| 傅祝婧,田野,楼毅云.“以补促通”论治早发性卵巢功能不全[J].浙江中医药大学学报,2022,46(8):867-871. |
| “以补促通”论治早发性卵巢功能不全 |
| Treatment of Premature Ovarian Insufficiency by “Promoting Fluency by Supplementing” |
| DOI：10.16466/j.issn1005-5509.2022.08.010 |
| 中文关键词: 早发性卵巢功能不全 以补促通 补肾填精 健脾护胃 冲任通盛 辨证论治 |
| 英文关键词: premature ovarian insufficiency promoting fluency by supplementing tonifying the kidney and filling essence strengthening the spleen and protecting the stomach making the Chong-Ren sufficient and unobstructed treatment based on syndrome differentiation |
| 基金项目:国家自然科学基金青年基金项目(81801475)；浙江省公益技术应用研究项目(LGF22H270021)；浙江省卫生健康科技计划(2022RC232)；浙江省中医药科技计划项目(2019ZA078、2020ZA074、2022ZA111)；杭州市科技计划项目(20180533B51)；浙江省医坛新秀培养项目(浙卫办[2020]18号) |
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| 中文摘要: |
| [目的] 基于“以补促通”，探讨早发性卵巢功能不全(premature ovarian insufficiency，POI)的病因病机及中医辨证论治。[方法] 通过临床跟诊学习，收集整理相关医案，结合经典及现代文献，分析总结POI的病因病机、辨证思路及遣方用药。[结果] POI的基本病因病机可归为先天肾精不足、后天脾运不化、心肝气郁等，引起冲任亏虚及瘀堵之病理改变，治疗上主要是补肾填精，阴阳并补，重视血肉有情之品及交通心肾之法的应用；补益脾胃，以助冲任之充盈；调理心肝，佐以少量活血化瘀、祛湿化痰诸药，以确保冲任之通畅。医案所列举的POI患者证属肾虚肝郁，夹杂痰凝血瘀诸实，治疗时补通结合，通调冲任，终致经调孕成。 [结论] 中医药治疗POI以补肾健脾为主，辅以通调心肝及平和祛邪之法，以补促通，使冲任通盛，具有良好的临床疗效。 |
| 英文摘要: |
| [Objective] To explore the etiology and pathogenesis of premature ovarian insufficiency(POI) and traditional Chinese medicine(TCM) syndrome differentiation and treatment， based on “promoting fluency by supplementing”. [Methods] Through clinical study， collecting and sorting out relevant medical records， combining classical and modern literatures， the etiology， pathogenesis， syndrome differentiation and prescription medication of POI were analyzed and summarized. [Results] The basic etiology and pathogenesis of POI can be attributed to congenital insufficiency of kidney essence， acquired deficiency of spleen transport， stagnation of heart and liver Qi， etc.， which lead to the pathological changes of Chong-Ren deficiency and stasis. The treatment mainly adopts the method of tonifying the kidney and filling essence， supplementing Yin and Yang， attaching importance to the application of flesh-and-blood sentient products and the method of communicating the heart and kidney; tonifying the spleen and stomach to help Chong-Ren sufficiency; regulating the heart and liver， assisted with a small amount of herbs to promot blood circulation and remove blood stasis， dispell dampness and resolve phlegm， so as to ensure the unobstructed state of Chong-Ren. The POI patient in the medical case was characterized by kidney deficiency and liver stagnation， mixed with phlegm congealing， blood stasis and other factors， treated with method of supplement combined with promoting fluency， and finally led to menstrual adjustment and pregnancy. [Conclusion] The treatment of POI with TCM is mainly to tonify the kidney and spleen， supplemented by the methods of regulating the heart and liver and removing evil mildly， promoting fluency by supplementing to make the Chong-Ren sufficient and unobstructed， showing good clinical efficacy. |
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