogenesis of this disease lies in the dysfunction of the"Shaoyang(少阳)Pivot Axis","Mind and Emotion Axis",and"Kidney-essence Fixation Axis".Internal injury due to emotional distress initiates the pathological process,which impairs the normal pivot function of the Shaoyang and leads to disordered Qi transformation of the Sanjiao(三焦).Subsequently,stagnated fire disturbs the upper Jiao,unsettles the heart spirit,and disrupts the opening and closing of the urinary bladder.Prolonged illness damages the kidney root,resulting in deficiency-cold of the lower origin and failure of the body to consolidate and control of urinary function.Based on this understanding,Professor HUANG Xinyan advocates the method of"regulating the pivot to tranquilize the mind and warming and consolidating the lower origin".She uses the classic prescription Chaihu Jia Longgu Muli Tang(柴胡加龙骨牡蛎汤)to regulate Shaoyang and tranquilize the mind to treat the upper and middle Jiao symptoms;and combines it with the Gongdi Wan(巩堤丸)to warm the kidney,solidify the essence and tonify the lower origin to addressing lower Jiao and root causes.The two prescriptions are used together to regulate the three axes and address both the branch and root causes.Clinical practice has proved that this method can significantly improve the cardinal symptoms such as frequency,urgency and pain of urination and can also alleviate the emotional distress such as anxiety and tension in the patients.It provides a new idea for the syndrome differentiation and treatment in US.