| 引用本文: |
陈盼, 刘文娥.从窠囊理论探讨多内分泌代谢卵巢综合征不孕症的分期治疗[J].湖南中医药大学学报,2026,46(9):1899-1904[点击复制] |
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| 从窠囊理论探讨多内分泌代谢卵巢综合征不孕症的分期治疗 |
| 陈盼,刘文娥 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 朱丹溪窠囊理论对痰瘀顽疾的辨治具有重要指导意义。本文在尤昭玲教授“生殖链终端”与“时空观”学术思想指导下，提出多内分泌代谢卵巢综合征（PMOS）不孕症的核心病机为“痰瘀结窠、双困巢膜”，即痰瘀胶结于卵巢、子宫内膜两大生殖终端，形成巢窠与膜窠并存的病理状态，阻碍卵泡发育与排出，降低子宫内膜容受性。窠囊随月经周期呈现“伏浊-阴凝-胶着-痰瘀”的时空变化规律，据此，本文提出“清窠-软窠-破窠-安窠”的分期消窠策略：行经期因势利导、清热解毒化瘀以“清窠”，祛除伏浊；经后期温润补肾、健脾化痰以“软窠”，融化阴凝；围排卵期温肾助阳、宣散通络以“破窠”，开壅塞之机关；既孕后健脾益肾、理气活血以“安窠”，固护胎元。该策略将窠囊病机模型与尤昭玲教授“调泡四法”“卵膜论”“假定月经法”等临证思想贯通，为PMOS不孕的中医分期辨治提供了新的理论思路。 |
| 关键词: 多内分泌代谢卵巢综合征|不孕症|痰瘀互结|分期论治|尤昭玲 |
| DOI：10.3969/j.issn.1674-070X.2026.09.021 |
| 投稿时间：2026-05-29 |
| 基金项目:湖南省自然科学基金医卫行业联合基金项目(2025JJ80983);湖南省卫生健康委科研课题一般项目(20257722);湖南中医药大学第一附属医院中医药传承创新专项(2024XYLH341)。 |
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| Stage-based treatment of infertility due to polyendocrine metabolic ovarian syndrome: insights from the “nesting theory” |
| CHEN Pan, LIU Wen'e |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| ZHU Danxi's "nesting theory" (a TCM concept denoting entrenched lesions formed by the interplay of phlegm and blood stasis) provides important guidance for differentiating and treating refractory diseases caused by phlegm and blood stasis. Guided by Professor YOU Zhaoling's academic concepts of the "reproductive chain terminal" and the "space-time perspective," this paper proposes that the core pathogenesis of infertility due to polyendocrine metabolic ovarian syndrome (PMOS) is "phlegm and blood stasis forming a nest (an entrenched lesion) and trapping both the ovary and the endometrium"; that is, phlegm and blood stasis become entrenched at the two reproductive terminals, the ovary and the endometrium, producing a pathological state in which an ovarian nest and an endometrial nest coexist, thereby impeding follicular development and ovulation and reducing endometrial receptivity. The nest follows a spatiotemporal pattern of evolution across the menstrual cycle, namely "latent turbidity, yin coagulation, adhesive stagnation, and phlegm and blood stasis." Accordingly, this paper proposes a stage-based nest-eliminating strategy of "clearing, softening, breaking, and stabilizing the nest": clearing the nest during the menstrual phase by following the natural outflow to clear heat, remove toxins, and transform blood stasis, thereby expelling latent turbidity; softening the nest during the postmenstrual phase by warmly nourishing the kidney and strengthening the spleen to transform phlegm, thereby melting yin coagulation; breaking the nest during the peri-ovulatory phase by warming the kidney and reinforcing yang and by dispersing and unblocking collaterals, thereby opening the blocked pivot; and stabilizing the nest after conception by strengthening the spleen and tonifying the kidney and by regulating qi and circulating blood, thereby protecting the fetus. This strategy integrates the nesting pathogenesis model with Professor YOU's clinical concepts, including the "four methods of regulating follicles," the "egg-membrane interaction theory," and the "hypothetical menstruation method," providing new theoretical insights for the stage-based differentiation and treatment of PMOS-related infertility with Chinese medicine. |
| Key words: polyendocrine metabolic ovarian syndrome|infertility|intertwined phlegm and blood stasis|stage-based treatment|YOU Zhaoling |
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