马融从肾论治月经性癫痫验案

李孟权1，张喜莲2，指导：马融 2

1.天津中医药大学，天津 301617；2.天津中医药大学第一附属医院，天津 300381摘要：月经性癫痫与月经周期相关，其迁延性和反复性严重影响女性癫痫患儿的生活和学习。马融教授根据月经性癫痫与月经周期的关系及儿童“肾常虚”生理特点，通过“肾-骨-髓-脑”理论，辨病与辨证相结合，提出从肾论治月经性癫痫的学术思想，以豁痰熄风、补肾调周法取得良好临床疗效。关键词：月经性癫痫；补肾调周；从肾论治；验案

中图分类号：R277.721 文献标识码：A 文章编号：1005-5304(2020)03-0124-02

DOI：10.3969/j.issn.1005-5304.201811400 开放科学（资源服务）标识码（OSID）：

Medical Cases of Ma Rong of Treating Catamenial Epilepsy from Kidney

LI Mengquan1, ZHANG Xilian2, Instructor: MA Rong2

1. Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;

2. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China Abstract: Catamenial epilepsy is associated with the menstrual cycle, and its prolonged and repetitive nature seriously affects the life and learning of female children with epilepsy. Referring to the relationship between catamenial epilepsy and menstrual cycle and the physiological characteristics of children's “kidney deficiency”, and TCM theory of “kidney-bone-medullary-brain” with the combination of disease differentiation and syndrome differentiation, Professor Ma Rong put forward academic thoughts of treating catamenial epilepsy from the kidney, and achieved good clinical results through eliminating phlegm for calming endogenous wind and tonifying kidney. Keywords: catamenial epilepsy; tonify kidney and regulate menses; treating from the kidney; medical cases

随着研究的深入，业界逐渐认识到癫痫与女性患儿的关系，其中包括癫痫发作与月经周期之间关系、抗癫痫药物代谢动力学与性激素之间的相互影响等。临床上，不少女性癫痫患儿通常在月经周期中的某个时间点发作频率较平时增加2倍以上。目前，学术界对月经性癫痫尚无统一定义，一般将月经某个时期癫痫发作频率增加或程度恶化的癫痫称作月经性癫痫。国外有学者将月经性癫痫分为月经期月经性癫痫（C1

基金项目：国家自然科学基金（81574018）

通讯作者：张喜莲，E-mail：zxl2072@126.com

型）、排卵期月经性癫痫（C2 型）、黄体功能不全型

[1]

月经性癫痫（C3型） 。其治疗主要包括抗癫痫药物、性激素及乙酰唑胺等，但可能引起月经周期紊乱、不孕等，而抗癫痫药物联合性激素治疗会导致抑郁、乳

腺增生、阴道出血、体质量增加等[2]。中医治疗月经性癫痫有一定优势。天津中医药大学第一附属医院儿科主任医师马融教授是第三、五批全国名老中医药专家学术经验继承工作指导老师，长期致力于小儿癫痫、抽动障碍、多动障碍等脑系疾病研究，临床诊治月经性癫痫有丰富经验。兹结合案例将马教授相关经验介绍如下。