张帆教授治疗多囊卵巢综合征经验总结

Professor Zhang Fan’s Experience Summary in the Treatment of Polycystic Ovary Syndrome

摘要: 多囊卵巢综合征(PCOS)是育龄期女性常见的生殖内分泌代谢性疾病，以排卵障碍、高雄激素血症、卵巢多囊样改变为主要特征，常伴随月经失调、不孕、肥胖等症状，严重影响患者生活质量。目前现代医学治疗多以调节激素、促排卵为主，但存在易复发、副作用明显等问题。张帆教授从事中医妇科临床与教研工作数十年，对PCOS的诊治具有丰富经验，认为本病核心病机为“肾虚为本、痰瘀为标”，确立“补肾祛痰、化瘀调经”为核心诊疗原则，并根据月经周期不同阶段的生理特点，采用“分期论治”策略，经前期以桃红四物汤加减调理气血、化瘀通络，经后期以补肾祛痰汤滋补肝肾、化痰散结。本文通过梳理张帆教授治疗PCOS的用药理论、具体方药分析及临床经验，为中医治疗PCOS提供参考。

Abstract: Polycystic ovary syndrome (PCOS) is a common reproductive, endocrine and metabolic disease in women of childbearing age, characterized by ovulatory dysfunction, hyperandrogenemia and polycystic ovarian morphology. It is often accompanied by menstrual disorders, infertility and obesity, which seriously impair patients’ quality of life. Current modern medical treatments mainly focus on hormone regulation and ovulation induction, with the disadvantages of high recurrence rate and obvious side effects. Professor Zhang Fan, who has decades of experience in the clinical practice, teaching and research of gynecology in traditional Chinese medicine (TCM), holds that the core pathogenesis of PCOS is kidney deficiency as the root and phlegm-stasis as the branch, and has established the core therapeutic principle of tonifying the kidney, resolving phlegm, removing blood stasis and regulating menstruation. Based on the physiological characteristics of different stages of the menstrual cycle, she adopts the strategy of treatment based on menstrual stages: modified Taohong Siwu Decoction is used to regulate qi and blood, remove blood stasis and unblock collaterals in the premenstrual phase, and Bushen Qutan Decoction is used to tonify the liver and kidney, resolve phlegm and dissipate masses in the postmenstrual phase. This paper summarizes her medication theory, prescription analysis and clinical experience, providing a reference for the TCM treatment of PCOS.