多囊卵巢综合征伴胰岛素抵抗中西医研究进展

Progress of Traditional Chinese Medicine and Western Medicine Treatment in Polycystic Ovary Syndrome with Insulin Resistance

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是育龄期妇女常见的内分泌疾病之一,其中约有超过半数的PCOS患者伴随着不同程度的胰岛素抵抗(insulin resistance,IR)。现阶段,西医对于多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)的认识多从遗传、慢性炎症反应、环境等因素入手,临床治疗多在生活方式干预基础上,口服避孕药以及双胍类、噻唑烷二酮类等药物。西药治疗虽疗效显著但存在着停药后复发率高,胃肠道反应等各类不良反应。中医认为该病病因包括“湿”“痰”“瘀”,涉及肝、脾、肾三脏。临床上治以补肾疏肝健脾,佐以祛痰、利湿、化瘀,但由于中医大样本研究的缺乏,一定程度上限制了中医药优势的发挥。该文从中医、西医两个角度,对PCOS-IR的病因以及治疗进行整理综述,以期为探索PCOS-IR的中西医结合疗法提供思路。

In women of childbearing age,endocrine diseases caused by polycystic ovary syndrome(PCOS)account for the most common portion.And in these patients,PCOS have accompanied by varying degrees of insulin resistance(IR).At this stage,Western medicine's understanding of PCOS-IR mostly starts from genetics,chronic inflammatory response,environment and other factors,and clinical treatment is mostly based on lifestyle interventions,oral contraceptives combined with biguanides or thiazolidinediones.Although Western medicine treatment has significant efficacy,there are various side effects such as high recurrence rate after stopping the drug and gastrointestinal reactions.Traditional Chinese medicine believes that the causes of this disease include“dampness”“phlegm”and“blood stasis”,involving the liver,spleen and kidney in traditional Chinese medicine.Clinically,it is treated to tonify the kidneys,sooth the liver and strengthen the spleen,accompanied by eliminating phlegm,expelling dampness and removing blood stasis,but due to the lack of large sample studies of traditional Chinese medicine,the advantages of traditional Chinese medicine are limited to a certain extent.This article reviews the etiology and treatment of PCOS-IR from the perspectives of traditional Chinese and western medicine,in order to provide ideas for exploring the combination of traditional Chinese and Western medicine therapy for PCOS-IR.