补肾法治疗多囊卵巢综合征的理论探讨

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是常见的妇科生殖内分泌代谢紊乱性疾病,PCOS临床表现多样,以稀发排卵或无卵、胰岛素抵抗、高雄激素血症及卵巢多囊样改变为主要病理特征,可导致无排卵性不孕和排卵障碍性不孕,引起闭经、糖尿病、脂代谢和糖代谢紊乱等并发症,危及机体远期健康。中医学并无此病名,依其临床表现,可归属"闭经""不孕症"和"癥瘕"等范畴。相比西医,中医治疗该病具有独特的见解,认为肝、肾、脾三脏功能的紊乱共同影响此病的发生和发展,且肾虚证为本病的主要证型。查阅文献表明,中医临床上多采用补肾法治疗PCOS,且用药灵活多样、标本兼顾,取得了较好的疗效。但在临床应用过程中,由于"补肾药用于男科疾病"的思维模式的影响,在一定程度上影响了补肾法在PCOS中的应用。鉴于此,本文从肾虚与生殖的关系,PCOS的病因病机,PCOS临床研究和实验研究等几方面对补肾法治疗PCOS的机理和相关研究进行分析和论述,以期为补肾法更好地用于PCOS及其他妇科疾病的治疗提供理论与实践上的支撑。

Effect of Kidney-reinforcing Traditional Chinese Medicine in Treating Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common gynecological reproductive endocrine and metabolic disorder disease. The clinical manifestations of PCOS are diversified, with and no ovulation, insulin resistance, hyperinsulinemia and polycystic ovaries as the main pathological and physiological changes, which can lead to non-ovulation infertility and ovulatory dysfunction infertility, cause complications, such as amenorrhea, diabetes, lipid metabolism and glucose metabolism disorder, and endanger the long-term health of the body. Traditional Chinese medicine (TCM) does not have the name of this disease, and classifies PCOS to the category of "amenorrhea", "infertility" and "abdominal mass kidney" according to its clinical manifestations. Compared with western medicine, TCM has a unique view in treating the disease, and believes that the disorders of liver, kidney and spleen functions jointly affect the occurrence and development of the disease. According to the literature review, kidney-deficiency syndrome is the main syndrome type of this disease, the kidney-tonifying method has achieved a good effect in clinic. Besides, the drug use is flexible and diversified, and both primary and secondary symptoms are taken into consideration. However, in the clinical application process, the application of kidney-tonifying method in PCOS has been affected by the thinking mode of "kidney-tonifying medicine for male diseases" to some extent. In view of this, the therapeutic effect of kidney-tonifying drugs in the treatment of PCOS is preliminarily demonstrated from several aspects of the relationship between kidney deficiency and reproduction, pathogenesis of PCOS, clinical research and experimental research of PCOS, in the expectation of providing theoretical and practical supports for kidney-tonifying therapy for PCOS and other gynecological diseases.