從「二陽之病發心脾，有不得隱曲，女子不月」分析張景岳之調經種子法

張景岳詮釋「二陽之病發心脾，有不得隱曲，女子不月」，並貫穿於調經種子思想，「二陽心脾」供應衝脈月經，進而為命門精血之源，情志傷心、飲食勞倦傷脾，心脾病延及胃，依序損傷衝脈、腎氣、命門真陰，最終引起經亂、經閉、不孕。且對此提出治則與方藥，認同調經當理心脾。治應依序，病未甚宜解初病；病已劇必計所歸，培補脾腎。以「血盈」治經閉。思鬱過度致經亂者治心脾或心脾腎兼治。種子需調補命門、顧惜陽氣，調經種子均提出治療方藥，然養心健脾胃亦是滋養命門精血，強調紓解情志且情志飲食及起居應優先於調治經。

關鍵字

張景岳；二陽之病；調經；不孕

並列摘要

Zhang Jing-Yue interpreted the sentence ＂The diseases of the two yang originate from the heart and spleen, resulting in impotence and amenorrhea.＂ and run this concept through his thoughts on regulating the menses and treating infertility. The two yang and the heart and spleen supply the Chong Mai and menstruation and therefore serve as the source of life gate essence-blood. Improper emotions damage the heart and, improper diet and fatigue damage the spleen, and further impair the stomach, Chong Mai, kidney qi, life gate and true yin sequentially, finally resulting in irregular menstruation, amenorrhea, and infertility. To solve these problems, Zhang Jing-yue recommended many principles and formulas. Menstruation should be regulated by managing the heart and spleen, and a sequence of treating irregular menstruation was proposed: initially dealing with the cause, while the disease progressing, managing the spleen and kidney. Replenishing blood should be adopted to treat amenorrhea. The irregular menstruation caused by overthinking should be treated by managing the heart and spleen or kidney added. The infertility is treated by nourishing life-gate and preserving the yang qi. Besides, supplementing the heart, spleen and stomach can also nourish life gate and essence-blood. Zhang Jing-yue highly concerned emotions, diet, and daily life, emphasizing releasing emotions and managing the emotions, diet, and daily life has a high priority over regulating the menses.