原发性闭经指女性年满16岁、第二性徵出现但尚无月经来潮，或年满14 岁仍无第二性徵发育；继发性闭经指曾有正常月经，停经6个月以上或根据自 身周期停经3个周期以上。而常见继发性闭经原因有高泌乳激素血症、多囊性 卵巢症候群、甲状腺功能低下、下视丘功能障碍、卵巢早衰，甚至是药物的影 响等等。临床上除优先排除怀孕的可能性之外，须配合病史询问、实验室数据 检查及影像检查进行评估，方能准确诊断原因。 本病例患者为一名26岁女性，月经後期逾6个月未至，於西医实验室数 据检查，AMH1.74 ng/mL、Estrogen<10 pg/ml，贺尔蒙数值过低，西医臆测早发 性卵巢衰竭，服用排卵药及避孕药後仍无法自行来经，因患者畏惧依赖西医贺 尔蒙药物进而寻求中医介入。以女科柏子仁丸为主方，补肾养血调理约三个月 後，可正常自行来经。从本病例之临床观察，进而探讨现代社会年轻女性月经 周期不规律甚而闭经原因、中医病因病机、证型及治则，辅助西医治疗。 【关键词】闭经、减重、下视丘功能障碍、卵巢早衰、中医药 |
Primary amenorrhea refers to females aged 16 or older with the appearance of secondary sexual characteristics but no menstruation, or aged 14 or older with no development of secondary sexual characteristics. Secondary amenorrhea refers to those who have had regular menstruation but have ceased for more than 6 months, or have missed three or more menstrual cycles according to their own cycle. Common causes of secondary amenorrhea include hyperprolactinemia, polycystic ovary syndrome, hypothyroidism, dysfunction of the hypothalamus, premature ovarian insufficiency, and even medication effects. In clinical practice, besides the possibility of pregnancy as a priority, evaluation through medical history inquiry, laboratory data examination, and imaging studies is necessary for an accurate diagnosis. In this case, a 26-year-old female patient had not menstruated for over 6 months. Laboratory tests in showed AMH 1.74 ng/mL and Estrogen <10 pg/ml, indicating low hormone levels. Impressed premature ovarian insufficiency, despite taking ovulation-inducing and contraceptive drugs, menstruation did not resume. Due to the patient’s fear of dependence on hormone medication from Western medicine, she sought intervention from traditional Chinese medicine (TCM). With the main prescription of Ba Zhen Wan, which tonifies the kidneys, nourishes blood, and regulates menstruation, the patient resumed menstruation after approximately three months of treatment. Through the clinical observation of this case, it can be further explored how modern society’s young women with irregular menstrual cycles or even amenorrhea can be assisted by TCM in terms of etiology, pathogenesis, pattern identification, and treatment principles, complementing Western medicine treatments. 【Keywords】Amenorrhea ； weight loss； hypothalamic dysfunction； premature ovarian insufficiency； Traditional Chinese Medicine |
282.8闭经合并卵巢早衰之中医介入治疗 病例报告
