多囊卵巢综合征中医病机研究进展

Research progress on the pathogenesis of polycystic ovary syndrome in traditional Chinese medicine

多囊卵巢综合征是一种生殖内分泌疾病,常见于育龄期女性,以排卵障碍、高雄激素血症及卵巢多囊样改变为主要特征,主要表现为月经失调、胰岛素抵抗以及不孕等,对患者造成严重影响。传统中医理论并无多囊卵巢综合征相关论述,根据症状可归为“月经后期”、“经闭”、“崩漏”等范畴,目前大多数现代中医学者均认同肾虚在多囊卵巢综合征发生发展中的关键作用,但未形成统一的病机认识。基于黄元御“中气周流”理论可认为该病的共同病机特点为脾肾不足无以提供物质基础,肝郁无以推动气机运行。近年来,众多学者对卵巢综合征的中医病机进行了研究,发现肾虚在多囊卵巢综合征发生发展中起关键作用,但并未形成统一的认知,也有学者提出应重视肾、肝、脾三脏以及痰湿、瘀血等病理在本病发生发展过程中的作用。本文总结梳理了近年来临床医师对于多囊卵巢综合征的中医病机研究,并且从黄元御“中气周流”角度切入,阐述多囊卵巢综合征的中医病机认识,以期为中医认识及治疗多囊卵巢综合征提供理论基础支持。

Polycystic ovary syndrome is a reproductive endocrine disease,which is common in women of childbearing age.It is characterized by ovulation disorders,hyperandrogenism and polycystic ovarian changes,mainly manifested as menstrual disorder,insulin resistance and infertility,and has a serious impact on patients.There is no relevant discussion on polycystic ovary syndrome in traditional Chinese medicine theory.According to the symptoms,it can be classified into"late menstruation","amenorrhea","metrorrhagia"and other categories.At present,most modern Chinese medicine scholars agree that kidney deficiency plays a key role in the occurrence and development of polycystic ovary syndrome,but there is no unified understanding of the pathogenesis.Based on Huang Yuanyu's theory of"circulation of qi",it can be considered that the common pathogenesis of this disease is that the spleen and kidney are insufficient to provide a material basis,and liver stagnation is unable to promote the operation of qi.In recent years,many scholars have conducted research on the pathogenesis of ovarian syndrome in traditional Chinese medicine and found that kidney deficiency plays a key role in the occurrence and development of polycystic ovary syndrome.However,there has not been a unified understanding.Some scholars have also proposed that attention should be paid to the role of the kidney,liver,spleen,as well as pathological products such as phlegm dampness and blood stasis in the occurrence and development of this disease.This article summarizes and sorts out the research on the pathogenesis of polycystic ovary syndrome in traditional Chinese medicine by clinical physicians in recent years,and from the perspective of Huang Yuanyu's"circulation of qi",elaborates on the understanding of the pathogenesis of polycystic ovary syndrome in traditional Chinese medicine,in order to provide theoretical support for the understanding and treatment of the disease with traditional Chinese medicine.