围绝经期综合征的病因及中西医治疗的研究进展

Research Progress on the Etiology and Treatment of Perimenopausal Syndrome with Traditional Chinese and Western Medicine

摘要: 围绝经期综合征是女性在绝经前后因卵巢功能逐渐衰退、雌激素水平波动性下降所引起的一组以自主神经功能紊乱和神经精神症状为主要表现的疾病，全球约75%的围绝经期女性会出现不同程度的相关症状，严重影响其身心健康和生活质量。现代医学认为，围绝经期综合征的发生与下丘脑–垂体–卵巢轴功能失调、雌激素受体敏感性改变、神经递质代谢异常、氧化应激及炎症反应等多因素密切相关，主要采用激素治疗，辅以非激素类药物及心理治疗。中医学虽无“围绝经期综合征”之病名，但依据其潮热汗出、心烦失眠、情志异常等临床表现，可将其归属于“脏躁”“百合病”等范畴，治疗应补肾填精、调和阴阳，兼以疏肝解郁、养心安神、健脾益气。本文通过系统梳理近十年来围绝经期综合征中西医治疗的相关文献，总结其发病机制、治疗方法及最新研究进展，探讨中西医治疗的优势与不足，以期为该病的临床防治提供理论依据和实践参考。

Abstract: Perimenopausal syndrome is a group of diseases mainly characterized by autonomic nervous system dysfunction and neuropsychiatric symptoms caused by the gradual decline of ovarian function and the fluctuation of estrogen levels in women before and after menopause. About 75% of perimenopausal women worldwide will experience varying degrees of related symptoms, seriously affecting their physical and mental health and quality of life. Modern medicine believes that the occurrence of perimenopausal syndrome is closely related to multiple factors such as dysfunction of the hypothalamic pituitary ovarian axis, changes in estrogen receptor sensitivity, abnormal neurotransmitter metabolism, oxidative stress, and inflammatory response. Hormone therapy is mainly used, supplemented by non-hormone drugs and psychological therapy. Although there is no specific name for “perimenopausal syndrome” in traditional Chinese medicine, based on its clinical manifestations such as hot flashes, sweating, restlessness, insomnia, and emotional abnormalities, it can be classified as “visceral restlessness” and “lily disease”. Treatment should focus on tonifying the kidneys, replenishing essence, regulating yin and yang, as well as soothing the liver, relieving depression, nourishing the heart and mind, and strengthening the spleen and qi. This article systematically reviews the relevant literature on the treatment of perimenopausal syndrome with traditional Chinese and Western medicine in the past decade, summarizes its pathogenesis, treatment methods, and latest research progress, explores the advantages and disadvantages of traditional Chinese and Western medicine treatment, in order to provide theoretical basis and practical reference for the clinical prevention and treatment of this disease.