基于“毒损络脉”理论探析多囊卵巢综合征的治疗  

Exploring the treatment of polycystic ovary syndrome based on the theory of toxicity damages collaterals

作　　者：彭锦 何泽[2] PENG Jin

机构地区：[1]长春中医药大学,吉林长春130117 [2]长春中医药大学附属医院,吉林长春130021

出　　处：《中医临床研究》2024年第29期35-39,共5页Clinical Journal Of Chinese Medicine

摘　　要：多囊卵巢综合征是育龄期常见的妇科内分泌代谢性疾病,临床除高雄激素表现、排卵异常、卵巢多囊样改变外,还多伴有内分泌代谢障碍如胰岛素抵抗、肥胖、糖脂代谢紊乱,其发病机制复杂,病情缠绵,病程长。西医针对多囊卵巢综合征以对症治疗为主,而中医针对本病的整体治疗有独特的优势。根据临床表现,可概括久、顽、杂为其发病特点。多囊卵巢综合征患者的发病与肝、脾、肾有密切联系,先天肾精亏虚,后天脾虚、肝气郁结,病理产物胶着久蕴成毒,络脉痹阻,气血运行不畅,冲任气血生化乏源,胞宫失于濡养,气血失和,痰聚瘀结,发为多囊卵巢综合征。这与中医毒邪致病理论和络病学说的内涵相符合。根据患者临床不同病证特点,可将毒邪分为瘀毒、痰毒、浊毒、虚毒,在此基础上提出“毒损络脉”是多囊卵巢综合征发生发展的核心病机。在诊治过程中,根据病证的不同阶段特点,基于肝脾肾虚、痰、瘀、浊毒相互交织的病理状态,以“扶正解毒通络”为指导原则,灵活应用滋肾健脾疏肝、解毒通络导邪等治法,并根据多囊卵巢综合征之瘀毒阻络脉、浊毒损络脉、虚毒损络脉及肾虚、肝虚、脾虚等侧重点的不同辨证用药,且在药物中重视虫类药、藤类药等通络药物的应用,为临床治疗本病拓展思路。Polycystic ovary syndrome is a common gynecological endocrine metabolic disease in women of reproductive age.In addition to hyperandrogenism,abnormal ovulation,ovarian polycystic changes,the disease is often accompanied by endocrine metabolic disorders such as insulin resistance,obesity,glucose and lipid metabolism disorders.The pathogenesis is complex,and its condition is lingering with a lengthy course.Western medicine focuses on symptomatic treatment in the treatment of PCOS,while TCM has unique advantages in the overall treatment of PCOS.According to the clinical manifestations,its pathogenesis can be summarized as long,stubborn,miscellaneous.The incidence of PCOS is closely related to liver,spleen and kidney.Due to congenital kidney deficiency,and acquired spleen deficiency and liver Qi(气)stagnation,the pathological products are accumulated and became poison over time,leading to collateral veins paralysis,then Qi and blood circulation in collateral veins is not smooth,and the functions of production and metaplasia of Qi and blood in Chong meridian(冲脉)and Ren meridian(任脉)is abnormal,leading to the loss of the nourishing of Qi and blood in uterus,which causes phlegm aggregation and stasis,resulting in PCOS finally.This view is consistent with the connotation of the poisoningpathogenic disease theory and collateral-disease theory in TCM.Toxic pathogens can be classified into stasis toxin,phlegm toxin,turbidity toxin,and deficiency toxin according to different clinical characteristics of patients,therefore,on this basis,it is proposed that toxicity damages the collaterals is the core pathogenesis of PCOS.In the process of diagnosis and treatment,according to the characteristics of different stages of the disease,based on the intertwined pathological states of deficiency,phlegm,blood stasis,and turbid toxicity of liver,spleen,and kidney,guided by the principle of supporting vital energy,detoxifying,and clearing collaterals,the methods of nourishing kidney,strengthening spleen,dredging liver and so on ar

关 键 词：多囊卵巢综合征 毒损络脉 扶正解毒通络法 络病学说 毒邪 

分 类 号：R271.1[医药卫生—中医妇科学]