中医药治疗痰湿型多囊卵巢综合征的研究进展

doi:10.12280/gjszjk.20240557

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovary syndrome，PCOS）是一种好发于青春期及育龄期女性的妇科常见内分泌疾病，以持续性无排卵、卵巢多囊样改变、高雄激素血症（hyperandrogenism，HA）及胰岛素抵抗（insulin resistance，IR）等为主要病理特征。中医发现痰湿型PCOS患者占比大，且“痰湿”与患者肥胖、性激素水平异常及代谢紊乱密切相关，是关键的致病因素。与非痰湿型PCOS患者相比，痰湿型PCOS患者肥胖程度、空腹胰岛素水平、IR指数及游离睾酮指数更高，糖脂代谢障碍及性激素水平紊乱显著，易患亚临床性甲状腺功能减退症及高尿酸血症等代谢性疾病。中医治疗痰湿型PCOS已获得显著的临床疗效。其中，辨证治疗包括补肾化痰法、健脾祛湿法、清肝除湿法、化痰祛湿法等，辨证论治疗效显著。针灸可降低体质量、调整内分泌，改善糖脂代谢，提高排卵率和妊娠率。调整饮食习惯和运动也是重要的非药物治疗手段，可有效改善症状。但可能由于大多中医治疗方案缺乏高级别循证医学证据，缺乏深入基础研究，未来需进一步探索痰湿与PCOS的生物学机制，实现中西医结合优势。

关键词: 多囊卵巢综合征, 痰湿, 辨证论治, 针灸疗法, 内分泌特征

Abstract:

Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder that is more common in women of puberty and childbearing age. The main pathological features of PCOS include persistent anovulation, polycystic ovary changes, hyperandrogenism (HA), and insulin resistance (IR). Traditional Chinese medicine has found that the patients with Dampness Phlegm type PCOS account for a large proportion, and that “Dampness Phlegm” as a key pathogenic factor is closely related to obesity, abnormal sex hormone levels and metabolic disorders. Compared with non-Dampness Phlegm type PCOS patients, Dampness Phlegm type patients have higher obesity level, fasting insulin level, IR index, free testosterone index, significant glucose and lipid metabolism disorders, and sex hormone level disorders. Dampness Phlegm type patients are also prone to subclinical hypothyroidism and hyperuricemia, as well as other metabolic diseases. Traditional Chinese medicine has achieved significant efficacy in treating Dampness Phlegm type PCOS. The dialectical treatment includes tonifying the kidney and resolving phlegm, strengthening the spleen and eliminating dampness, clearing the liver and eliminating dampness, resolving phlegm and eliminating dampness, etc. The therapeutic effect of dialectical treatment is significant. Acupuncture and moxibustion can reduce body mass, adjust endocrine, improve glucose and lipid metabolism, and increase ovulation rate and pregnancy rate. Adjusting dietary habits and exercise are also important non-pharmacological treatments that can effectively improve symptoms. However, due to the lack of high-level evidence-based medicine and in-depth basic research in most traditional Chinese medicine treatment plans, further exploration of the biological mechanisms of Dampness Phlegm and PCOS is needed in the future to achieve the tangible advantages of the combined treatment with traditional Chinese and Western medicine.

Key words: Polycystic ovary syndrome, Dampness phlegm syndrome, Treatment based on syndrome differentiation, Acupuncture moxibustion therapy, Endocrine characteristics

卢凤娟, 王宇, 丛晶, 刘洋, 石百超, 关木馨, 张蓓, 吴效科. 中医药治疗痰湿型多囊卵巢综合征的研究进展[J]. 国际生殖健康/计划生育杂志, 2025, 44(2): 161-165.

LU Feng-juan, WANG Yu, CONG Jing, LIU Yang, SHI Bai-chao, GUAN Mu-xin, ZHANG Bei, WU Xiao-ke. Research Progress on the Treatment of Dampness Phlegm Type Polycystic Ovary Syndrome with Traditional Chinese Medicine[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(2): 161-165.

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