1、Polycystic Ovarian Syndrome (PCOS) Treatment guidelines with chinese medicine 多囊卵巢综合征中医治疗指南,2016级科硕一班 袁榕澧 米婧 柴少竹 段颖,subject,PCOS outline,polycystic ovary syndrome(多囊卵巢综合征)Polycystic Ovarian Syndrome is the characteristic lesion which has a Kaohsiung hormones,ovulatory dysfunction and polycystic ovar
2、y.such as menstrual disorder infertility,hirsutism,obesity，etc.The disease involves multiple systems，and it is complex for clinical diagnosis and treatment.In the ancient literature of TCM disease had not described in Polycystic Ovary Syndrome,that mainly according to clinical manifestations.It can
3、be attributed to be on the treatment of hypomenorrhea,amenorrhea infertility, menstrual period etc.In recent years, the disease of Chinese medicine treatments is gradually highlight its advantages，which can fundamentally relieve the patient pain.多囊卵巢综合征是一种高雄激素血症、排卵障碍及多囊卵巢为特征的病变。临证多见月经失调、不孕、肥胖、多毛等症。中
4、医古代文献中并无多囊卵巢综合征病名,主要根据其临床表现予以论治,可归于月经过少、月经后期、闭经、不孕症等范畴。近些年中医药对该病的治疗逐渐凸显其优势,可从根本上缓解病患痛。,Etiology and pathogenesis analysis 病因病机分析,Among 209 articles, 141 articles believe PCOS is related to kidney deficiency; 11 articles believe it s related to spleen among which 9 believe it s due to spleen deficien
5、cy; 22 articles beieve its related to spleen and kidney deficiency; 39 articles believe its related to liver; Pathological factors:130 articles believe its occurrence is related to phlegm; 77 articles believe its related to blood stasis; 1 articles believes its related to phlegm-heat. 从病因病机学分析的209篇文
6、章中看，有141篇文章认为多囊卵巢综合征与肾虚关系密切； 有11篇认为脾脏有关，其中9篇认为脾虚所致； 有22篇认为与脾肾相关，即脾肾两虚。 有39篇(占18.66%)认为与肝脏有关。 从病理因素上看，有130篇认为与痰有关；有77篇认为与血瘀有关；有1篇则认为与郁热有关。,Medication analysis 常用药物分析,The common yang reinforcing medicines are semen cuscutae, herba epimedii, velvet antler,radix morindae officinalis, rhizoma curculigini
7、s,psoralens,cistanche, eucommia ulmoides, radix dipsaci, placenta hominis, etc. 补阳药:菟丝子、淫羊藿、鹿角胶、鹿角霜、巴戟天、仙茅、补骨脂、肉苁蓉、杜仲、续断、紫河车等 The common qi reinforcing medicines are codonopsis, astragalus, actractylodes macrocephala, yam, licorice. 补气药:党参、黄芪、白术、山药、甘草等； The common blood reinforcing medicine are ange
8、lica, prepared radix rehmanniae, radices paeoniae alba, polygonum multiflorum, etc. 补血药:当归、熟地、白芍、何首乌等； The common yin reinforcing medicine are medlar, fructus ligustri lucidi, herba celiptae, etc. 补阴药:枸杞子、女贞子、旱莲草等；,Medication analysis 常用药物分析,medicine for promoting blood circulation and removing bloo
9、d stasis including ligustrazin, radixcurcumae, red sage root, peach seed, safflower, motherwort, radix achyranthis bidentatae, caulis spatholobi, pangolin, herba lycopi, etc. 活血化瘀药:川芎、丹参、郁金、桃仁、红花、益母草、牛膝、穿山甲、鸡血藤、泽兰等； medicine for relieving fever, including prunella, fructus gardeniae,radix Scutellari
10、ae, root of rehmannia, cortex moutan, radix paeoniae alba,anemarrhena asphodeloides, etc. 清热药:夏枯草、栀子、黄芩、生地、丹皮、赤芍、知母等； medicine for regulating qi ,including dried tangerine peel, rhizoma cyperi, fructus aurantii immaturus, etc. 理气药:陈皮、香附、枳实等；,Medication analysis 常用药物分析,medicine for removing phlegm, i
11、ncluding pinellia ternata,arisaema cum bile, spina gleditsiae, caladium, semen brassicae,etc. 化痰药:半夏、胆南星、阜角刺、贝母、白芥子等； medicine for clearing dampness and promoting diuresis, including tuckahoe, rhizoma alismatis, plantain seeds, semen coicis, etc. 利水渗湿药:茯苓、泽泻、车前子、薏苡仁等； These six kinds of medicine mak
12、e up 81. 63% of the total medicine used. 此六种在用药中所占比例（累计频率）达81.63%。,Cluster analysis of medicine 聚类方分析,CI prescription: radix bupleuri, prunella C1方：柴胡、夏枯草。 C2 prescription: arisaema cum bile, fructus aurantii immaturus, pangolin,rhizoma curculiginis, rhizoma cyperi, red sage root, radix paeoniae alb
13、a,motherwort, cortex moutan, root of rehmannia, plantain seeds, radices paeoniae alba, rhizoma alismatis C2方：胆南星、枳实、穿山甲、仙茅、香附、丹参、赤芍、益母草、丹皮、生地、车前子、白芍泽泻。 C3 prescription: yam, codonopsis, licorice, medlar, radix achyranthis bidentatae, tuckahoe, peach seed。 C3方：山药、党参、甘草、枸杞子、牛膝、获苓、桃仁。,Cluster analysis
14、of medicine 聚类方分析,C4 prescription: actractylodes macrocephala, astragalus, acorus gramineus soland, atractylodes rhizome, psoralens, pinellia ternata, dried tangerine peel, spina gleditsiae。 C4方：白术、黄芪、石菖蒲、苍术、补骨脂、半夏、陈皮、皂角刺。 C5 prescription: radix dipsaci, caulis spatholobi, fructus ligustri lucidi, v
15、elvet antler, eucommia ulmoides, semen cuscutae, istanche, herba epimedii, radix morindae officinalis, angelica, amethyst, prepared radix rehmanniae, safflower, ligustrazin. C5方：续断、女贞子、鸡血藤、鹿茸、杜仲、冤丝子、肉灰蓉、淫羊藿、巴戟天、当归、紫石英、熟地黄、红花、川芎。,conclusion 结论,(1) Kidney deficiency, blood stasis and phlegm are the ba
16、sic pathogenesis of PCOS. 肾虚血瘀痰浊是PCOS的基本病机。 (2) PCOS medicines are generally tonics and medicine for promoting blood circulation and removing stasis. PCOS治疗用药以补虚药、活血化瘀药味为主导。 (3) According to the medicine theory and clinical knowledge, the author clusters the medicine into 5 groups and summarizes the
17、 basic prescription for various PCOS types: liver qi stagnation; kidney deficiency, dampness and blood stasis; spleen and kidney yang deficiency and blood stasis; spleen and kidney yang deficiency and phlegm and dampness stagnation; kidney deficiency and blood stasis.,conclusion 结论,(3)PCOS治疗用药以补虚药、活血化瘀药味为主导。依据药性理论和临床专业知识，聚为个聚类组合体，分别用于治疗多囊卵巢综合征各证型的基础方：肝气郁结型；肾虚痰湿血疲型；脾肾阳虚、疲血内阻型；脾肾阳虚、疲湿阻滞型；肾虚血瘀证。,Thank You !,2016.12.06,()/,
