从疏肝补肾健脾论治高泌乳素血症

Treatment of Hyperprolactinemia by Soothing Liver,Tonifying Kidney,and Strengthening Spleen

高泌乳素血症是一种内分泌紊乱性疾病,可影响男女的生殖功能,属中医“乳泣”等范畴。笔者导师曹振健认为,本病应以肝郁、肾虚、脾虚为辨证要点,采用疏肝、补肾、健脾为治疗原则,同时兼顾气滞、血瘀、痰湿等病理因素。其据此拟定清乳汤(柴胡、炒白芍、生麦芽、香附、当归、黄芪、白术、茯苓、续断、桑寄生、菟丝子、女贞子、甘草),并归纳出肝气郁结、肝郁化火、气滞血瘀、肝肾阴虚、脾肾阳虚、肝郁脾虚、脾虚痰湿7种临床常见证型,治疗在主方基础上进行加减,探索中医药治疗高泌乳素血症的临床方法。

Hyperprolactinemia(HPRL)is a kind of endocrine disorder that can affect the reproductive function of men and women,and it belongs to the category of galactorrhea in traditional Chinese medicine(TCM).Cao Zhenjian,the tutor of the authors in this paper,thought that the disease is manifested by liver depression,kidney deficiency,and spleen deficiency,and the treatment should focus on soothing the liver,tonifying the kidney,and strengthening the spleen,while taking into account the Qi stagnation,blood stasis,phlegm,and other pathological factors.Cao Zhenjian developed the milk-clearing soup(Radix Bupleuri,stir-fried Radix Paeoniae Alba,raw Fructus Hordei Germinatus,nutgrass galingale rhizome,Radix Angelicae Sinensis,Radix Astragali,Rhizoma Atractylodis Macrocephalae,Poria,Radix Dipsaci,Chinese taxillus herb,dodder seed,glossy privet fruit,and Radix et Rhizoma Glycyrrhizae)and summarized seven kinds of clinical evidence,such as liver-Qi stagnation,liver depression transforming into fire,Qi stagnation and blood stasis,liver-kidney Yin deficiency,spleen-kidney Yang deficiency,liver depression and spleen deficiency,spleen deficiency and phlegm dampness.The treatment should be modified on the basis of the main prescription and explore the clinical method of TCM treatment of hyperprolactinemia.