基于“少阴为枢”论治围绝经期高脂血症  

Treatment of Perimenopausal Hyperlipidemia Based on"Shaoyin as the Pivot"Theory

作　　者：王雪晴 王斌[1] WANG Xueqing;WANG Bin(Department of Endocrinology,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Medical Research Center of Chinese Medicine and Acupuncture,Tianjin 300381,China)

机构地区：[1]天津中医药大学第一附属医院内分泌科/国家中医针灸临床医学研究中心,天津300381

出　　处：《临床误诊误治》2025年第7期104-110,共7页Clinical Misdiagnosis & Mistherapy

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医人教函[2022]75号)。

摘　　要：高脂血症是人体脂代谢紊乱、血脂水平异常的常见疾病。目前高脂血症的发病率逐年增加,长期的血脂异常可增加冠心病、脑卒中等心脑血管疾病发生风险,其早期管理具有重要意义。随着年龄增长,女性体内的雌激素分泌衰减。脂代谢受雌激素影响,故围绝经期女性高脂血症的发病率高于同龄男性。但多数高脂血症患者无明显临床症状,使其危害更为隐蔽,因此围绝经期高脂血症的筛查及预防尤为重要,是临床亟待解决的重要问题。西药只能暂时降低血脂水平,不能从根本上调整血脂升高的原因,停药后极易复发,且不良反应较大。而中医药在预防围绝经期高脂血症的发生发展、治疗疾病及改善预后等方面能够发挥整体调节作用,远期疗效显著。本文就围绝经期高脂血症的危害、病因病机、临床表现、治疗及与少阴枢机的相关性进行深入探讨,基于“少阴为枢”理论,通过枢转阴阳、水火共济、调和寒热、调整少阴枢机,对围绝经期女性少阴虚衰的特点予以调治,进一步影响太阴脾与厥阴肝的开阖,并对引起高脂血症的痰湿、血瘀等病理因素进行干预,为围绝经期高脂血症提供新的临床诊治思路。Hyperlipidemia is a common disorder of lipid metabolism and abnormal blood lipid levels.Currently,the incidence of hyperlipidemia is increasing year by year.Long⁃term dyslipidemia can increase the risk of cardiovascular and ce⁃rebrovascular diseases such as coronary heart disease and stroke,so early management is of great significance.Estrogen pro⁃duction declines with age in women.Lipid metabolism is affected by estrogen,so the incidence of hyperlipidemia in perimeno⁃pausal women is higher than that in men of the same age.However,most patients with hyperlipidemia have no obvious clinical symptoms,which makes its harm more hidden.Therefore,screening and prevention of hyperlipidemia in perimenopausal peri⁃od is particularly important,and it is an important problem to be solved urgently.Western medicine can only temporarily re⁃duce the level of blood lipid without fundamentally addressing the underlying causes of blood lipid elevation.It is more likely to recur after drug withdrawal with substantial adverse reactions.Traditional Chinese medicine can play an overall regulatory role in preventing the occurrence,development and treatment and improving prognosis of perimenopausal hyperlipidemia,and the long⁃term effect is significant.In this study,the harm,etiology and pathogenesis,clinical manifestations,treatment of perimenopausal hyperlipidemia and its correlation with Shaoyin pivot mechanism are discussed.Based on the theory of"Shaoy⁃in as the pivot",it proposes a therapeutic approach by balancing yin⁃yang through pivot rotation,harmonizing water⁃fire inter⁃dependence,and reconciling cold⁃heat disharmony to restore the Shaoyin pivot function.This approach regulates the character⁃istics of Shaoyin deficiency in perimenopausal women,thereby influencing the opening⁃closing functions of taiyin spleen and jueyin liver,and intervening in pathological factors such as phlegm⁃dampness and blood stasis that cause hyperlipidemia.Ulti⁃mately,this study provides innovative clinical diagnosis and

关 键 词：围绝经期 高脂血症 少阴 雌激素 心经 肾经 开阖枢 综述 

分 类 号：R589.2[医药卫生—内分泌]