中医诊治卵巢早衰的现代临床文献研究
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摘要
目的系统分析研究现代文献对卵巢早衰病因病机的认识及证治、用药规律。
     方法
     运用文献学、统计学分析相结合的方法,分别建立病因病机、证治方药数据库,运用频数统计法,系统分析现代医家对卵巢早衰病因病机的认识及用药特点。对中医治疗本病的高频药物进行研究和整理,从中组合出治疗本病的基本方药。结果
     所有病因病机中肾虚精亏所占比例最大,为23.23%,中药出现总体频次为927味次,其中补益药532味次,占57.39%,居于首位;居第二、第三位的分别为活血化瘀药147味次,占15.86%,清热泻火药57味次,占6.15%。按统计学析方原则,若将高频药物中累积频率超过50%的药物味次累积相加,合为一剂,则方药组成为当归、熟地、菟丝子、枸杞子、仙灵脾、白芍。
     结论
     1.卵巢早衰的病因病机:肾肝脾心功能失调是根本病机,其中肾虚是发病的基础;肝脾心功能失调与肾虚互为因果;气虚血瘀是发病的重要环节。肾虚精亏是最根本病机。
     2.治疗卵巢早衰的基本思路与方法:①调整脏腑功能,为补肾为主,佐以健脾养心、调肝泻火;②治病求本,标本兼治,活血化瘀是常用的治标之法;③中药分期论治,建立自然周期;④中西医结合是有效治疗手段;⑤身心同治,提高疗效;⑥积极预防,减少发病。
     3.现代医家治疗卵巢早衰的基本药物组合为当归、熟地、菟丝子、枸杞子、仙灵脾、白芍。
Objective
     The study intends to systematically analyze the etiopathogenisis, etiology, the differentiation, treatment and medication laws about premature ovarian failure (POF) that were discussed in modern literature. Methods
     Adopting the bibliography and statistics methods together, the author establishes the pathogenesis, the differentiation, treatment and medication databases. With pykno-statistical methods, the author systematically analyzes modern physicians'understanding about POF and their medication features. The author studies and sorts out the high-frequency medications on POF and finds out the basic prescriptions and medicine for POF treatment.
     Results
     Renal deficiency and essence deficiency occupies the largest proportion of all pathogenesis and etiology, i.e.23.23%.927 kinds of Chinese Herbal Medicine are used, among which 532 are tonics, occupying 57.39% and ranking the first place; 147 are drugs for invigorating blood circulation and eliminating stasis, occupying 15.86% and ranking the second; 57 are heat-clearing and fire-purging drugs, occupying 6.15% and ranking the third. According to the prescription analysis principles in statistics, if the drugs with accumulated frequency above 50% are combined to be one dosis, then the prescription should be angelica, prepared rhizome of rehmannia, cuscuta seed, fructus lycii, herba epimedii and radix paeoniae alba.
     Conclusion
     1. Pathogenesis and etiology of POF:dysfunction of kidney, liver, spleen and heart is the fundamental etiology, among which renal deficiency is the foundation; the dysfunction of liver, spleen and heart and the deficiency of kidney are mutual causes and results; qi deficiency and blood stasis is the important pathogenetic cause. Renal deficiency and essence deficiency are the most basic etiology.
     2. Basic thoughts and methods for POF treatment:①Adjust zang and fu organs' function. Take invigorating the kidney as the major method and replenishing spleen and heart, adjusting liver and clearing pathogenic fire as the complementary method.②Cure the root of disease and take care of the appearance and substance a the same time. Invigorating blood and dissolving stasis is the common method.③Treat POF with Chinese Herbal Medicine by different stages and establish the natural cycles.④Combining Chinese Medicine and Western Medicine together to treat POF is the effective way.⑤Treat physically and psychologically to improve the efficacy.⑥Active prevention may reduce the incidence of diseases.
     3. The basic medication combination adopted by modern physicians to treat POF are angelica, prepared rhizome of rehmannia, cuscuta seed, barbary wolfberry fruit, herba epimedii and radix paeoniae alba.
引文
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