阴火理论体系下PCOS继发T2DM的病机及治则

Pathogenesis and Therapeutic Principles of T2DM Secondary to PCOS under the Yin Fire Theoretical System

摘要: 本文以李东垣“阴火”理论为纲，系统阐释多囊卵巢综合征(PCOS)继发2型糖尿病(T2DM)的中医病机与治则体系。其病理演变可分为三期：初起脾胃内伤、元气亏虚；进而清阳下陷、阴火上冲；终致阴火灼阴、散精无权。针对此三期病机，分别施以补中益气汤健运中州、补脾胃泻阴火升阳汤调理枢机、黄芪鳖甲散育阴泻火，由此构建起理法方药一以贯之的完整辨治体系。此体系不仅深刻体现了“扶正祛邪、标本兼顾”的中医治疗精髓，更彰显了古典理论在应对现代复杂疾病中的独特价值与生命力。

Abstract: Based on Li Dongyuan’s theory of “yin fire”, this paper systematically elucidates the pathogenesis and therapeutic principles of polycystic ovary syndrome (PCOS) complicated by type 2 diabetes mellitus (T2DM) from the perspective of traditional Chinese medicine. The pathological progression can be divided into three stages: it begins with spleen-stomach impairment and deficiency of primordial qi; progresses to the failure of clear yang to ascend and the uprising of yin fire; and culminates in yin fire scorching yin and disrupting nutrient distribution. Corresponding to these three stages, the treatments applied are Buzhong Yiqi Tang to strengthen the middle energizer, Bupiwei Xieyinhuo Shengyang Tang to regulate the pivotal qi movement, and Huangqi Biejia San to nourish yin and clear fire. This approach establishes a comprehensive diagnosis and treatment system that integrates theory, principle, formula, and herb into a coherent whole. This system not only deeply embodies the TCM essence of “supporting healthy qi and eliminating pathogenic factors, addressing both the root and the branch”, but also highlights the unique value and vitality of classical theories in addressing complex modern diseases.