庞颖 王国华 赵秀萍 高悦

[摘要] 近年来多囊卵巢综合征（PCOS）发病率明显升高，其中痤疮为本病大多数患者最为苦恼和关注的问题，但相关报道较少。王国华教授认为随着生活方式的改变，PCOS型痤疮的主要中医病因病机为气郁、虚火，主要病因为由肝郁血瘀和肺经郁火所致的气机升降失调，以及由上热下寒和心肾不交所致的虚火上浮于面。王国华教授在临床治疗上“治病求本”，同时重视患者的健康教育和生活方式调摄，善用经典方剂灵活加减，收到了良好的临床效果，值得学习和推广。

[关键词] 多囊卵巢综合征；痤疮；气郁；虚火

[中图分类号] R711.75 [文献标识码] A [文章编号] 1673-7210（2018）02（c）-0149-04

Professor Wang Guohua's experience in treating acne caused by polycystic ovary syndrome

PANG Ying WANG Guohua ZHAO Xiuping GAO Yue

Department of Gynecology， the Third Hospital of Beijing University of Chinese Medicine， Beijing 100029， China

[Abstract] In recent years， the incidence of polycystic ovary syndrome （PCOS） was increased year by year， among which， acne is the most distressing and concerned problem for most patients， while there are only few related reports. Professor Wang Guohua believes that as the changes of lifestyle， the main Chinese etiology and pathogenesis of acne caused by PCOS are qi depression and deficient fire. The main etiology are the disorder of qi movement caused by stagnation of liver qi and blood stasis and stagnated fire in lung meridian， and the flaring up of deficient fire caused by upper heat and lower cold and disharmony between heart and kidney. Professor Wang Guohua pays attention to “treatment aiming at its root causes” in clinical treatment， and focuses on the regulation of health education and lifestyle， she is also good at using modified classic prescriptions， which has received good clinical effects. It is worthy of learning and promotion.

[Key words] Polycystic ovary syndrome； Acne； Qi depression； Deficient fire

多囊卵巢综合征（PCOS）是目前育龄期妇女常见的妇科内分泌代谢紊乱综合征。紊乱的内分泌引起了人体内部激素分布的不协调，进而导致痤疮、黑棘皮、肥胖等并发症。随着社会文明的进步，女性更加注重个人形象，因此痤疮为本病患者除生育外更为关注和苦恼的问题，也是相当一部分PCOS患者就诊的首要原因。PCOS型痤疮皮损好发于颜面部和胸背部，初期表现为炎性丘疹，病情日久不愈者，可出现结节、瘢痕、囊肿等[1]。西医学认为PCOS型痤疮主要与升高的雄激素相关，由性腺及肾上腺分泌的雄激素对皮脂腺发育和皮脂分泌起着调控作用，尤其是睾酮。睾酮经5α-还原酶的作用转为双氢睾酮（DHT），DHT激发皮脂增生不仅可与皮脂腺细胞内的受体结合，刺激皮脂腺细胞增生和促使皮脂分泌增加，还能使皮肤细胞内核蛋白合成和产生游离脂肪酸等物质，皮脂中游离的脂肪酸含量升高，从而可使毛囊漏斗部和皮腺导管过度角化，造成栓塞使皮脂排泄产生障碍，导致痤疮[2]。……