肝郁型经前期综合征的中医证治研究现状

Research Status on Traditional Chinese Medicine Syndrome Differentiation and Treatment for Premenstrual Syndrome of Liver Depression Type

经前期综合征(premenstrual syndrome, PMS)是女性在黄体期反复出现周期性以情感、行为和躯体障碍为特征的综合征,为育龄期女性常见的疾病之一,临床常表现为经前头痛背痛、乳房胀痛、失眠、运动协调功能减退、焦虑抑郁等。经前期综合征在育龄期妇女中的发生率约为30%~40%,其中将近三成的女性临床症状较为明显,严重影响女性的身心健康及生活质量,是妇科临床治疗的一大挑战。祖国医学认为,该病属于“经行头痛”、“经行乳房胀痛”等疾病范畴。古代医家对其病因病机及治疗研究深入,早已为现代中医学研究该疾病打下了坚实的基础。肝藏血,主疏泄,调情志,肝气郁结容易导致气滞血瘀,这与PMS的发生和发展密切相关,相关研究表明临床尤以肝郁型PMS较为多见。近年来,运用中医药手段治疗该疾病的研究日趋增多,中医药在治疗过程中较西医治疗发挥着独到优势,且治疗效果显著。本文分别从肝郁型PMS的中医病因病机、内分泌因素的相关研究、中医证候分型及其特点、中医治疗等方面对肝郁型PMS的中医证治研究现状作进一步阐述,以期为中医临床从肝论治经前期综合征提供相关依据及诊疗思路。Premenstrual syndrome (PMS) is a syndrome characterized by emotional, behavioral and somatic disorders that occur repeatedly during the luteal phase of a woman’s life, and is one of the most common illnesses among women of childbearing age. It is often manifested by premenstrual headache and backache, breast swelling and pain, insomnia, loss of motor coordination, anxiety and depression, and so on. The incidence of PMS in women of childbearing age is about 30% to 40%, of which nearly 30% of women have more obvious clinical symptoms, which seriously affects women’s physical and mental health and quality of life, and is a major challenge for gynecological clinical treatment. According to Chinese medicine, this disease belongs to the category of “menstrual headache” and “menstrual breast pain”. Ancient physicians have conducted in-depth research on the etiology, pathogenesis and treatment of this disease, which has long laid a solid foundation for the study of this disease in modern Chinese medicine. The liver stores blood, is the main detoxifier, and regulates emotions, and liver qi stagnation can easily lead to qi stagnation and blood stasis, which is closely related to the occurrence and development of PMS, and relevant studies have shown that liver-depression-type PMS is more common in clinical practice. In recent years, research on the use of traditional Chinese medicine (TCM) in the treatment of this disease has been increasing, and TCM plays a unique advantage over Western medicine in the treatment process, and the therapeutic effect is remarkable. In this paper, we further elaborate on the current status of Chinese medicine treatment of liver-depressed PMS from the aspects of Chinese medicine etiology and pathogenesis of liver-depleted PMS, research on endocrine factors, Chinese medicine symptomatology and its characteristics, Chinese medicine treatment, etc., with a view to providing relevant bases and diagnostic and therapeutic ideas for the treatment of premenstrual syndrome from the theory of liver in the Chinese medicine clinic.