【摘要】：目的:收集及整理近20年有關(guān)治療多囊卵巢綜合征(PCOS)不孕的中醫(yī)文獻(xiàn),探討現(xiàn)代醫(yī)家治療本病的主要證型、治法及其用藥規(guī)律,為優(yōu)化中醫(yī)治療本病提供理論依據(jù)。方法:搜索1996年1月至2015年12月刊登在中國知網(wǎng)、維普數(shù)據(jù)、中國萬方數(shù)據(jù)庫的關(guān)于PCOS不孕的中醫(yī)臨床研究文獻(xiàn)。對其中的證型分布、治法及藥物性味歸經(jīng)等進(jìn)行統(tǒng)計(jì)建立數(shù)據(jù)庫,采用頻數(shù)統(tǒng)計(jì)和聚類分析,總結(jié)出PCOS不孕的主要證型、治法及用藥規(guī)律。結(jié)果:經(jīng)篩選后納入符合標(biāo)準(zhǔn)文獻(xiàn)106篇,共收納病例4538例,方劑192首,中藥136味,共使用1988次。歸納總結(jié)出本病的11種中醫(yī)證型中3種較常見的為腎虛血瘀型38.8%,腎虛痰瘀型22.0%,腎虛痰濕型12.2%。13種不同的治療方法中3種較常見的為補(bǔ)腎活血法39.3%,補(bǔ)腎祛痰、化瘀通絡(luò)法18.4%,補(bǔ)腎化痰法10.8%。腎虛血瘀型高頻藥物為:當(dāng)歸、菟絲子、熟地黃、淫羊藿、丹參、枸杞子、川芎、山藥、赤芍、香附、白芍、女貞子,藥性以溫、平、微溫、微寒為主,藥味以甘、辛、苦為主,藥物歸經(jīng)以肝、腎、脾、心經(jīng)為主,聚類藥物組合為當(dāng)歸-熟地黃,附子-肉桂,紅花-桃仁,菟絲子-淫羊藿。腎虛痰瘀型高頻藥物為:當(dāng)歸、熟地黃、丹參、香附、茯苓、菟絲子、山茱萸、淫羊藿、半夏、山藥、赤芍、川芎,藥性以溫、平、微寒、微溫為主,藥味以甘、辛、苦為主,藥物歸經(jīng)以肝、腎、脾為主,聚類藥物組合為茯苓-半夏,桃仁-紅花,枸杞子-菟絲子,赤芍-白芍,山藥-山茱萸-當(dāng)歸-熟地黃-茯苓-半夏-川芎。腎虛痰濕型高頻藥物為:茯苓、菟絲子、蒼術(shù)、陳皮、淫羊藿、續(xù)斷、山藥、半夏、當(dāng)歸、川芎、熟地黃,藥性以溫、平、微溫為主,藥物歸經(jīng)以肝、腎、脾為主,藥味以辛、甘、苦為主,聚類藥物組合為陳皮-半夏,熟地黃-山茱萸-山藥,陳皮-半夏-蒼術(shù)-茯苓。結(jié)論:整理文獻(xiàn)發(fā)現(xiàn),PCOS不孕的辨證以虛實(shí)夾雜為主,多數(shù)為在腎虛的基礎(chǔ)上兼有血瘀或痰濕或痰瘀并存,其中腎虛血瘀型最常見,此外,單純實(shí)證的患者以肝經(jīng)郁熱型、痰濕內(nèi)阻型為主。治法以補(bǔ)腎活血為主,藥性以溫、平為主,藥味以味甘、辛、苦為主,歸經(jīng)以肝、腎、脾為主�？梢�,本病的病機(jī)以虛為本,治療上以補(bǔ)虛為主,兼顧活血化瘀,理氣祛痰。
[Abstract]:Objective: to collect and collate the literature on the treatment of (PCOS) sterility in polycystic ovary syndrome (PCOS) in recent 20 years, and to explore the main syndrome types, treatment methods and medication rules of modern doctors in the treatment of PCOS, so as to provide theoretical basis for optimizing the treatment of PCOS. Methods: from January 1996 to December 2015, the Chinese medicine clinical research literature on PCOS sterility published on China knowledge Network, Weipu data and China Wanfang Database was searched. The distribution of syndrome types, treatment methods and drug flavor meridians were statistically established. The main syndrome types, treatment methods and drug use rules of PCOS sterility were summarized by frequency statistics and cluster analysis. Results: after screening, 106 articles in accordance with the standard were included. A total of 4538 cases, 192 prescriptions and 136 traditional Chinese medicines were collected. A total of 1988 times were used. Three of the 11 TCM syndromes of the disease were kidney deficiency and blood stasis type 38.8%, kidney deficiency phlegm stasis type 22.0%, kidney deficiency phlegm dampness type 12.2%. Among the 13 different treatment methods, the common treatment methods were tonifying kidney and activating blood circulation (39.3%), tonifying kidney and dispelling phlegm, removing blood stasis and dredging collaterals (18.4%) and tonifying kidney and removing phlegm (10.8%). The high frequency drugs of kidney deficiency and blood stasis type were Angelica sinensis, Cuscuta chinensis, Rehmannia glutinosa, Herba Epimedii, Salvia miltiorrhiza, Lycium barbarum, Ligusticum chuanxiong, Yam, Radix Paeoniae Rubra, Xiangfu, Paeonia lactiflora, Ligustrum lucidum, warm, flat, slightly warm, slightly cold, Gan, Xin and bitter, the drugs were mainly liver, kidney, spleen, heart meridians, and cluster drugs were Angelica-cooked Rehmannia glutinosa, aconite cinnamon, safflower peach kernel, dodder seed-Epimedium. The high frequency drugs of kidney deficiency and phlegm stasis type are: Angelica sinensis, Rehmannia glutinosa, Salvia miltiorrhiza, Xiangfu, Poria, dodder, Cornus officinalis, Herba Epimedii, Pinellia ternata, Chinese yam, Radix Paeoniae Rubra, Ligusticum chuanxiong, mainly warm, flat, slightly cold, slightly warm, Gan, Xin, bitter, drugs classified as liver, kidney, spleen, Poria paniculata, peach kernel safflower, Lycium barbarum Cuscuta, Radix Paeonia lactiflora, Radix Paeonia lactiflora, Yam, Cornus officinalis, Angelica sinensis, Rehmannia glutinosa, Poria, Pinellia ternata and Ligusticum chuanxiong. Kidney deficiency phlegm dampness type of high frequency drugs are: Poria, dodder, Atractylodes macrocephala, Herba Epimedii, Dioscorea opposita, Pinellia ternata, Angelica sinensis, Ligusticum chuanxiong, Rehmannia glutinosa, mainly warm, flat, slightly warm, drugs mainly belong to liver, kidney, spleen, medicine flavor is mainly Xin, sweet, bitter, cluster drug combination is Chenpi-Pinellia ternata, Rehmannia officinalis-Cornus officinalis-yam, Chen Pei-Pinellia ternata-Atractylodes macrocephala-Poria. Conclusion: it is found that the syndrome differentiation of PCOS sterility is mainly due to deficiency and excess, most of which have blood stasis or phlegm dampness or phlegm stasis on the basis of kidney deficiency, among which kidney deficiency and blood stasis type is the most common. In addition, the simple empirical patients are liver meridians stagnation heat type and phlegm dampness internal obstruction type. The treatment is mainly to tonify the kidney and activate blood, the medicine is warm and flat, the taste of medicine is sweet, Xin, bitter, and the meridians are mainly liver, kidney and spleen. It can be seen that the pathogenesis of this disease is based on deficiency, the treatment is mainly based on tonifying deficiency, taking into account promoting blood circulation and removing blood stasis, regulating qi and dispelling phlegm.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R271.9

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