基于下丘脑-垂体-肾上腺轴应激探讨肝主疏泄与经前期综合征/经前烦躁障碍症的相关性  

Exploration of correlation between liver controlling conveyance and dispersion and premenstrual syndrome/premenstrual dysphoric disorder based on hypothalamic-pituitary-adrenal axis stress

作　　者：邱兆艳 王海军 孟庆岩 郭英慧[2] QIU Zhaoyan;WANG Haijun;MENG Qingyan;GUO Yinghui(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Shandong Province,Jinan250355,China;College of Medicine,Shandong University of Traditional Chinese Medicine,Shandong Province,Jinan250355,China)

机构地区：[1]山东中医药大学中医学院,山东济南250355 [2]山东中医药大学医学院,山东济南250355

出　　处：《中国医药导报》2025年第6期143-146,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(82074293);山东中医药大学科学研究基金项目(KYZK2024M08)。

摘　　要：经前期综合征(PMS)/经前烦躁障碍症(PMDD)是指月经来临前2~7 d周期性出现的全身或局部不适症状,以情志异常为主,对育龄期女性的日常生活造成严重影响。中医普遍认为PMS/PMDD的发生主要归因于肝失疏泄,肝喜调达而恶抑郁,从肝论治亦遵循“木郁达之”之旨,木郁得解、脏腑通达,经行有常则诸证自无所起。现代医学认为,经前应激性下丘脑-垂体-肾上腺(HPA)轴损伤可能是肝失疏泄导致PMS/PMDD发病的重要现代科学内涵之一。本文从应激性HPA轴损伤研究PMS/PMDD肝失疏泄深层机制,旨在阐明肝主疏泄现代科学内涵,不断丰富中医肝藏象及情志病证理论,对PMS/PMDD发病机制和临床诊疗具有重要意义。Premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD)refers to systemic or local discomfort symptoms that occur periodically 2-7 days before menstruation,mainly characterized by emotional abnormalities,which seriously affect the daily life of women of childbearing age.Traditional Chinese medicine generally believes that the occurrence of PMS/PMDD is mainly attributed to liver dysfunction and diarrhea,liver likes to regulate and dislikes depression,the treatment of liver also follows the principle of“treating wood depression”,where wood depression is relieved,organs are unobstructed.If there are regular meridians,then the various syndromes do not arise naturally.Modern medicine believes that premenstrual stress-induced hypothalamic-pituitary-adrenal(HPA)axis injury may be one of the important modern scientific connotations of PMS/PMDD caused by liver dysfunction.This article studies the deep mechanism of PMS/PMDD liver dysfunction from the perspective of stress-induced HPA axis injury,aiming to clarify modern scientific connotation of liver’s role in regulating liver function and continuously enrich the theory of liver storage and emotional disorders in traditional Chinese medicine.It is of great significance for the pathogenesis and clinical diagnosis and treatment of PMS/PMDD.

关 键 词：经前期综合征 经前烦躁障碍症 应激 下丘脑-垂体-肾上腺轴 肝主疏泄 病因病机 

分 类 号：R271.1[医药卫生—中医妇科学]