摘要
多囊卵巢综合征(polycystic ovary syndrome,PCOS)是临床上导致女性排卵障碍的常见原因,常见月经紊乱,甚则闭经。PCOS伴发多种与顶焦相关的激素异常,高黄体生成素(luteinizing hormone,LH)血症为其中之一。四焦八系理论为PCOS提供了新的论治策略,其中顶焦包括神系与髓系,由颅腔、脊髓腔及其中的脑、延髓、脊髓构成,主神明、司神志。LH由垂体分泌,PCOS合并高LH血症病位在顶焦,适宜采用刚柔辨证,临证当从神、髓二系调理阴阳,使刚柔相济。PCOS-LH患者素体阳刚,顶焦郁结,情绪急躁者多为刚证,多伴失眠、眼干、眼胀等症,用白芍、牡蛎镇定安神,滋阴潜阳;素体阴柔,顶焦亏虚,情绪低落者多为柔证,多伴神疲乏力、语声低微等症,用黄芩、黄连、白芍、炒枣仁、生地黄充髓安神,滋阴复阳。对于降低高LH水平,恢复PCOS-LH患者的规律月经效力颇捷。
Polycystic ovary syndrome(PCOS)is a common cause of ovulation disorders in women in clinical practice,usually manifested as menstrual disorder and even amenorrhea.It is complicated with a variety of hormonal abnormalities related to the Ding Jiao,with high serum level of luteinizing hormone(LH)as one of them.The theory of four Jiaos and eight systems provides a new treatment strategy for PCOS,in which the Ding Jiao covers the nervous system and the medullary system,consisting of the cranial cavity,the spinal cord cavity and the organs of brain,medulla oblongata and spinal cord in them.The Ding Jiao's function mainly lies in governing the spirit.As LH is secreted by the pituitary gland,PCOS combined with high LH level is thus located in the Ding Jiao,so it is appropriate to use the rigidity-gentleness syndrome diff erentiation strategy to regulate yin and yang by interfering the nervous system and the medullary system in clinical practice.When patients with PCOS-LH are diff erentiated as a hyperactive yang syndrome,they are manifested as a depressed Ding Jiao and an irritable mood,and are mostly accompanied by symptoms such as insomnia or dry eyes.In such a case,they should be treated with debark peony root and oyster shell to calm down the Ding Jiao and spirit,and to nourish yin for suppressing hyperactive yang.When patients with PCOSLH are diff erentiated as an exuberant yin syndrome,they are manifested as a deficient Ding Jiao and a low mood,and are mostly accompanied by symptoms like mental fatigue and low voice.In such a case,they should be treated with baical skullcap root,golden thread,debark peony root,fried date kernel,unprocessed rehmannia root to fill the medulla for calming down the spirit and to nourish yin for rebalancing yang.The above treatment methods are quite effective in reducing high LH level and restoring regular menstruation in PCOS-LH patients.
作者
刘庭秀
杨靓靓
刘新敏
LIU Tingxiu;YANG Liangliang;LIU Xinmin*(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《吉林中医药》
2024年第12期1401-1405,共5页
Jilin Journal of Chinese Medicine
基金
国家自然科学基金项目(81674011)。
关键词
多囊卵巢综合征
黄体生成素
顶焦
刚柔辨证
polycystic ovary syndrome
luteinizing hormone
Ding Jiao
syndrome differentiation of rigidity and gentleness