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刘宇新教授治疗多囊卵巢综合征的临床经验总结

【作者】 杨旭

【导师】 刘宇新;

【作者基本信息】 辽宁中医药大学 , 中医妇科学, 2011, 硕士

【摘要】 多囊卵巢综合征是临床妇科疾病中的常见病与多发病。以持续性无排卵、雄激素过多和胰岛素抵抗为主要特征。临床表现为月经失调、不孕、多毛、痤疮及肥胖、黑棘皮等,多起病于青春期[1]。其病因现代医学研究并不明确,一般认为与以下因素有关:下丘脑-垂体功能障碍、肾上腺皮质功能异常、胰岛素抵抗与高胰岛素血症、卵巢局部自分泌旁分泌调控机制失常、遗传因素及高泌乳素血症。治疗上主要对症调整月经周期或对于生育期无排卵者行促排卵治疗。中医本病属月经后期、月经量少、闭经、不孕等范畴,历代医家多有描述。现代医家多认为“痰浊壅于胞宫”为本病的病理基础,治疗方法多样化。吾师刘宇新教授师承国家名老中医王文彦教授,从事妇产科工作近40载,博采众长,对妇科疾病有很深造诣,擅长中西医结合治疗妇科疾病。在多年临床中,其对PCOS积累了丰富的经验,总结出一套有效的中西医结合治疗方案。笔者在随师出诊过程中,刻苦钻研,对导师治疗PCOS从病因病机、治法、方药方面进行了经验总结。导师认为PCOS的基本病机是以脾肾阳虚为本,其中以肾阳虚为主,痰瘀互结为标。由于脾肾阳虚导致了体内水液代谢异常,痰瘀生成,壅塞胞宫,而导致月经后期、闭经、不孕等疾病的发生。治疗上以温阳化湿为大法,自拟方剂温阳化湿消囊汤,取得明显疗效。

【Abstract】 Polycystic ovarian syndrome (PCOS) is gynecology department clinical common disease and frequently-occurring disease in gynecology. Principal characters are menstrual disorder、infertility、hairiness、acne and obesity、acanthosis nigricans. It is common at puberty. Modern medicine hasn′t got a clear etiology about PCOS. It is generally acknowledged that which is connected with following factors: hypothalamus-pituitary body dysfunction、the adrenal cortex dysfunction、insulin resistance and hyperinsulinemia、autocrine and paracrine regulation mechanism of the part of the ovaries dysfunction、heredity and hyperprolactinemia.The main therapies of this disease is regulating menstruation and giving presses the ovulation treatment.It belongs to hypomenorrhea, delayed menorrhea, amenorrhea, infertility and so on in the view of TCM. In the history, many famous doctors have described them. Most modern medical practitioners think that“sputum accumulates in the uterus”is the pathological basis of this disease and the therapies are diversified. My mentor professor Liu Yuxin who was taught by Wang wenyan, has high attainments in gynecology. He has worked on gynecology for nearly 40 years, absorbing, excelling in treating diseases with the methods of combined traditional Chinese medicine and western medicine. He has accumulated rich experience in practice in these years and summarized effective treatment. The writer studied assiduously during the last one year, and summarized her teacher′s experience in respect of the etiology and pathogenesis, the treatment and prescriptions and herbs. My teacher′s viewpoint is that: the base pathogens of PCOS is deficiency of Yang in the spleen and kidney, kidney yang deficiency as major point , Phlegm accumulating with blood stasis in the tip. The organism will come to water metabolism abnormal ,then phlegm accumulating with blood stasis is produced, uterus is obstructed.These will lead to menstrual disorder、amenorrhea and infertility as a result of deficiency of Yang in the spleen and kidney. In therapy, my mentor professor Liu Yuxin has gained satisfying effect,with the methods of Warming Yang to resolving wetness, applying self-made Wenyang huashixiaonang Tang.

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