基于“情志致病”理论探讨心理应激相关性 多囊卵巢综合征的治疗

Treatment of Psychological Stress-Related Polycystic Ovary Syndrome Based on the Theory of Emotional Pathogenesis

摘要: 本文基于中医“情志致病”理论，探讨心理应激与多囊卵巢综合征(PCOS)之间的病理联系及其中医治疗策略。PCOS作为常见的内分泌代谢性疾病，其发生发展与肝、肾、脾三脏功能失调密切相关，尤其与情志不畅导致的肝郁、肾虚、脾虚等病机相关。现代女性长期面临的心理应激可扰乱“肾–天癸–冲任–胞宫”生殖轴，并通过神经–内分泌–免疫网络加剧胰岛素抵抗、炎症反应及脑肠轴功能紊乱，从而诱发或加重PCOS。在治疗上，本文主张辨证分型施治，肝郁气滞型以疏肝解郁为主，肾虚肝郁型注重补肾疏肝，脾虚痰湿型则以健脾化痰为法，配合针灸及情志调节等非药物疗法，以恢复气血调和、冲任通畅。本文强调在PCOS的临床诊治中应重视情志因素，融入心理干预，契合生物–心理–社会医学模式，从而提高疗效、促进患者身心整体康复。

Abstract: Based on the traditional Chinese medicine (TCM) theory that emotions can cause disease, this paper examines how psychological stress contributes to polycystic ovary syndrome (PCOS) and discusses TCM-based treatment approaches. PCOS, a common endocrine and metabolic disorder, is closely linked to dysfunction of the liver, kidney, and spleen—particularly patterns such as liver stagnation, kidney deficiency, and spleen deficiency resulting from emotional distress. In modern women, chronic psychological stress may disrupt the TCM “kidney-tiangui-chong-ren-uterus” reproductive axis and, via the neuro-endocrine-immune network, worsen insulin resistance, inflammation, and brain–gut axis dysfunction, thereby triggering or exacerbating PCOS. For treatment, syndrome differentiation is essential. The liver qi stagnation type focuses on soothing the liver and relieving depression; the kidney deficiency with liver stagnation type emphasizes nourishing the kidney and soothing the liver; and the spleen deficiency with phlegm-dampness type aims to strengthen the spleen and resolve phlegm. These methods are combined with non-pharmacological therapies like acupuncture and emotional regulation to restore balanced qi and blood and promote circulation through the chong and ren meridians. Overall, this paper stresses the importance of addressing emotional factors in PCOS management, integrating psychological support, and adopting a biopsychosocial approach to improve treatment outcomes and support patients’ holistic recovery.