原發性閉經指女性年滿16歲、第二性徵出現但尚無月經來潮，或年滿14 歲仍無第二性徵發育；繼發性閉經指曾有正常月經，停經6個月以上或根據自 身週期停經3個週期以上。而常見繼發性閉經原因有高泌乳激素血症、多囊性 卵巢症候群、甲狀腺功能低下、下視丘功能障礙、卵巢早衰，甚至是藥物的影 響等等。臨床上除優先排除懷孕的可能性之外，須配合病史詢問、實驗室數據 檢查及影像檢查進行評估，方能準確診斷原因。 本病例患者為一名26歲女性，月經後期逾6個月未至，於西醫實驗室數 據檢查，AMH1.74 ng/mL、Estrogen<10 pg/ml，賀爾蒙數值過低，西醫臆測早發 性卵巢衰竭，服用排卵藥及避孕藥後仍無法自行來經，因患者畏懼依賴西醫賀 爾蒙藥物進而尋求中醫介入。以女科柏子仁丸為主方，補腎養血調理約三個月 後，可正常自行來經。從本病例之臨床觀察，進而探討現代社會年輕女性月經 週期不規律甚而閉經原因、中醫病因病機、證型及治則，輔助西醫治療。 【關鍵詞】閉經、減重、下視丘功能障礙、卵巢早衰、中醫藥 |
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閉經合併卵巢早衰之中醫介入治療 病例報告
