排卵障碍性疾病“异病同治”:“天癸”本质及与排卵障碍性疾病关系的探讨  

Ovulatory disorders under"common therapeutic principle for different diseases":essence of"Tiangui"and relationship with ovulation disorders

作　　者：刘晓倩 马堃[2] 杨斌[3] 张晓雨[1] 尹昀东 LIU Xiao-qian;MA Kun;YANG Bin;ZHANG Xiao-yu;YIN Yun-dong(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;China Academy of Chinese Medical Sciences,Beijing 100700,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100191,China)

机构地区：[1]天津中医药大学,天津301617 [2]中国中医科学院,北京100700 [3]中国中医科学院西苑医院,北京100091

出　　处：《中国中药杂志》2022年第12期3397-3401,共5页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金面上项目(81674019);北京市科学技术委员会项目(Z17110000107104);中国民族医药学会科研项目(2021Z2072-340503)。

摘　　要：“异病同治”的本质是病证结合,病证结合是中医认识疾病、治疗疾病的经典模式。该文认为异病同治是排卵障碍性疾病的最佳治疗模式:排卵障碍性疾病具有共同的病机特点,即“肾-天癸-冲任-胞宫轴”的紊乱,肾是生殖轴的重要基础,肾精、肾阳、肾气是推动生殖轴运转的关键物质和动力,冲任是重要传输路径,“天癸”是其中起承转合的上游物质,与心脑肾相关,在排卵机制中起到关键作用,是生殖轴功能的高度体现和凝结。在排卵障碍性疾病中常见的“天癸”异常有四:癸水不足、阴虚阳弱、重阴偏盛、时相性异常,“天癸”动态变化可以导致不同疾病的发生,如多囊卵巢综合征、高泌乳素血症,这些疾病最终指向排卵障碍性不孕的共同结局。故以天癸为切入点,将几种排卵障碍性疾病总结统一,异病同治,是不孕病的治疗趋势。The essence of the"common therapeutic principle for different diseases"(Yibing Tongzhi in Chinese for short)is the disease-syndrome combination,which is the classic mode of understanding and treating diseases in traditional Chinese medicine(TCM).This study holds the view that Yibing Tongzhi is the optimal treatment mode of ovulation disorders since ovulation disorders have the common pathogenesis,i.e.,"kidney-Tiangui(reproduction-stimulating essence)-Chongren(thoroughfare and conception vessels)-uterus axis"disorder.Kidney is an important basis of the reproductive axis,where kidney essence,kidney yang,and kidney Qi are the key substances and driving forces promoting the operation of the reproductive axis.Chongren is an important transmission path."Tiangui",the upstream substance related to the heart,brain and kidney with a connecting effect,plays a key role in the ovulation mechanism and is a representative of the reproductive axis function.There are four common Tiangui abnormalities in ovulatory disorders,including hypomenorrhea,yin and yang deficiency,abnormal exuberance of extreme yin,and abnormal phase.The dynamic changes of"Tiangui"can induce different diseases,such as polycystic ovary syndrome and hyperprolactinemia,which ultimately lead to anovulatory infertility.Therefore,with"Tiangui"as the entry point,it is the treatment trend for ovulatory disorders under Yibing Tongzhi.

关 键 词：天癸 异病同治 排卵障碍性疾病 

分 类 号：R271.9[医药卫生—中西医结合]