多囊卵巢综合征的中医病名、病因病机探讨

Discussion on the name,etiology and pathogenesis of polycystic ovary syndrome in traditional Chinese medicine

多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)是目前临床上常见的妇科内分泌疾病,其病因及发病机制不明、临床表现多样及发病率日趋升高,且治愈率低、并发症多,已成为目前妇科常见的疑难杂症之一,愈加受到重视。中医在改善症状、调整月经周期、提高妊娠率等方面颇具优势,但对其病名、病因病机的认识尚未达成统一。刘文峰教授从事临床工作50余年,在治疗各种疑难杂症上颇有心得,刘教授倡导中西医结合诊治疾病,将西医辨病与中医辨证相结合,着眼于其病位及病因病机,分析疾病的标本、虚实、寒热,并根据其发展变化,分期而治、标本兼顾。文章以刘教授的学术思想及临证经验为基础,依循刘老的疾病诊疗思路,以PCOS的中医病名“胞宫癥瘕”作为切入点,根据其月经稀发、毛发生长旺盛、出现男性特征及不孕、卵巢多囊改变、肥胖等临床症状,对其中医病因病机进行了探讨和分析,将病因归纳为先天、情志、体质、生活因素四个方面,病机责之于肾阳虚衰,督阳亏损,冲任不通,肾、肝、脾脏腑功能失调,以肾为本,痰湿、瘀血为标,气血失调,共同作用于胞宫而发为本虚标实之证,以期通过对其病因病机的论述抛砖引玉,在治疗上发挥中医药的特色,为PCOS的中医深入研究提供一定的思路。外妇骨伤。

Polycystic ovary syndrome(PCOS)is a common gynecological endocrine disease in clinical practice.Its etiology and pathogenesis are unknown,its clinical manifestations are diverse and its incidence is increasing.Coupled with its low cure rate and many complications,it has become one of the common and difficult gynecological diseases at present and has received more and more attention.Traditional Chinese medicine has advantages in relieving symptoms,regulating menstrual cycle and increasing pregnancy rate,but the understanding of its etiology and pathogenesis has not reached a consensus.Professor LIU Wenfeng,who has been engaged in clinical work for more than 50 years,has been quite experienced in the treatment of various difficult and complicated diseases.The professor advocates the combination of traditional Chinese medicine and Western medicine in the diagnosis and treatment of diseases,combining disease differentiation of Western medicine with syndrome differentiation of traditional Chinese medicine,focusing on the disease location and etiology and pathogenesis,analyzing the symptoms and root causes,deficiency and excess,cold and heat property of diseases,and taking into account the treatment by stages and symptoms and root causes according to their development and changes.Based on Professor LIU’s academic thinking and clinical experience,following his diagnosis and treatment idea,taking the TCM name of polycystic ovary syndrome(lump)as an entry point,the etiology and pathogenesis of PCOS are discussed and analyzed in terms of clinical symptoms such as irregular menstrual discharge,strong hair growth,male characteristics,infertility,polycystic changes of ovaries,and obesity.The etiology is summarized into four aspects:congenital,emotional,physical and life factors.The pathogenesis can be attributed to deficiency of kidney Yang(阳),the deficiency of Duyang(督阳),disharmony of Chong and Ren(冲任)Channels,the dysfunction of kidney,liver and spleen and viscera.The deficiency of the kidney is the root cause,and it is manifested in phlegm-damp and static blood,and the disorder of Qi(气)and blood jointly acts on the uterus and becomes the syndrome of asthenia in origin and asthenia in superficiality.Through the discussion of the etiology and pathogenesis of polycystic ovary syndrome,the author gives play to the characteristics of traditional Chinese medicine in the treatment,and provides certain ideas for the in-depth study of polycystic ovary syndrome in traditional Chinese medicine.