补肾法在多囊卵巢综合征中的临床应用

Clinical Application of Kidney-Tonifying Method in Polycystic Ovary Syndrome

多囊卵巢综合征是以月经稀发或闭经、不孕、高雄激素血症、胰岛素抵抗、卵巢多囊样改变为特征的一组临床综合征的简称。因其临床表现多样,且祖国传统医学中并无多囊卵巢综合征的病名,根据其临床表现归属为不同的中医病名。文章根据古籍相关记载,对多囊卵巢综合征的主要临床表现月经稀发、闭经、不孕、肥胖进行归类,将月经后期、月经稀发、闭经和不孕的发病机理归属为肾虚血瘀,将肥胖单独归类为肾虚痰凝。文中从现代医家对多囊卵巢综合征的认识及其治疗思想出发,重点强调补肾法为多囊卵巢综合征的基本治疗大法,并提出临床要重视辨其兼夹证,是肾虚夹瘀还是肾虚夹痰,肾虚血瘀应以补肾为本益气活血化瘀为标,肾虚痰凝应补肾为本益气化痰为标,若肾虚血瘀痰凝兼有,应补肾为主活血化瘀益气祛痰为标,并分享了一则肾虚血瘀痰凝的经典病案进行讨论,以期能为多囊卵巢综征的后期研究提供些帮助。

Polycystic ovary syndrome(PCOS)is a group of clinical syndromes with oligomenorrhea or amenorrhea,infertility,hyperandrogen,insulin resistance and polycystic ovarian changes.Because of its various clinical manifestations,and there is no record of PCOS in traditional Chinese medicine,it is mainly classified into different TCM disease names according to its clinical manifestations.According to the relevant records of ancient books,the main clinical manifestations of PCOS were classified as hypomenorrhea,amenorrhea,infertility and obesity.The pathogenesis of late menstruation,hypomenorrhea,amenorrhea and infertility was classified as kidney deficiency and blood stasis,and obesity was classified as kidney deficiency and phlegm coagulation.Based on modern doctors’treatment ideas of PCOS,this paper emphasized that tonifying kidney is the basic treatment for PCOS,and put forward that clinical attention should be paid to the differentiation of its syndrome,that is,kidney deficiency with blood stasis or kidney deficiency with phlegm.If there are both kidney deficiency,blood stasis and phlegm coagulation,we should focus on tonifying kidney,promoting blood circulation,removing blood stasis,benefiting Qi and eliminating phlegm.We share a classic case of kidney deficiency,blood stasis and phlegm coagulation for discussion in order to provide some help for the later research of PCOS.