通讯作者: 陈明玉, 1648929018@qq.com

DOI：10.12201/bmr.202604.00063

Exploring the Diagnosis and Treatment Approaches for Perimenopausal Syndrome Based on the Exhaustion of Heavenly Essence Theory

• 摘要：围绝经期综合征是女性绝经前后因卵巢功能衰退、性激素水平波动引发的一组以自主神经功能紊乱为主,伴精神心理症状的临床综合征,其发生发展与“天癸”理论密切相关。本文系统梳理了“天癸”理论的中医源流,从《素问·上古天真论》的经典论述入手,结合刘河间“天癸既绝,属太阴经”的学术创见,深入探讨围绝经期综合征“肾虚为本,五脏同病,冲任失调”的病机特点。研究认为,天癸衰竭是围绝经期综合征发生的根本原因,其影响涉及肾-天癸-冲任-胞宫轴的功能紊乱,并可波及心、肝、脾、肺等脏腑。基于此,本文提出“补肾填精以滋天癸、调补五脏以和气血、调理阴阳以平为期”的辨治思路,并结合现代医学研究,阐释中医药治疗围绝经期综合征的科学内涵,以期为临床诊疗提供理论参考。

  关键词： 天癸竭; 围绝经期综合征; 冲任失调; 中医辨治

   

  Abstract: Perimenopausal syndrome is a clinical syndrome occurring in women before and after menopause, caused by ovarian function decline and fluctuations in sex hormone levels. It is mainly characterized by autonomic nervous dysfunction, accompanied by psychological and mental symptoms. Its onset and development are closely related to the theory of Tian Gui (Heavenly Essence). This article systematically reviews the origins of the Tian Gui theory in traditional Chinese medicine, beginning with the classic discussion in Su Wen·Ancient Natural Theory, and, combined with Liu Hejians academic insight that when Tian Gui is exhausted, it belongs to the Taiyin meridian, deeply explores the pathophysiological characteristics of perimenopausal syndrome, namely rooted in kidney deficiency, involving multiple zang organs, with disharmony of Chong and Ren vessels. The study suggests that the depletion of Tian Gui is the fundamental cause of perimenopausal syndrome, affecting the kidney-Tian Gui-Chong Ren-uterus axis, and potentially impacting the heart, liver, spleen, and lungs. Based on this, the article proposes a treatment approach of tonifying the kidney and replenishing essence to nourish Tian Gui, regulating and tonifying the five zang organs to harmonize qi and blood, and balancing yin and yang for stabilization, and, combined with modern medical research on neuroendocrinology, elucidates the scientific connotation of traditional Chinese medicine in treating perimenopausal syndrome, aiming to provide theoretical reference for clinical diagnosis and treatment.

  Key words: Exhaustion of Tiangui; Perimenopausal Syndrome; Chong and Ren Dysregulation; Traditional Chinese Medicine Differentiation and Treatment

  提交时间：2026-04-09

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• 序号	提交日期	编号	操作
  1	2026-03-21	10.12201/bmr.202604.00063V1	下载

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