大全云∶肾主腰足,因劳伤损动其经,虚则风冷乘之,故腰痛,冷气乘虚入腹则腹痛,
故令腰腹相引而痛,其痛不止,多动胎气,妇人肾以系胞,妊娠而腰痛甚者,则胞堕也。
薛氏曰∶前证若外邪所伤,用独活寄生汤;劳伤元气,用八珍汤加杜仲、砂仁、阿胶、
艾;脾肾不足,以前药加白术、补骨脂;气血郁滞,用紫苏饮加桔梗、枳壳;肝火所动,用小柴
胡汤加白术、枳壳、山栀;肝脾郁结,用归脾汤加柴胡、枳壳。
一妊妇颈项强直,腰背作痛,此膀胱经风邪所致,用拔萃羌活汤,一剂而愈,又用独活
寄生汤,及八珍汤,以祛邪固本而痊。
汪石山治一妇怀妊八月,尝病腰痛,不能转侧,大便燥结,医用人参等补剂,痛益加,用
硝、黄通利之药,燥结虽行,而痛如故。汪诊之,脉稍洪近快。曰∶血热、血滞也。宜用四物
加木香、乳、没、黄柏、火麻仁煎服,四五帖,痛稍减,燥结润,复加发热面赤,或时恶寒,仍用
前方去乳香、没药,加柴胡、黄芩,服二帖,而寒热除,又背心觉寒,腹痛复作,汪曰∶血已利
矣,可于前方加人参一钱,服之而安。
通气散 治妊娠腰痛,状不可忍,此药神效。
破故纸(瓦上炒香为末)
上先嚼胡桃肉一个烂,后以温酒调下故纸末三钱,空心服。
五加皮散 治妊娠腰痛不可忍,或胯痛,先服此散。
杜仲(四两,炒) 五加皮 阿胶(炙,另入) 防风 狗脊 川芎 白芍药 细辛 萆 (各三
两) 杏仁(八十个,去皮尖,面炒)
上 咀,以水九升煮取二升,去滓下胶,作三服。
五加皮丸 治妊娠腰痛不可忍者,次服此丸。
续断(炒) 杜仲(各二两半) 川芎 独活(各三两) 五加皮 狗脊 萆 芍药 诃子肉(各
四两)(此与前方不甚相远,而以杏仁易诃子,通塞不同者,此宜详之)
上为细末,炼蜜丸,如桐子大,每服四十丸,空心酒下,日三服。
疗触动胎以致腰痛背痛
杜仲 五加皮 当归 芍药 川芎 萆 (各等分)
上为末,每用三钱,空心酒调下。
疗妊娠气壅攻腰痛不可忍兼治腹痛
当归(三两) 阿胶 甘草(各二两) 葱白(切二升)
上细锉,以水七升煮取三升,去滓,分温三服。
短剧苎根汤 疗损动胎,腰腹痛,去血,胎动向下。
生地黄 苎根(各二两) 当归 芍药 阿胶 甘草(各一两)
上细切,以水六升煮取二升,去滓,纳胶煎烊,分温三服,忌海藻、芜荑。
大地黄丸 治产前后腰腹疼,一切血疼。兼治血气虚,四肢不举,骨髓热疼。(此方不特
产前后妙,即平日血虚内热者,亦宜)
熟地黄(二两) 乌梅肉 当归(各一两)
上为细末,炼蜜丸,如弹子大,每服一丸,空心白汤嚼下。
紫酒 治妊娠腰痛如折,亦治常人卒腰痛者。
大黑豆二合炒令香熟,酒一大盏煮取七分,去豆,空心顿服。
杂方
治胎动腰痛抢心,或下血,取葱白不拘多少,浓煎汁饮之。
一方用鹿角长六寸,烧令赤,酒中淬,再烧再淬,以角碎为度,取酒饮之,鹿角为末,服
方寸匕。
一方用菖蒲汁酒,一升服之。
一方用艾叶一把,如鸡子大,以酒四升煮取二升,分为二服良。
《大全》说:肾主宰腰部和足部,因劳累损伤导致经络受损,正气虚弱时风冷之邪便会乘虚而入,从而引起腰痛;冷气侵入腹部则导致腹痛,因此出现腰腹相互牵引而痛的症状。如果疼痛不止,容易扰动胎气。妇女的肾脏通过经络系连子宫(胞宫),妊娠期间若腰痛剧烈,说明胞宫下坠(有流产或早产风险)。
薛己认为:上述病症如果是外邪侵袭所致,使用独活寄生汤;若是劳损伤及元气,使用八珍汤加入杜仲、砂仁、阿胶、艾叶;若是脾肾不足,在前方基础上加入白术、补骨脂;若是气血郁滞,使用紫苏饮加入桔梗、枳壳;若是肝火扰动,使用小柴胡汤加入白术、枳壳、山栀;若是肝脾郁结,使用归脾汤加入柴胡、枳壳。
曾有一位孕妇颈部僵硬强直,腰背部疼痛,这是膀胱经受风邪侵袭所致,服用拔萃羌活汤,一剂即愈,随后又服用独活寄生汤及八珍汤,以祛除病邪、巩固根本而痊愈。
汪石山治疗一位怀孕八个月的妇女,曾经患有腰痛,身体不能转动侧身,大便干燥坚硬。医生用人参等补益药剂,疼痛反而加剧;改用硝石、大黄等通利泻下的药物,虽然大便通畅了,但疼痛依旧。汪石山诊察其脉象稍洪大且接近快速。他说:这是血热、血滞导致的。适宜使用四物汤加入木香、乳香、没药、黄柏、火麻仁煎服,服用四五帖后,疼痛稍减,大便变得滋润。之后又出现发热面赤,有时恶寒,仍然用前方去掉乳香、没药,加入柴胡、黄芩,服用两帖后,寒热症状消除。接着感觉背心发冷,腹痛再次发作,汪石山说:血液已经通畅了,可以在前方中加入人参一钱,服用后便安定了。
通气散:治疗妊娠腰痛,痛苦难以忍受,此药神效。
破故纸(在瓦上炒香研为粉末)
先嚼烂一个胡桃肉,然后用温酒调服破故纸末三钱,空腹服用。
五加皮散:治疗妊娠腰痛难以忍受,或者胯部疼痛,先服用此散剂。
杜仲(四两,炒制) 五加皮 阿胶(炙烤,另入) 防风 狗脊 川芎 白芍药 细辛 萆薢(各三两) 杏仁(八十枚,去皮尖,面粉炒制)
将药材切碎,用水九升煮取二升,去渣后加入胶类烊化,分三次服用。
五加皮丸:治疗妊娠腰痛难以忍受的,其次服用此丸剂。
续断(炒制) 杜仲(各二两半) 川芎 独活(各三两) 五加皮 狗脊 萆薢 芍药 诃子肉(各四两)(此方与前方相差不远,只是用诃子替换了杏仁,针对通塞不同的情况,此处需仔细斟酌)
将药材研为细末,炼蜜制成丸剂,如梧桐子大小,每次服用四十丸,空腹用酒送下,每日三次。
治疗因触动胎气导致腰痛背痛:
杜仲 五加皮 当归 芍药 川芎 萆薢(各等分)
将药材研为粉末,每次用三钱,空腹用酒调服。
治疗妊娠气机壅滞攻冲腰部疼痛难以忍受,兼治腹痛:
当归(三两) 阿胶 甘草(各二两) 葱白(切二升量)
将药材细细切碎,用水七升煮取三升,去渣,分三次温服。
短剧苎根汤:治疗损伤触动胎气,腰腹痛,阴道出血,胎动向下。
生地黄 苎根(各二两) 当归 芍药 阿胶 甘草(各一两)
将药材细细切碎,用水六升煮取二升,去渣,加入胶类烊化,分三次温服,忌食海藻、芜荑。
大地黄丸:治疗生产前后腰腹疼痛,一切血瘀疼痛。兼治血气虚弱,四肢无法抬起,骨髓热痛。(此方不仅对产前后有效,即使是平日血虚内热者也适宜)
熟地黄(二两) 乌梅肉 当归(各一两)
将药材研为细末,炼蜜制成丸剂,如弹子大小,每次服用一丸,空腹用白开水嚼服。
紫酒:治疗妊娠腰痛如折断感,也治疗普通人突发腰痛者。
大黑豆二合炒至香熟,用一大盏酒煮取七分,去掉豆粒,空腹一次性服下。
杂方
治疗胎动腰痛冲击心胸,或者下血,取葱白不拘多少,浓煎汁液饮用。
一方用鹿角长六寸,烧至通红,在酒中淬火,再烧再淬,直到鹿角碎裂为止,取酒饮用,鹿角磨成粉末,服用一方寸匕。
一方用菖蒲汁配酒,一升服用。
一方用艾叶一把,如鸡蛋大小,用酒四升煮取二升,分为两次服用,效果良好。
Quan (The Great Compendium) states: The Kidney governs the waist and feet. Due to strain and injury damaging the meridians, when deficiency occurs, wind-cold pathogens take advantage of the weakness, causing lower back pain. When cold qi enters the abdomen due to deficiency, it causes abdominal pain; thus, the waist and abdomen pull each other in pain. If the pain persists, it often disturbs fetal vitality. In women, the Kidney connects to the uterus (Bao Gong). During pregnancy, severe lower back pain indicates that the uterus is descending (risk of miscarriage or premature birth).
Xue Ji stated: For the aforementioned conditions, if caused by external pathogens, use Duhuo Jisheng Tang (Sanguisorba and Sangjisheng Decoction); if caused by labor injuring Yuan Qi (Original Qi), use Bazhen Tang (Eight Treasure Decoction) added with Duzhong (Eucommia Bark), Sharen (Amomum Fruit), Ejiao (Donkey-hide Gelatin), and Aiye (Mugwort Leaf); if there is Spleen and Kidney deficiency, add Baizhu (Atractylodes Rhizome) and Buguzhi (Psoralea Fruit) to the previous prescription; if there is Qi and Blood stagnation, use Zisu Yin (Perilla Infusion) added with Jiegeng (Platycodon Root) and Zhike (Aurantium Fructus); if stirred by Liver Fire, use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Baizhu, Zhike, and Shanzhi (Gardenia Fruit); if there is Liver and Spleen depression and knotting, use Guipi Tang (Restore the Spleen Decoction) added with Chaihu (Bupleurum Root) and Zhike.
A pregnant woman once suffered from neck stiffness and rigidity, along with lower back and back pain. This was caused by wind pathogen invading the Bladder Meridian. After one dose of Bacui Qianghuo Tang (Excellence Extract Notopterygium Decoction), she was cured. Subsequently, she took Duhuo Jisheng Tang and Bazhen Tang to dispel pathogens and consolidate the root, leading to full recovery.
Wang Shishan treated a woman who was eight months pregnant and had previously suffered from lower back pain, unable to turn or shift her body. Her stool was dry and hard. The physician used tonifying agents such as Renshen (Ginseng), which worsened the pain. Then, laxatives containing Xiaoshi (Niter) and Huanglian (Rhubarb) were used. Although the constipation was relieved, the pain remained. Wang diagnosed her pulse as slightly surging and rapid. He said: This is due to Blood Heat and Blood Stasis. It is appropriate to use Siwu Tang (Four Substance Decoction) added with Muxiang (Aucklandia Root), Rushi (Frankincense), Moyao (Myrrh), Huangbai (Phellodendron Bark), and Huomaren (Hemp Seed). After four or five doses, the pain decreased slightly, and the stool became moist. Later, fever and red face appeared, accompanied by occasional aversion to cold. The same formula was used, removing Rushi and Moyao, and adding Chaihu and Huangqin (Scutellaria Root). After two doses, the alternating chills and fever subsided. Then, she felt coldness in the back and abdominal pain recurred. Wang said: The blood has now circulated. Add one qian of Renshen to the previous formula, and she will be at peace.
Tongqi San (Qi-Regulating Powder): Treats unbearable lower back pain during pregnancy. This medicine is miraculous.
Pugu Zhi (Psoralea Fruit, fried on a tile until fragrant and powdered).
First, chew one walnut meat thoroughly, then mix three qian of Pugu Zhi powder with warm wine and take it on an empty stomach.
Wujia Pi San (Acanthopanax Powder): Treats unbearable lower back pain during pregnancy, or hip pain. Take this powder first.
Duzhong (Eucommia Bark, four liang, stir-fried), Wujia Pi (Acanthopanax Cortex), Ejiao (Donkey-hide Gelatin, roasted, added separately), Fangfeng (Saposhnikovia Root), Gouji (Cibotium Rhizome), Chuanxiong (Ligusticum Rhizome), Baishaoyao (White Peony Root), Xixin (Asarum Root), Bibi (Dioscorea Hypoglauca Rhizome) (each three liang), Xingren (Apricot Kernel, eighty pieces, peeled and tipped, stir-fried with flour).
Chop the herbs finely, boil in nine sheng of water to obtain two sheng, remove the dregs, dissolve the gelatin, and divide into three doses.
Wujia Pi Wan (Acanthopanax Pill): For unbearable lower back pain during pregnancy, take this pill next.
Xuduan (Dipsacus Root, stir-fried), Duzhong (Eucommia Bark) (each two and a half liang), Chuanxiong, Duhuo (Angelica Pubescens Root) (each three liang), Wujia Pi, Gouji, Bibi, Shaoyao (Peony Root), Hezi Rou (Chebulic Myrobalan Flesh) (each four liang). (This formula is not very different from the previous one, but replaces Xingren with Hezi. The difference in promoting unblocking versus astringing should be considered carefully.)
Grind into fine powder, make pills with refined honey, sized like paulownia seeds. Take forty pills per dose, with wine on an empty stomach, three times a day.
Treating lower back and back pain caused by disturbing the fetus:
Duzhong, Wujia Pi, Danggui (Angelica Sinensis Root), Shaoyao, Chuanxiong, Bibi (equal parts).
Grind into powder. Take three qian per dose, mixed with wine on an empty stomach.
Treating unbearable lower back pain caused by Qi stagnation attacking the waist during pregnancy, also treating abdominal pain:
Danggui (three liang), Ejiao, Gancao (Licorice Root) (each two liang), Congbai (Scallion White) (two sheng, chopped).
Finely chop, boil in seven sheng of water to obtain three sheng, remove dregs, and divide into three warm doses.
Duanju Zhugen Tang (Short Drama Bamboo Shoot Root Decoction): Treats damage and disturbance of the fetus, lower back and abdominal pain, bleeding, and downward fetal movement.
Shengdihuang (Rehmannia Root, fresh), Zhugen (Bamboo Shoot Root) (each two liang), Danggui, Shaoyao, Ejiao, Gancao (each one liang).
Finely chop, boil in six sheng of water to obtain two sheng, remove dregs, dissolve the gelatin, and divide into three warm doses. Avoid Haizao (Sargassum) and Wuyi (Madagascar Periwinkle).
Dadihuang Wan (Great Rehmannia Pill): Treats lower back and abdominal pain before and after delivery, and all types of blood-related pain. Also treats Qi and Blood deficiency, inability to move limbs, and bone marrow heat pain. (This formula is excellent not only for pre- and post-delivery but also for daily cases of Blood deficiency with internal heat.)
Shudihuang (Rehmannia Root, prepared), Wumei Rou (Mume Fruit Flesh), Danggui (each one liang).
Grind into fine powder, make pills with refined honey, sized like bullet shots. Take one pill per dose, chewed with plain hot water on an empty stomach.
Zijiu (Purple Wine): Treats pregnancy lower back pain feeling like breaking, and also sudden lower back pain in ordinary people.
Stir-fry two he of large black beans until fragrant and cooked. Boil in one large cup of wine to reduce to seven-tenths. Remove the beans and drink in one dose on an empty stomach.
Miscellaneous Formulas
To treat fetal movement causing lower back pain rushing to the heart, or bleeding: Take an arbitrary amount of Congbai, decoct thickly, and drink the juice.
Another prescription uses a six-cun deer horn, burn until red, quench in wine, burn again, quench again, until the horn breaks. Drink the wine. Powder the deer horn and take one fangcun bi (measure).
Another prescription uses one sheng of Changpu juice mixed with wine.
Another prescription uses one handful of Aiyi (Mugwort Leaf), size of a chicken egg, boiled in four sheng of wine to obtain two sheng. Divide into two doses; this is effective.