【作者】 王玉娜；

【导师】 侯丽辉；

【作者基本信息】 黑龙江中医药大学 ， 中医妇科学， 2010， 硕士

【摘要】 目的:运用文献研究和统计学分析相结合的方法,以补肾化痰活血法治疗PCOS的现代中医文献为研究对象进行系统研究,分析探索补肾化痰活血法治疗PCOS的“理法方药”等中医证候治疗规律。为中医治疗PCOS规范化提供理论支持。方法:通过检索分析近10年补肾化痰活血法治疗PCOS的现代中医文献,建立补肾化痰活血法治疗PCOS“理法方药”资料数据库,运用统计学软件的帮助,对近10年文献中补肾化痰活血法治疗PCOS的病因病机和证治理论、治法的确立、方药的配伍等规律进行研究。分析研究现代医家对补肾化痰活血法治疗PCOS病因病机的认识及用药特色,建立补肾化痰活血法治疗PCOS病因病机、证治方药数据库,并对现代中医治疗PCOS之高频药物进行分析和整理,并分析其使用规律,从中探索补肾化痰活血法治疗PCOS的基本方药。从整体上把握补肾化痰活血法在PCOS中的应用,为今后临床和科研提供明确的药物和方剂依据。结果:检索有效文献到91篇,结合文献研究和相关中医理论,得到以下结果:病因分析:肾虚(91次,100%)、血瘀(75次,86.2%)、痰湿(68次,78.16%)、脾虚(39次,42.86%)为主;治法分析以补肾(91次,100%)、活血(78次,85.71%)、化痰(69次,75.82%)、健脾(37次,40.66%)为主;症状:月经迟发(213例,19.07 %)、不孕(280例,25.07 %)、肥胖(163例,14.59 %)为常见;高频药物:菟丝子(74,64.35%)、当归(66,57.39%)、仙灵脾(57,49.57%)、熟地(56,48.70%)、茯苓(43,37.39%)。结论:(1)本研究表明PCOS以肾虚、血瘀、痰湿三者为基本病因,其中以肾虚为根本病机(阳虚为主),痰瘀互结为标,属虚实夹杂之证。病变脏腑涉及肾、脾、肝三脏。(2)补肾化痰活血法是治疗以肾虚为本、痰瘀互结为标PCOS的治疗大法,与导师侯丽辉教授的“痰瘀胞宫”理论基本一致。(3)本研究发现以补肾化痰活血大法治疗的PCOS患者,以月经迟发、不孕、肥胖、腰膝酸软、经色淡暗、舌有瘀点,脉滑为主要症状。(4)通过对应用补肾化痰活血法治疗PCOS临床常用药物的数据频次分析得出:高频次序依次为补虚类、活血化瘀类、化痰利湿类。补虚类高频药物为菟丝子、当归、仙灵脾、熟地、巴戟天;活血化瘀类高频药物为川芎、丹参、赤芍、桃仁、丹皮、牛膝、红花、益母草;化痰利湿类高频药物为茯苓、半夏、胆南星、皂刺、苍术。(5)“痰瘀胞宫”代表了PCOS的一种主要的或者是基础的病理机制,但不能囊括其发病过程中所有的病理状态,在诊治PCOS的过程中注意与体质观、整体观结合。更多还原

【Abstract】 Objective: Literature research and statistical analysis using the combination approach to treatment of PCOS with invigorate the kidney promoting blood flow eliminate sputum modern Chinese literature as a systematic study research, analysis exploration of invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS " etiopathogenisis, pathogenesis ,formulas and herbs" and so on TCM Designate treatment law. To provide theoretical support for PCOS Treatment standardization of Chinese medicineMethods: Analysis of the past 10 years by searching invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS in modern Chinese literature, the establishment of invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS " etiopathogenisis,pathogenesis,formulas and herbs " database, using statistical software to help in the literature in recent 10 years, invigorate the kidney promoting blood flow eliminate sputum for Treatment of gynecological diseases, the cause of disease and its treatment theory, the rule law, the prescription to study the compatibility of such laws. Analysis of the modern physician invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS understanding pathogenesis and drug characteristics, the establishment of invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS pathogenesis, syndrome and treatment prescription database, and Modern Chinese Medicine PCOS high frequency of drug analyze and organize, and analyze the use of the law, from which to explore invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS in the basic recipe. from the whole to grasp the application of invigorate the kidney promoting blood flow eliminate sputum in PCOS for future clinical and scientific research to provide a clear basis for drugs and prescriptions. Result: Effective literature retrieval to 91, combined with traditional Chinese medicine theory and related literature, the following findings: etiological factor: renal deficiency (91, 100%), blood stagnation (75, 86.2%), phlegmatic hygrosis (68, 78.16%), splenic asthenia (39, 42.86%), mainly; treatment method: invigorate the kidney (91, 100%), promoting blood flow (78, 85.71%), eliminate sputum (69, 75.82%), invigorate the spleen (37 time, 40.66%) dominated; dominated symptoms:delayed menstruation(213 times,19.07%), infertility (280 times,25.07%), obesity (163 times,14.59%) were common; high frequency of drug: dodder seed( 74,64.35%) , Chinese angelica root(66,57.39%),Epimedium Herb(57,49.57%),Prepared Rehmannia Root(56, 48.70%),Poria(43,37.39%).Conclution: (1) This research shows that PCOS to kidney deficiency, blood stasis, phlegm three basic causes, of which the fundamental pathogenesis of kidney (Yang mainly), phlegm became standard, the evidence is false is mixed . lesions involving organs kidney, spleen, liver and three dirty. (2) invigorate the kidney promoting blood flow eliminate sputum is standard treatment for PCOS of kidney deficiency, blood stasis phlegm, and which is basically the same theory to mentor Professor Hou Lihui of " phlegmatic hygrosis and stagnation of blood uterus ".(3) The study found invigorate the kidney promoting blood flow eliminate sputum treatment of PCOS patients to delayed menstruation, infertility, obesity, weak waist, by dark pale tongue with blood spots, slippery pulse was The main symptoms. (4) the application by invigorate the kidney promoting blood flow eliminate sputum for Treatment of PCOS commonly used drugs, the clinical data obtained frequency analysis: high-frequency sequence followed by tonic type, blood circulation category, phlegm dampness class. Buxu class HF drugs Semen, Angelica, Epimedium, Rehmannia, Morinda officinalis; blood circulation category for the high frequency of drug chuanxiong, red sage root, red peony root, peach kernel, paeonol, Achyranthes, flowers, Leonurus; phlegm dampness type high-frequency drugs Poria, Pinellia, gall Southern Star, soap thorn, herb. (5) " phlegmatic hygrosis and stagnation of blood uterus " PCOS represents a major (base) pathology, but can not cover all of its pathogenesis pathological state, in the process of diagnosis and treatment of PCOS, attention and physical outlook, combined with the overall concept .更多还原