Syndrome differentiation and treatment is the essence of TCM. For the same disease, due to different pathogenic factors, the time and place of occurrence and the individual's response to the pathogenic factors are different, or different syndromes are shown due to different stages of disease development.
Since the onset of polycystic ovary syndrome is multi-factorial, the clinical manifestations are polymorphic, which provides a broad space for TCM syndrome differentiation and treatment.
Hyperandrogenemia and hyperinsulinemia are one of the main pathophysiological features of polycystic ovary syndrome, and it is generally believed that the occurrence of polycystic ovary syndrome is related to metabolic dysfunction.
Chinese medicine believes that "Qi" is the basic substance that constitutes the human body and maintains life activities. It has the functions of promoting warming, defense, and gasification. Qi originates from two aspects: congenital qi and acquired qi.
Congenital qi is received from parents, qi transforms into essence, and is stored in the kidneys: Acquired qi comes from diet, water and grain, self-cultivation and exercise, exhaling the old and absorbing the new, mainly depends on the strengthening of the spleen, and transforms into qi under the action of raising the clear and lowering the turbidity blood body fluid.
Therefore, there are sayings that "the spleen is the foundation of acquired constitution" and "the source of Qi and blood biochemistry". The innate qi is the body of qi, and the acquired qi is the function of qi.
Acquired qi obtained from innate qi will be endlessly alive, and innate qi obtained from acquired qi will be endlessly transformed. It can be seen that whether the function of the spleen and stomach is healthy or not is of great significance to the production of qi, blood and body fluid.
And women's menstruation must be able to overflow on time under the condition of full blood.
"Jingyue Quanshu Women's Regulations" says: "Menjing water is the essence of water and grain, and all its sources come from the spleen to generate and transform." Zhang Jingyue believes that there are three roots of menstruation: from the Chongmai, from the stomach, and from the heart and spleen The Chongmai is the foundation of menstruation, the stomach qi is the foundation of the Chongmai, and the heart and spleen are the foundation of the biochemical commander's blood.
"Gynecology Summary" said: "Blood, the essence of water and grain, harmonizes the five internal organs, sprinkles Chen and six internal organs, and turns into essence in men, milk on the top and moon water on the bottom." "Good Prescription" puts forward in terms of treatment that "but to help the stomach strengthen the Qi, the blood will be produced and the menstrual flow will be spontaneous", so the root of menstruation lies in the spleen and stomach. Healthy temper can continuously convert the essence of water and grain into qi and blood, nourish and nourish the chongren, so that the chongren qi and blood are vigorous, and the sea of blood overflows on time; a series of incentives such as excessive thinking, injury from diet, and unsuitable daily life are intervened. Injury to the temper, spleen failure, affects the biochemistry of Qi, causing Qi to gather and not disperse, and Qi gathers to affect the transformation of water and grain essence into Qi, blood and body fluid. Chong Ren emptiness, the sea of blood cannot overflow, and the moon water metabolizes and produces no source: one phlegm and fluid block the cell veins, causing the menstrual period to fail.
Insulin plays an important role in the metabolism of the body, and hyperinsulinemia is one of the pathophysiological characteristics of polycystic ovary syndrome. According to traditional Chinese medicine, the spleen is an important viscera involved in the metabolism of the body. Unhealthy luck related.
The clinical manifestations of patients with polycystic ovary syndrome with hyperinsulinemia are mainly characterized by spleen deficiency syndrome.
Under the premise of syndrome differentiation and treatment, the patients with polycystic ovary syndrome of spleen deficiency syndrome were treated with prescriptions for invigorating spleen and replenishing qi, and the symptoms of insulin resistance were significantly reduced, indicating that patients with polycystic ovary syndrome of spleen deficiency syndrome were related to hyperinsulinemia.
According to the theory of "Internal Classics", the kidney is the root of menstrual water and plays a vital role in menstruation. Moon water is not blood, but it comes from blood; qi is yang, blood is yin: Zhu Danxi, the representative of the Yin-nourishing School of the Four Great Masters of the Jin and Yuan Dynasties, put forward the theory of "the excess of yang and the deficiency of yin". Today's pace of life is accelerating, social competition is fierce, and work pressure is generally increasing. "If you know what is difficult to lose, you can supply it" ("Ge Zhi Yu Lun") Zhang Jingyue's "Lei Jing Tu Yi" said: " Today's people's diseases are yin deficiency, eight or nine out of ten." "A deficiency of fire is a disease, and six or seven of ten are common... Those with a deficiency of fire are also suffering from deficiency of true yin." "Water deficiency of its source is a disease of yin deficiency. stack out"
Many patients with polycystic ovary syndrome have deficiency of kidney yin, deficiency of fire and calm movement as the main clinical manifestations, such as dysphoria and fever, dry mouth and drinking, dry stool, flushed face, red tongue with less moss, etc. In patients with polycystic ovary syndrome, yin deficiency is the foundation and fire is the standard. The more yin deficiency, the more vigorous the fire, and the more prosperous the fire, the more yin deficiency. Such a cycle will make the condition worse. Only nourishing yin and reducing fire can be used together. Then yin can replenish and fire can fall.
The representative prescription of Zhu Danxi for nourishing yin and reducing fire recorded in "Danxi Xinfa·Buicuimen"--Dabuwan (also known as Dabuyinwan) is used to reduce yinfire and tonify kidney water. Mainly to reduce fire, supplemented by nourishing yin, that is, "replenishing with diarrhea"
Clinically, in many patients with polycystic ovary syndrome, there are a series of changes such as abnormal increase of androgen, abnormal prolactin, and some hyperinsulinemia. Due to the low adjustment ability of the body, many substances exceed the physiological needs, and metabolic hyperactivity Hyperandrogenism, deficiency of Yin fluid; in patients with hyperandrogenism and polycystic ovary syndrome, the increase in androgen is related to excessive metabolism. , the syndrome of deficiency of yang rising and deficiency of fire.
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At the same time, it is also proved that the traditional Chinese medicine prescription for nourishing yin and reducing fire can reduce hyperandrogenism in patients with polycystic ovary syndrome of kidney yin deficiency syndrome.
