多囊性卵巢症候群病例報告暨中西醫典籍期刊文獻回顧

A Case Study and Review of Chinese Medicine and Western Medicine Periodicals, Literatures and Textbooks about Polycystic Ovarian Syndrome (PCOS)

多囊性卵巢症候群（PCOS, Polycystic Ovary Syndrome）傳統上認為在有三個診斷的要件，包括：月經稀發或閉經（Oligomenorrhea or amenorrhea）、多毛（Hirsutism）、肥胖（Obesity），但隨著相關的臨床觀察及研究發現，多囊性卵巢症候群為一複雜且多變的症候群，除了前述的三個症狀外，也牽涉到高雄性激素（Hyperandrogenism）及胰島素阻抗（Insulin resistance）的一系列相關症狀表現。一般育齡期婦女患有多囊性卵巢症候群的發生率約為5~10%，診斷隨著臨床症狀的多變而困難度而增加，各項症狀影響的層面很廣，包括生理、心理、預防醫學的角度都牽涉在內。中醫典籍並無“多囊性卵巢症候群＂的病名，根據臨床症狀，一般歸屬於“月經後期＂、“閉經＂、“不孕＂、“癥瘕＂的範疇，認為與肝、脾、腎關係密切。臨床上多考慮多囊性卵巢症候群的臨床表現，以月經失調、閉經、不孕為主要治療目標。本文以一例病案為出發點，擬從中西醫典籍期刊文獻中探討治療多囊性卵巢症候群的思路，提供臨床治療參考。

Traditional common symptoms of PCOS include oligomenorrhea (or amenorrhea), hirsutism and obesity. But more and more clinical observation and research show that PCOS is actually a kind of complicated and volatile syndrome. In addition to the above mentioned symptoms, hyperandrogenism and insulin resistance are also regarded as the associating symptoms. PCOS is one of the most common female endocrine disorders affecting approximately 5%~10% of women of reproductive age. The diagnosis difficulty increased along with the enormous variety of the clinical symptoms. These symptoms are widely involved with the aspects of physiology, psychology and preventive medicine. According to the clinical symptoms, PCOS is known as 'retarded menstruation', 'amenorrhea', 'infertility', and 'pelvic mass' in traditional Chinese medicine literatures and textbooks. In traditional Chinese medicine, PCOS is supposed to be closely related to the liver, spleen and kidney. The main objects of PCOS treatment in traditional Chinese medicine are irregular menstruation, amenorrhea and infertility depending on the clinical manifestations. Based on a review of Chinese medicine and western medicine periodicals, literatures and textbooks and a case study, we tried to discuss the treatment approaches to PCOS in order to offer some reference for clinical treatment.