多囊卵巢综合征的文献综述

【作者】 孙健；

【导师】 陈艳；

【作者基本信息】 北京中医药大学 ， 中医妇科学， 2015， 硕士

【摘要】 多囊卵巢综合征是育龄期女性常见的妇科内分泌疾病,持续性无排卵、雄激素分泌过多和胰岛素抵抗是其重要特征,是导致生育期妇女月经紊乱最常见的原因,临床多以月经稀发、或月经量少甚至闭经、多毛、痤疮、不孕及双侧卵巢多囊样改变等为主要表现。随着生活节奏的逐渐加快、环境污染的日益严重,多囊卵巢综合征的发病率逐年升高,患者不仅饱受着身体上的不适,还要承担来自家庭的负担,严重的影响了生活质量。大多数学者通过临床大量研究认为遗传、饮食、精神及环境等因素是本病的主要发病原因,而下丘脑-垂体-卵巢轴功能失调、胰岛素抵抗、高雄激素血症、肾上腺内分泌功能失调等是其主要的发病机制,也有研究显示与胰岛素样生长因子、促炎因子、肿瘤坏死因子、瘦素、脂联素、抗苗勒激素等细胞因子有关。本文将对近年来西医从病因、发病机制、诊断及治疗等方面的研究情况进行逐一概述。中医古文献中并没有与本病准确相对应的病名,但依照本病所表现的症状及特征,多将其归属于“月经后期”、“月经过少”、“闭经”、“不孕症”、“癥瘕”等范畴,故对本病的文献综述源于中医古文献中对上述疾病的论治及名老中医长期临床经验的总结。大多数医家认为本病主要与肾、肝、脾三脏的功能失调有关。肾精不足,元阴亏虚,血海空虚,导致冲任气血乏源而无以化生经血；肾阳不足,气化无力,水湿停聚,日久渐生痰湿,瘀阻胞宫胞脉,经络阻滞不通,则气血不能正常下注胞宫。肝主储藏血液,疏泄气机,喜条达。肝失疏泄,气机不畅,致使无力行血,血脉瘀阻,经水不调；肝气郁结,肝木横克脾土,脾气受损,健运失司,气血生化无源,血海无以充盈,再者脾失健运,痰湿内生,瘀阻经络,导致月经不调、量少、闭经甚或不孕以及痤疮、肥胖等。故本病的病因病机多以肾虚为主,兼见肝郁、脾虚、血瘀、痰湿阻滞、痰瘀互结等证。治疗上以补肾调经为主,佐以疏肝理气、疏肝泻火、健脾化湿、祛痰通络、行气活血等。本文通过查阅中医古籍中与多囊卵巢综合征症状相类似的病证以及治疗经方,按病机分类选取所治疗病证的证型与多囊卵巢综合征可出现的证型相似的经方,以及现代学者应用经方治疗多囊卵巢综合征的实验与临床研究,进一步阐述了经方治疗多囊卵巢综合征的合理性及有效性。同时总结了现代多位名老中医根据多年临床经验总结的对本病的学术思想特点,从病因病机到辨证论治上的不同见解以及用药特点,以及其他中医学者应用中药治疗多囊卵巢综合征的临床及实验研究。本文通过对本病的中医证治论述,进一步确认了中医在治疗多囊卵巢综合征当中的优势与重要地位。更多还原

【Abstract】 Polycystic ovary syndrome is a common gynaecologic endocrine disease in child-bearing period women.Persistent no ovulation.the excessive secretion of androgen and insulin resistance are the important characteristic.PCOS is the most common cause of child-bearing period women’s menstrual disorders.OLigomenorrhea,hypomenorrhea,even amenorrhoea.Ster-ility,hairy,acne and bilateral ovaries polycystic change are the main performances. As the pace of life gradually accelerated.the increasing seriousness of environmental pollution, the incidence of polycystic ovary syndrome increases year by year.Patients not only suffer from the physical discomfort,but also must bear the burden of the family.These have a strong impact on their qualities of life.Through a large number of clinical studies,Most scholars think that genetic,spirit and environmental factors are the main cause of this disease.The dysfunction of hypothalamus-pituitary-ovary axis,insulin resistance,hyperandrogenemia and the Dysfunction of the adrenal glands endocrine are the main pathogenesis.In addition,in recent years many scholars at home and abroad discover many cytokines such as insulin-like growth factor,proinflammatory factor,tumor necrosis factor,Leptin,adiponectin,anti-mullerian hormones play an important role in the process of the pathogenesis of PCOS.But most of the researches are found that these factors have a correlation with the incidence of PCOS.How to cause PCOS remains to be elucidated.This article will expound the western medical stadies from the etiology.pathogenesis,diagnosis and treatment of PCOS in recent years.Ancient literature of traditional Chinese medicine have no accurate corresponding disease with the disease.But according to the disease symptoms and characteristics.it belongs to "delayed menstrual cycle", "hypomenorrhea", amenorrhea"."infertility"and "remove lump".So the research on the disease summary is from the ancient literature of traditional Chinese medicine in treatment of the disease and old scholars of traditional Chinese medicine’s clinicalexperiences summarized for a long time. Most physicians believe that the disease is mainly with the function of kidney, liver, spleen and three related disorders.Kidney essence deficiency,yuan yin deficiency,blood emptiness,cause the rush of blood lack source im not menstrual blood.Kidney Yang deficiency, gasification weakness,wet park together,time will gradually ShengTan wet,blood stasis resistance cell palace cell pulse,meridian block, qi and blood can’t bet normal cellular palace.The liver storing blood, pathogenesis is qi activity, article xi da.Liver pathogenesis,poor person,the weak line of blood,blood stasis resistance,the water is not.Diseases with ease, liver wood transverse grams of spleen earth,temper is impaired,nutrilite transport department,passive,qi and blood biochemical blood without filling,moreover the spleen health delivery,phlegmy wet endogenous,blood stasis resistance meridians,cause menstruation to be not moved,the quantity is little,amenorrhoea or infertility,and acne,obesity,etc.Diseases with stasis,long hot,burn Yin fluid,so that less jin kui blood.It can appear clinical in the kidney,qi and blood stasis and phlegm dampness resistance.liver via card such as windcold.mostly on treatment with kidney and regulate the menstrual function is given priority to.with liver qi. spleen phlegm.qi and activating blood.liver.purging fire.etc.In this paper, by referring to the ancient literature of traditional Chinese medicine,summa rize physicians with similar disease symptoms of polycystic ovary syndrome and treatment.se-veral old scholars of traditional Chinese medicine’s academic thought from the etiology and pathogenesis to the treatment based on syndrome differentiation according to many years clinical experience,and other medical workers’s application of traditional Chinese medicine clinical and experimental research for the treatment of polycystic ovary syndrome.This paper further confirm the advantages and important status of traditional Chinese medicine in the treatment of polycystic ovary syndrome.更多还原