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中医药调节绝经过渡期内分泌变化研究进展
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Abstract:
绝经过渡期是女性必然会经历的一个阶段。在这一时期，女性内分泌会发生改变。大部分女性出现的一系列与绝经相关的身体和心理的综合表现，称为绝经综合征。使用中医药治疗可以一定程度上改善绝经综合征症状，同时也能够调节内分泌变化。本文从生殖衰老分期、绝经过渡期的诊断及内分泌的变化、中医病因病机认识、中医药疗效四方面进行综述，为后续深入研究及临床应用提供参考。
The menopausal transition is a stage that women are bound to go through. During this period, a woman’s endocrine system changes. Most women experience a combination of physical and psychological manifestations associated with menopause, known as menopausal syndrome. The use of TCM treatment can improve the symptoms of menopausal syndrome to a certain extent, and it can also regulate endocrine changes. This article reviews the stages of reproductive aging, the diagnosis of menopausal transition and endocrine changes, the understanding of the etiology and pathogenesis of TCM, and the efficacy of TCM, so as to provide reference for subsequent in-depth research and clinical applications.
| [1] | 王洪雪, 王杰琼, 高杰. 围绝经期综合征的中医药研究进展[J]. 西部中医药, 2022, 35(7): 144-147. |
| [2] | Wang, M., Kartsonaki, C., Guo, Y., et al. (2021) Factors Related to Age at Natural Menopause in China: Results from the China Kadoorie Biobank. Menopause (New York, NY), 28, 1130. https://doi.org/10.1097/GME.0000000000001829 |
| [3] | Ruan, X., Cui, Y., Du, J., et al. (2017) Prevalence of Climacteric Symptoms Comparing Perimenopausal and Postmenopausal Chinese Women. Journal of Psychosomatic Obstetrics & Gynecology, 38, 161-169. https://doi.org/10.1080/0167482X.2016.1244181 |
| [4] | 中华医学会妇产科学分会绝经学组. 中国绝经管理与绝经激素治疗指南2023版[J]. 中华妇产科杂志, 2023, 58(1): 4-21. |
| [5] | 陈蓉. 《中国绝经管理与绝经激素治疗指南2023版》解读[J]. 协和医学杂志, 2023, 14(3): 514-519. |
| [6] | 李冀, 潘明月, 李想, 等. 中医药治疗围绝经期综合征研究进展[J]. 辽宁中医药大学学报, 2021, 23(9): 1-5. |
| [7] | 张国丽, 傅萍, 马娴. 中医药治疗围绝经期综合征实验研究进展[J]. 长春中医药大学学报, 2015, 31(2): 434-436+440. |
| [8] | Soules, M.R., Sherman, S., Parrott, E., Rebar, R., Santoro, N., Utian, W., et al. (2001) Executive Summary: Stages of Reproductive Aging Workshop (Straw). Climacteric, 4, 267-272. https://doi.org/10.1080/713605136 |
| [9] | Soules, M.R., Sherman, S., Parrott, E., Rebar, R., Santoro, N., Utian, W., et al. (2001) Stages of Reproductive Aging Workshop (Straw). Journal of Women’s Health & Gender-Based Medicine, 10, 843-848. https://doi.org/10.1089/152460901753285732 |
| [10] | Harlow, S.D., Gass, M., Hall, J.E., Lobo, R., Maki, P., Rebar, R.W., et al. (2012) Executive Summary of the Stages of Reproductive Aging Workshop +10: Addressing the Unfinished Agenda of Staging Reproductive Aging. Climacteric, 15, 105-114. https://doi.org/10.3109/13697137.2011.650656 |
| [11] | El Khoudary, S.R., Greendale, G., Crawford, S.L., Avis, N.E., Brooks, M.M., Thurston, R.C., et al. (2019) The Menopause Transition and Women’s Health at Midlife: A Progress Report from the Study of Women’s Health across the Nation (Swan). Menopause, 26, 1213-1227. https://doi.org/10.1097/gme.0000000000001424 |
| [12] | 林丽淑, 龙韵洪, 徐丽惠, 等. 抗缪勒氏管激素的结构､功能､临床应用与检测技术[J]. 国际检验医学杂志, 2019, 40(24): 3061-3066, 3072. |
| [13] | 李嘉, 马文, 童秋瑜, 等. 卵巢储备功能评估的研究进展[J]. 安徽医学, 2018, 39(1): 116-119. |
| [14] | Rosen, M.P., Johnstone, E., McCulloch, C.E., Schuh-Huerta, S.M., Sternfeld, B., Reijo-Pera, R.A., et al. (2012) A Characterization of the Relationship of Ovarian Reserve Markers with Age. Fertility and Sterility, 97, 238-243. https://doi.org/10.1016/j.fertnstert.2011.10.031 |
| [15] | Hall, J.E. (2015) Endocrinology of the Menopause. Endocrinology and Metabolism Clinics of North America, 44, 485-496. https://doi.org/10.1016/j.ecl.2015.05.010 |
| [16] | Santoro, N., Crawford, S.L., El Khoudary, S.R., Allshouse, A.A., Burnett-Bowie, S., Finkelstein, J., et al. (2017) Menstrual Cycle Hormone Changes in Women Traversing Menopause: Study of Women’s Health across the Nation. The Journal of Clinical Endocrinology & Metabolism, 102, 2218-2229. https://doi.org/10.1210/jc.2016-4017 |
| [17] | Barry, J.A., Parekh, H.S.K. and Hardiman, P.J. (2013) Visual-Spatial Cognition in Women with Polycystic Ovarian Syndrome: The Role of Androgens. Human Reproduction, 28, 2832-2837. https://doi.org/10.1093/humrep/det335 |
| [18] | Kim, C., Harlow, S.D., Zheng, H., McConnell, D.S. and Randolph, J.F. (2017) Changes in Androstenedione, Dehydroepiandrosterone, Testosterone, Estradiol, and Estrone over the Menopausal Transition. Women’s Midlife Health, 3, Article No. 9. https://doi.org/10.1186/s40695-017-0028-4 |
| [19] | 蒋小利, 陆启滨. 陆启滨诊治绝经综合征[J]. 长春中医药大学学报, 2019, 35(3): 444-447. |
| [20] | 贾汝楠, 刘玉兰. 高慧教授治疗围绝经期综合征经验[J]. 河北中医, 2020, 42(10): 1455-1457. |
| [21] | 甘珊珊, 袁娇, 王萍. 王萍教授治疗围绝经期综合征经验撷菁[J]. 中国民族民间医药, 2021, 30(2): 76-78. |
| [22] | 朱敏, 毛婷, 刘雅倩, 等. 补肾调营卫法治疗绝经综合征失眠症疗效及对肠道菌群的影响研究[J]. 广州中医药大学学报, 2023, 40(7): 1660-1671. |
| [23] | 洪帮振. 左归饮化学成分分析及对围绝经期综合征模型大鼠的治疗作用研究[D]: [硕士学位论文]. 合肥: 安徽中医药大学, 2023. |
| [24] | 赵铭宇. 五加丹方对去势雌性大鼠下丘脑Kiss-1/GPR54/GnRH信号通路影响的研究[D]: [博士学位论文]. 哈尔滨: 黑龙江中医药大学, 2020. |
| [25] | 李艳莹, 范立磊, 吴玲玲, 等. 坤泰胶囊对围绝经期大鼠血管内皮损伤及卵巢组织中血管内皮生长因子和胰岛素样生长因子-1表达的影响[J]. 安徽医药, 2023, 27(6): 1088-1093. |
| [26] | 田硕. 龟龄集胶囊对围绝经期综合征动物模型的干预研究[D]: [硕士学位论文]. 郑州: 河南中医药大学, 2016. |
| [27] | 陈思敏, 苏洁, 金小虎, 等. 黄精超微粉及水提物对自然围绝经期综合征模型大鼠的作用研究[J]. 中国中药杂志, 2023, 48(4): 1054-1065. |
| [28] | 邵芳. 定坤丹对围绝经综合征患者中医证候､内分泌激素水平的影响[J]. 内蒙古中医药, 2023, 42(10): 19-20. |
| [29] | 李娜. 固元补肾汤治疗肾虚肝郁型围绝经期综合征的效果[J]. 中国实用乡村医生杂志, 2023, 30(9): 40-43. |
| [30] | 万丹, 夏敏, 吴锦林, 等. 合黄滋阴汤治疗肾阴虚型绝经综合征的临床研究[J]. 中医临床研究, 2022, 14(32): 106-108. |
| [31] | 魏颖, 张水荣. 滋水清肝饮加味治疗肾虚肝郁型围绝经期综合征的效果及对患者血管内皮功能的影响[J]. 临床医学研究与实践, 2022, 7(19): 145-147. |
| [32] | 朱玲, 李爱平, 褚静萍, 等. 滋肾疏肝饮治疗肾虚肝郁型围绝经期综合征的临床观察[J]. 内蒙古中医药, 2023, 42(6): 8-9. |
| [33] | 成晓玲. “标本配穴”针刺治疗绝经综合征的临床研究[D]: [硕士学位论文]. 武汉: 湖北中医药大学, 2018. |
| [34] | 宋祖贤. 电针治疗围绝经期综合征的临床观察[D]: [硕士学位论文]. 合肥: 安徽中医药大学, 2017. |
| [35] | 陈姣洁, 黄烨, 刘文, 等. 穴位贴敷联合知柏地黄汤加味治疗围绝经期综合征的疗效观察[J]. 实用临床医学, 2022, 23(6): 26-29. |
| [36] | 周俊英, 黄旭博, 庞丹阳. 从“中年治肝”理论探讨中药联合耳穴疗法治疗围绝经期失眠的临床研究[J]. 医药论坛杂志, 2023, 44(10): 95-98. |
| [37] | 张蕙羽. 灵龟八法开穴针药结合治疗围绝经期失眠(心肾不交型)的临床观察[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2023. |
| [38] | 王皓宇. “养神开郁”针刺法联合耳穴压豆治疗肝气郁结型围绝经期抑郁症的临床观察[D]: [硕士学位论文]. 呼和浩特: 内蒙古医科大学, 2023. |
| [39] | 王丽媛. 柴胡加龙骨牡蛎汤加减合脐贴治疗少阳枢机不利, 胆火内扰型围绝经期综合征的临床研究[D]: [硕士学位论文]. 济南: 山东中医药大学, 2022. |
| [40] | 史乐辰. 隔药灸脐法联合针刺治疗围绝经期综合征(肾阴虚型)的临床观察[D]: [硕士学位论文]. 济南: 山东中医药大学, 2022. |
| [41] | 曾月. 头针结合调经安神汤治疗围绝经期亚健康态失眠的临床观察研究[D]: [硕士学位论文]. 泸州: 西南医科大学, 2022. |
| [42] | 边小平. 五脏俞埋线联合药物治疗肾虚肝郁型围绝经期抑郁症的临床研究[D]: [硕士学位论文]. 兰州: 甘肃中医药大学, 2021. |
