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全生妇科十讲5: 多囊卵巢综合征(10/10/2011)

多囊卵巢综合征(PCOS)是育龄期女性最常见的内分泌紊乱性疾病和生殖功能障碍性疾病,好发于20~30岁的育龄期妇女,其发病率占育龄妇女的 5%-10%。其发病原因可能与下面三个因素有关: 垂体促性腺激素的分泌失调、卵巢类固醇生成所需酶系统的功能缺陷和肾上腺皮质功能紊乱。
 
近几年的研究已广泛认识到多囊卵巢综合征的妇女存在不同程度的胰岛素抵抗,且胰岛素抵抗伴发高胰岛素血症引起许多临床症状,如雄激素水平过高、生殖紊乱、代谢紊乱、痤疮、多毛等。后天的环境因素,如学业压力、情感问题、营养过剩等,也容易导致卵巢的功能失调。
 
多囊卵巢综合征的主要病理变化是排卵障碍和雄激素增高,其主要症状和表现是:闭经或月经稀少、不孕、多毛、肥胖、痤疮、以及双侧卵巢增大。激素测定显示LH与FSH失常,FSH(促卵泡生成素)处于低水平,LH(促黄体生成素)偏高,形成LH/FSH≥2~3,雄激素(T)水平增高。
 
中医学虽无多囊卵巢综合症这一病名,但根据其症状表现与“月经失调”、“闭经”、“不孕”、“癥瘕”等有相似之处。其病因病机主要涉及肾虚、痰湿、血瘀、湿热。但冲任不足,肾虚痰湿为发病关键,故补肾化痰为其治疗的基本原则。
 
北京中医药大学名老中医程士德教授,全国百名名老中医之一,积70余年临床经验,对关节痹痛、咳嗽、胃脘痛、闭经、、不孕不育、失眠、抑郁等精神情志失调性疾病和过敏性疾病等疑难杂证有丰富的理论和经验。作者跟随程老坐诊时,采用健脾化湿、活血化瘀、清热化痰、补益肝肾等法辩证治疗多囊卵巢综合症,效果良好。
 
中药、针灸或中药加针灸联合治疗多囊卵巢综合症,均能取得良好的治疗效果。在治疗上,若根据月经周期分段施治,效果更好。比如,经后期以滋阴补肾为主,以促卵泡发育;两次月经期间以滋肾活血为主,以促卵泡排出;经前期以温补肾阳为主,以促黄体功能; 行经期以活血通经为主,以利经血正常排出。但临床上需根据患者的不同症状和病因病机,辩证治疗。
 
对多囊卵巢综合症患者而言,控制体重、改变生活方式也是非常必要的辅助治疗。患者在治疗的同时,需养成良好的生活起居习惯,如饮食清淡,多吃蔬菜、水果,适量运动,每天保持8小时的睡眠,放松心情,保持积极的心态,才能使治疗达到理想效果。
 
下期敬请关注全生妇科十讲6: 功能性子宫出血. 更多全生讲中医, 敬请访问卢全生中西医结合博士的网站www.wholelifeherb.com,或直接拨打中文热线电话301-340-7682,301-919-9898约诊. 全生中医针灸医疗中心地址:  416 Hungerford Dr, Suite 215, Rockville, MD 20850. 或 9801 Georgia Ave, Suite 337, Silver Spring, MD 20902
 

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