中西医对卵巢储备功能减退病因病机的探讨

Discussion on the etiology and pathogenesis of ovarian reserve function reduced by Chinese and Western Medicine

近年来,卵巢储备功能减退的发病率逐年增加,呈年轻化趋势,治疗棘手,效果欠佳。中医认为卵巢储备功能减退的病因多证夹杂,其中"虚"被视为本病病机的关键,责之肝肾,实证多因气滞、血瘀,临床以虚实夹杂多见。现代医学认为卵巢储备功能减退的发病与遗传、免疫、医源性损伤、感染、心理、反复多次流产等因素有关。本文就卵巢储备功能减退的病因病机进行探讨,为进一步临床防治提供参考。随着现代社会女性承担工作和家庭双重压力的增加,DOR的发病率逐年累增并呈年轻化趋势,特别是二孩政策的开放,更多DOR患者渴望再次生育,而如何解决DOR患者的迫切生育需求并提高其未来生活质量或将成为未来女性生殖领域的重点研究方向之一。女性是生殖过程的主要参与者,女性的生殖健康至关重要,因此探究DOR的发病机制以期找到有效的治疗方案尤为重要。目前,西医通常采取雌孕激素序贯疗法、诱导排卵、卵巢移植等方法治疗,但因其具有一定的副作用而限制了应用,不为大多数患者接受。祖国医学对调经治疗经验丰富,从整体观念出发,虚实辨纲,以补肾活血、滋补肝肾、疏肝健脾为主要治则,有效改善患者的临床症状,且具有个体化治疗、副作用小、复发率低等优势,现逐步为广大女性认可,因此中医在治疗DOR方面具有良好的发展前景。

In recent years,the incidence of ovarian reserve loss increased year by year,showing a trend of younger,difficult to treat,the effect is not good. Chinese medicine believes that the cause of ovarian reserve loss more evidence of mixed,including＂virtual＂is regarded as the key pathogenesis of this disease,the responsibility of the liver and kidney,which is mostly due to qi stagnation and blood stasis,clinical performance mixed are common reflected with actual situation. Modern medicine considers that the incidence of ovarian reserve loss has been affected by factors of heredity,immune,iatrogenic injury,infection,psychology and repeated abortion. In this paper,the etiology and pathogenesis of ovarian reserve loss was explored,so as to provide a reference for further clinical prevention and treatment. With the increasing pressure from women and men in the modern society,the incidence of DOR increases year by year and tends to be younger. Especially,the policy of opening a two-child policy is open. More DOR patients are anxious to have another childbearing. How to solve the urgent need of DOR patients and improve their quality of life of women in the future or will become one of the key research areas in the field of female reproduction in the future. Women are the main participants in the reproductive process. Female reproductive health is very important. Therefore,it is particularly important to explore the pathogenesis of DOR in order to find an effective treatment plan. At present,Western medicine usually adopts sequential therapy of estrogen and progesterone,inducing ovulation,ovarian transplantation and other methods of treatment,but because of its certain side effects and limited application,which is not for most patients. The motherland medicine has rich experience in the treatment of menstruation,starting from the holistic concept,combining the actual situation with the principle of regulating the kidney and promoting blood circulation,nourishing the liver and kidney and improving the spleen and invigorating the spleen as the main rule,which has effectively improved the clinical symptoms of patients. And it has the advantages of individualized treatment and low recurrence rate and so on,which is gradually recognized by the majority of women,so the Chinese medicine in the treatment of DOR has good prospects for development.