Treatment of PCOS Based on Xuanfu Theory
-
摘要: 多囊卵巢综合征(PCOS)是女性常见的生殖内分泌疾病。基于玄府理论辨治PCOS,认为玄府郁闭,气血津液运行失常是PCOS的基本病机,治疗PCOS以直接开玄为主,再根据气郁、痰湿、瘀血之主次,分别治以开玄行气、开玄化痰、开玄祛瘀,合理配伍,宣通气液,恢复玄府正常的生理功能。以拓展玄府理论的应用范围,深化对PCOS病因病机的认识,为PCOS的辨治提供新的思路与方法。Abstract: Polycystic ovarian syndrome (PCOS) is a common female reproductive endocrine disorder. Based on the syndrome differentiation and treatment from Xuanfu theory, it is believed that the basic pathogenesis of PCOS is the Xuanfu stagnation, combined with the improper functioning of qi, blood and fluids. Therefore, as for the treatment of PCOS, acrid medicinals can be used to directly unblock the Xuan. Then according to the pathogenesis priority of qi-depression, phlegm-dampness, and blood stasis, corresponding therapies including promoting qi movement, dissolving phlegm, as well as dispelling stasis can be applied to unblock the Xuanfu, promote the flow of qi and fluid, and restore the normal physiological function of the Xuanfu with reasonable medicinal combinations. The study not only expands the scope of application of Xuanfu theory, but deepens the understanding of the PCOS etiology and pathogenesis. Besides, it provides new ideas and methods for the syndrome differentiation and treatment of PCOS.
-
Key words:
- Xuanfu /
- polycystic ovarian syndrome /
- Xuanfu stagnation
-
[1] ESCOBAR-MORREALE HF. Polycystic ovary syndrome: Definition, aetiology, diagnosis and treatment[J]. Nat Rev Endocrinol, 2018, 14(5): 270-284. doi: 10.1038/nrendo.2018.24 [2] 王尧尧, 侯丽辉, 郝松莉, 等. 多囊卵巢综合征"辨病、辨体、辨证"诊疗思路[J]. 辽宁中医杂志, 2014, 41(6): 1144-1145. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY201406032.htmWANG YY, HOU LH, HAO SL, et al. Model of disease physique, and syndrome of polycystic ovary syndrome[J]. Liaoning J Tradit Chin Med, 2014, 41(6): 1144-1145. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY201406032.htm [3] TEEDE HJ, MISSO ML, COSTELLO MF, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome[J]. Hum Reprod, 2019, 34(2): 388. doi: 10.1093/humrep/dey363 [4] 张雯, 李娜, 许朝霞. 多囊卵巢综合征的中医证治研究进展[J]. 世界科学技术-中医药现代化, 2018, 20(5): 810-815. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202009042.htmZHANG W, LI N, XU ZX. Research progress in TCM syndrome treatment of polycystic ovary syndrome[J]. Mod Tradit Chin Med Mater Med World Sci Technol, 2018, 20(5): 810-815. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202009042.htm [5] 夏桂成. 夏桂成实用中医妇科学[M]. 北京: 中国中医药出版社, 2009: 245.XIA GC. Xia Guicheng's Practical Gynecology of Chinese Medicine[M]. Beijing: China press of traditional Chinese medicine, 2009: 245. [6] 左婧. 加减防风通圣散配合耳穴贴压法治疗肥胖型多囊卵巢综合征的临床研究[D]. 南京: 南京中医药大学, 2011.ZUO J. The clinical study on the "Jiajian Fang Fen Tong Sheng San" effect of overweight type of polyeystie ovary sydrome[D]. Nanjing: Nanjing University of Chinese Medicine, 2011. [7] 林青, 李以良, 王梦雨. 探讨防风通圣散对多囊卵巢综合征大鼠血清激素及卵巢组织学影响[J]. 环球中医药, 2021, 14(1): 14-18. doi: 10.3969/j.issn.1674-1749.2021.01.003LIN Q, LI YL, WANG MY. Discussion on effects of Fangfeng Tongsheng Powder on serum hormone and ovary histology in PCOS rats[J]. Glob Tradit Chin Med, 2021, 14(1): 14-18. doi: 10.3969/j.issn.1674-1749.2021.01.003 [8] 韩方, 张荧, 蒯顾平, 等. 防风通圣丸改善多囊卵巢综合征大鼠胰岛素抵抗的作用研究[J]. 中医药学报, 2022, 50(5): 24-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXB202205006.htmHAN F, ZHANG Y, KUAI GP, et al. Fangfeng Tongsheng pill alleviating IR in rats with PCOS[J]. Acta Chin Med Pharmacol, 2022, 50(5): 24-28. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXB202205006.htm [9] 黄帝内经素问[M]. 北京: 人民卫生出版社, 2005: 113.The Yellow Emperor's Inner Classic: Basic Questions[M]. Beijing: People's medical publishing house, 2005: 113. [10] 刘完素. 素问玄机原病式[M]. 北京: 中国医药科技出版社, 2011: 7-42.LIU WS. Explanation of Mysterious Pathogeneses and Etiologies Based on the Basic Questions[M]. Beijing: China medico-pharmaceutical sciences and technology publishing house, 2011: 7-42. [11] 向圣锦, 路雪婧, 张富文, 等. 中医玄府理论研究述评[J]. 中华中医药杂志, 2020, 35(8): 3803-3807. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202008003.htmXIANG SJ, LU XJ, ZHANG FW, et al. Review of the theoretical research of Xuanfu in traditional Chinese medicine[J]. China J Tradit Chin Med Pharm, 2020, 35(8): 3803-3807. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202008003.htm [12] 张仲景. 金匮要略[M]. 北京: 中国医药科技出版社, 2016: 2.ZHANG ZJ. Essentials from the Golden Cabinet[M]. Beijing: China medico-pharmaceutical sciences and technology publishing house, 2016: 2. [13] 王明杰, 罗再琼. 玄府学说[M]. 北京: 人民卫生出版社, 2018: 11-47.WANG MJ, LUO ZQ. Xuanfu Theory[M]. Beijing: People's medical publishing house, 2018: 11-47. [14] 张益生, 张君冬, 朱彦, 等. 基于CiteSpace的近60年玄府学说知识图谱分析[J]. 中国中医药信息杂志, 2022, 29(2): 34-40. https://www.cnki.com.cn/Article/CJFDTOTAL-XXYY202202007.htmZHANG YS, ZHANG JD, ZHU Y, et al. Analysis of knowledge map of xuanfu theory in the past 60 years based on CiteSpace[J]. Chin J Inf Tradit Chin Med, 2022, 29(2): 34-40. https://www.cnki.com.cn/Article/CJFDTOTAL-XXYY202202007.htm [15] 余海龙, 张馨月, 江玉. 玄府理论与应用研究[J]. 中国中医基础医学杂志, 2021, 27(9): 1512-1514. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202109040.htmYU HL, ZHANG XY, JIANG Y. Research of Xuanfu Theory and application[J]. J Basic Chin Med, 2021, 27(9): 1512-1514. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202109040.htm [16] 郑国庆, 黄培新. 玄府与微循环和离子通道[J]. 中国中医基础医学杂志, 2003, 9(4): 13-14, 31. doi: 10.3969/j.issn.1006-3250.2003.04.006ZHENG GQ, HUANG PX. Xuanfu, microcirculation and ion channels[J]. China J Basic Med Tradit Chin Med, 2003, 9(4): 13-14, 31. doi: 10.3969/j.issn.1006-3250.2003.04.006 [17] 张天娥, 罗再琼, 张勤修, 等. 玄府与水通道蛋白的比较[J]. 辽宁中医杂志, 2009, 36(7): 1110-1111. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY200907028.htmZHANG TE, LUO ZQ, ZHANG QX, et al. Comparison of Xuanfu with aquaporins[J]. Liaoning J Tradit Chin Med, 2009, 36(7): 1110-1111. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY200907028.htm [18] 常富业, 王永炎, 高颖, 等. 玄府与细胞间隙的比较[J]. 安徽中医学院学报, 2005, 24(2): 1-3. doi: 10.3969/j.issn.1000-2219.2005.02.001CHANG FY, WANG YY, GAO Y, et al. Comparison of Xuanfu and intercellular space[J]. J Anhui Tradit Chin Med Coll, 2005, 24(2): 1-3. doi: 10.3969/j.issn.1000-2219.2005.02.001 [19] 杨艳婷, 侯丽辉, 孙淼, 等. 1 125例多囊卵巢综合征患者中医体质类型分布及演变规律[J]. 辽宁中医杂志, 2020, 47(2): 7-10. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY202002004.htmYANG YT, HOU LH, SUN M, et al. Distribution and evolution of TCM constitutions of 1 125 patients with polycystic ovary syndrome[J]. Liaoning J Tradit Chin Med, 2020, 47(2): 7-10. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY202002004.htm [20] 朱志琴, 郝元涛, 陈爱兰, 等. 多囊卵巢综合征患者中医体质类型分布研究[J]. 中国妇幼保健, 2014, 29(15): 2389-2391. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201415036.htmZHU ZQ, HAO YT, CHEN AL, et al. Study on distribution of physiques categorization of traditional Chinese medicine in patients with polycystic ovary syndrome[J]. Matern Child Heal Care China, 2014, 29(15): 2389-2391. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201415036.htm [21] 秦静波, 王济, 王琦. 多囊卵巢综合征中医体质类型及辨体论治思路[J]. 中医杂志, 2016, 57(18): 1553-1556. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201618007.htmQIN JB, WANG J, WANG Q. Analysis of Chinese medicine constitution types of polycystic ovary syndrome and the treatment ideas based on constitution differentiation[J]. J Tradit Chin Med, 2016, 57(18): 1553-1556. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201618007.htm [22] COONEY LG, DOKRAS A. Depression and anxiety in polycystic ovary syndrome: Etiology and treatment[J]. Curr Psychiatry Rep, 2017, 19(11): 1-10. [23] BRUTOCAO C, ZAIEM F, ALSAWAS M, et al. Psychiatric disorders in women with polycystic ovary syndrome: A systematic review and meta-analysis[J]. Endocrine, 2018, 62(2): 318-325. doi: 10.1007/s12020-018-1692-3 [24] 李兆惠, 赵志梅, 夏天, 等. 基于情志致病理论探讨心理应激对多囊卵巢综合征的影响[J]. 中华中医药杂志, 2021, 36(6): 3706-3709. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202106159.htmLI ZH, ZHAO ZM, XIA T, et al. Effects of psychological stress on polycystic ovary infertility based on emotional pathogenicity theory[J]. China J Tradit Chin Med Pharm, 2021, 36(6): 3706-3709. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202106159.htm [25] 桑霞, 陶莉莉, 张玉珍, 等. 脂肪细胞因子瘦素、肿瘤坏死因子与痰湿证多囊卵巢综合征的相关研究[J]. 河南中医学院学报, 2008, 23(5): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZK200805020.htmSANG X, TAO LL, ZHANG YZ, et al. The correlation research between leptin, TNF-α and phlegmatic hygrosis syndrome in polycystic ovarian syndrome[J]. J Henan Univ Chin Med, 2008, 23(5): 42-44. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZK200805020.htm [26] 田思胜. 朱丹溪医学全书[M]. 北京: 中国中医药出版社, 2006: 349.TIAN SS. The Comprehensive Volume of Zhu Danxi[M]. Beijing: China press of traditional Chinese medicine, 2006: 349. [27] 喻嘉言. 寓意草[M]. 上海: 上海科学技术出版社, 1962: 80.YU JY. Case Records of Chinese Medicine[M]. Shanghai: Shanghai scientific and technical publishers, 1962: 80. [28] 冯皓月, 岳仁宋, 张晓晴, 等. 从"阳气怫郁-玄府-气液"探讨"郁乃痤"的发病机理[J]. 中国中医基础医学杂志, 2019, 25(10): 1466-1468. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC201910047.htmFENG HY, YUE RS, ZHANG XQ, et al. Pathogenesis of acne from the aspects of stagnant Yang heat-xuanfu-qi and liquid[J]. Chin J Basic Med Tradit Chin Med, 2019, 25(10): 1466-1468. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC201910047.htm [29] 李怡, 姜良铎. 从"毒"而论糖尿病的病因病机初探[J]. 中国医药学报, 2004, 19(2): 119-120. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY200402020.htmLI Y, JIANG LD. A preliminary investigation of the etiology and pathogenesis of diabetes from "toxin" theory[J]. China J Tradit Chin Med Pharm, 2004, 19(2): 119-120. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY200402020.htm [30] 韩凤娟, 秦榕婉, 宋长红. 从"玄府"与"气液昧之"探讨多囊卵巢综合征的病变特点[J]. 天津中医药大学学报, 2017, 36(6): 418-420. https://www.cnki.com.cn/Article/CJFDTOTAL-TZYY201706005.htmHAN FJ, QIN RW, SONG CH. Explore the characteristics of the lesion of polycystic ovary syndrome from "view of sweat pore" and "Qiye Meizhi"[J]. J Tianjin Univ Tradit Chin Med, 2017, 36(6): 418-420. https://www.cnki.com.cn/Article/CJFDTOTAL-TZYY201706005.htm [31] 王明杰, 黄淑芬. 风药增效论[J]. 新中医, 2006, 38(1): 1-4. https://www.cnki.com.cn/Article/CJFDTOTAL-REND200601001.htmWANG MJ, HUANG SF. A discussion on synergism of wind - medicine[J]. New J Tradit Chin Med, 2006, 38(1): 1-4. https://www.cnki.com.cn/Article/CJFDTOTAL-REND200601001.htm [32] 丁德正. 部分辛味药在精神疾病治疗上的特殊功效[J]. 中华中医药杂志, 2016, 31(10): 4094-4096. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201610068.htmDING DZ. Special effects of some pungent flavor herbs in the treatment of mental illness[J]. China J Tradit Chin Med Pharm, 2016, 31(10): 4094-4096. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201610068.htm [33] 周杨, 朱红梅. 辛味药研究现状与思考[J]. 中华中医药杂志, 2013, 28(6): 1647-1650. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201306004.htmZHOU Y, ZHU HM. Commentary and thought on the study of pungent medicine[J]. China J Tradit Chin Med Pharm, 2013, 28(6): 1647-1650. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201306004.htm [34] 杨茂艺, 胡志鹏, 岳仁宋. 岳仁宋基于玄府理论探讨糖尿病胃轻瘫经验[J]. 中国中医基础医学杂志, 2020, 26(5): 698-700. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202005045.htmYANG MY, HU ZP, YUE RS. Professor YUE ren-song's f experience in treating diabetic gastroparesis based on xuanfu theory[J]. Chin J Basic Med Tradit Chin Med, 2020, 26(5): 698-700. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202005045.htm [35] 蒋介繁. 本草择要纲目[M]. 上海: 上海科学技术出版社, 1985: 14.JIANG JF. The Selected Compendium of Materia Medica[M]. Shanghai: Shanghai scientific and technical publishers, 1985: 14. [36] 张景岳. 类经[M]. 北京: 中国医药科技出版社, 2011: 249.ZHANG JY. The Classified Classic[M]. Beijing: China medico-pharmaceutical sciences and technology publishing house, 2011: 249. [37] 张子和. 儒门事亲[M]. 北京: 人民卫生出版社, 2017: 349.ZHANG ZH. Confucians' Duties to Their Parents[M]. Beijing: People's medical publishing house, 2017: 349.
点击查看大图
计量
- 文章访问数: 317
- HTML全文浏览量: 85
- PDF下载量: 31
- 被引次数: 0