摘要
经前期综合征(PMS)及其严重类型经前烦躁障碍症(PMDD)是育龄期女性常见疾病,严重困扰女性正常生活,日益受到人们重视。中医认为PMS/PMDD核心病机为肝失疏泄,同时与冲任二脉失调密切相关。文章基于冲任二脉的循行及脏腑关系,以及中医肾-天癸-冲任-胞宫生殖轴与西医学下丘脑-垂体-卵巢(HPO)轴的功能对应关系,揭示冲任失调与HPO轴激素节律紊乱、负反馈异常等机制在PMS/PMDD发病中的作用。冲任气血的周期性骤变可导致肝、脾、肾功能失调,进而引发经前情绪及躯体症状;而HPO轴性激素波动通过影响神经递质及中枢反应性,加剧经前相关症状。中医药通过多靶点调节冲任和HPO轴功能,可改善黄体功能及内分泌状态,可为临床治疗提供新思路。通过整合中西医理论,深化中医肝藏象理论的现代科学内涵,为PMS/PMDD的机制研究与诊疗实践架设桥梁。
Premenstrual syndrome(PMS)and its severe type,premenstrual dysphoric disorder(PMDD),are common diseases among women of childbearing age,seriously disturbing their normal lives and receiving increasing attention.According to traditional Chinese medicine,the core pathogenesis of PMS and PMDD is the liver’s failure in governing conveyance and dispersion,and it is closely related to the imbalance of the Chong and Ren meridians.Based on the circulation and visceral relationship of the Chongren meridians,and the functional correspondence between the“kidney-Tiangui-Chong and Ren-uterine cavity”reproductive axis of traditional Chinese medicine and the hypothalamic-pituitary-ovarian(HPO)axis of western medicine,this article reveals the role mechanisms of hormonal rhythm disorder and negative feedback abnormality,etc.in the pathogenesis of PMS/PMDD.The periodic abrupt changes of qi and blood in the Chong and Ren meridians can lead to disorders of liver,spleen and kidney functions,which subsequently triggers premenstrual emotional and physical symptoms;whereas HPO-axis sex hormone fluctuations exacerbate premenstrual-related symptoms by affecting neurotransmitters and central responsiveness.Through multi-targeted regulation of Chongren meridians and HPO axis functions,TCM can improve luteal function and endocrine status,providing new ideas for the clinical treatment.By integrating the theories of traditional Chinese and western medicine and deepening the modern scientific connotation of the theory of liver storage in traditional Chinese medicine,a bridge is built for the mechanism research and diagnosis and treatment practice of PMS/PMDD.
作者
刘桦沅
王玉芳
孟庆岩
郭英慧
LIU Huayuan;WANG Yufang;MENG Qingyan;GUO Yinghui(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan250355,China;School of Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)
出处
《山东中医杂志》
2025年第11期1187-1191,共5页
Shandong Journal of Traditional Chinese Medicine
基金
国家自然科学基金项目(编号:82074293)
山东省研究生教育教学改革研究项目(编号:SDYJSJGC2024063)
山东省研究生精品和优质专业学位教学案例库项目(编号:SDYAL2024147)
山东中医药大学科学研究基金项目(编号:KYZK2024M08)。
关键词
经前期综合征
经前烦躁障碍症
肝失疏泄
冲任
下丘脑-垂体-卵巢轴
premenstrual syndrome
premenstrual dysphoric disorder
liver’s failure in governing conveyance and dispersion
Chongren meridians
hypothalamic-pituitary-ovarian axis
