Polycystic ovary syndrome (PCOS) is a syndrome characterized by chronic anovulation, amenorrhea or scanty menstruation, infertility, obesity, hirsutism and polycystic enlargement of the ovaries. Polycystic ovary syndrome is very harmful to women and can lead to infertility in severe cases. Chinese medicine has special advantages in the treatment of polycystic ovary syndrome, and Chinese medicine is very effective in the treatment of this disease. This textbook is a good contribution to the combined diagnosis and treatment of PCOS by Chinese and Western medicine.
I. Advantages of Chinese medicine in the treatment of polycystic ovary syndrome (PCOS)
At present, the treatment of PCOS by Chinese and Western medicine has become a trend, and Chinese medicine has the following advantages.
1. kidney tonics and blood activators can reduce insulin and androgen levels and improve ovarian microcirculation.
2, kidney tonics can regulate the sexual reproductive axis.
3. kidney tonics can overcome the side effects of insufficient estrogen secretion caused by clomiphene and improve the endometrial tolerance to embryos.
4. Kidney yang tonics can improve luteal function and facilitate early pregnancy.
Second, Chinese medicine recognizes the pathogenesis and treatment principles of PCOS
The Chinese medicine recognizes PCOS, and believes that its symptoms are mixed with deficiency, kidney deficiency, liver fire, “phlegm”, “stasis” as the main pathogenesis. The kidney Yang deficiency phlegm and dampness evidence is more, this type of PCOS treatment principle is to nourish the kidney, warm Yang and resolve phlegm. Some patients are identified as Yin deficiency and blood stasis, the principle of treatment for this type of PCOS is to nourish Yin and clear heat, activate blood and remove blood stasis.
Third, Chinese medicine ideas
In the past, obesity and hairiness were thought to be the result of kidney yang deficiency which could not transpire fluid to form phlegm and dampness, as the ancient saying goes, “fat people have more phlegm and dampness, thin people have more yin deficiency”. After that, some people proposed the method of nourishing Yin and lowering fire. The reasons are as follows.
1, the body is manifested as a hyperfunctional state: the examination of PCOS can be seen in high LH, high T, high INS, high blood sugar, hirsutism, acne, acanthosis nigricans, polycystic ovaries and other manifestations.
2, nourishing Yin and lowering fire medicine can regulate the gonadal axis and inhibit hyperactivity.
3, high insulin obese type has the tendency to develop into diabetes mellitus, the patient is obese, but a school of Yin deficiency internal heat symptoms, nourishing Yin and clearing heat method in line with the Chinese medicine thirst treatment.
With the gradual improvement of understanding, the identification of PCOS typing more diversified: 1.
1, kidney deficiency phlegm-dampness should be the main type of evidence.
2, Yin deficiency, internal heat and blood stasis are mostly seen in insulin resistance. Such patients have high insulin levels and are not sensitive to clomiphene. After 3 months of nourishing Yin and clearing heat and activating blood stasis, 59. 7% showed ovulation, and most patients could show ovulation with clomiphene.
IV. Chinese herbal treatment
First diagnosis.
Treatment principle: clear heat and cool the blood, invigorate the blood and remove blood stasis. For heavy internal heat, first use Gentian-Diarrhea Liver Soup with addition and subtraction.
Supplemented with progesterone 20mg im qd*3 days
Second consultation.
After taking the medicine, the patient had menstrual flow with normal volume and color, with menstruation for 6 days, feeling warm, headache relieved, one line of stool for 2 days, still dry mouth and bitterness, no sweating, purple tongue and smooth pulse. The treatment is to nourish Yin and cool Blood, resolve blood stasis and soften hardness.
Combined with Feng Feng Tong Sheng Wan 1 bag/day
Third diagnosis.
After taking 20 pills, stool is normal, body heat is gone, sweating, and pulse is fine. Fasting insulin is high, endocrinology department gives Ventia 1 tablet/day. To reduce internal heat, nourish Yin and Blood, and slightly cool the Blood. Zuo Gui Wan with flavour.
Radix Rehmanniae 10g each, Yam 10g, Yam 20g, Fructus Lycii 20g, Tortoise Board 10g
Radix et Rhizoma Deerstalk 10g Semen Cuscutae 30g Radix Achyranthes Bidentatae 15g Radix Paeoniae Alba 10g Radix Rehmanniae 10g
Rhizoma Polygonati 20g Radix Bupleurum 10g Salviae Miltiorrhizae 10g Salviae Miltiorrhizae 20g Andrographis paniculatae 10g
The patient was pregnant in 2008.
V. Treatment experience.
The treatment of PCOS also requires evidence-based treatment according to the different characteristics of the patients themselves.
1, for patients with hyperandrogenemia, avoid using kidney tonics, or pairing with heat-clearing drugs.
2, for obesity, insulin resistance, high blood lipids, with anti-lipid and phlegm medicine: can use cassia, jiao shancha, bile south star, white mustard seeds, mountain cicada, saponaria, mother of pearl, Xia Gu Cao Cao, Fa Han Xia.
3.For those with enlarged ovaries and thick peritoneum, which inhibit ovulation, we can use: Radix Rehmanniae, Peach kernel, Safflower, Salviae Miltiorrhiza, Radix Paeoniae, Zelenia, Trigonella, Curcuma, etc. to activate blood circulation and promote ovulation.
4. For those with significantly enlarged ovaries: turtle nail, oyster, chicken naijin, etc., to soften the hardness and disperse the nodules.
5. For menstruation, amenorrhea, dull purple tongue and heavy stasis, leeches, stinging insects and penetrating beetles can be used to break the blood.
6. Di Long, San Qi, Ze Di, Ze Lan, Wang Bu Liu Xing can invigorate the blood and promote the flow of water, smooth the flow of Qi and help the discharge of eggs.