女性高泌乳激素血症的中醫證型及處方探討

高泌乳激素血症（Hyperprolactinemia）是很容易被忽視的女性婦科疾患，其產生的主要症狀為：溢乳、無月經。根據《黃帝內經》關於乳房的描述，溢乳可以歸咎於肝、脾、腎、衝任經的失調，也與脾胃運化水穀精微的衰少有關，依陳立德教授所編中醫婦科學的證型分類，屬於:氣血虛弱、肝買蘊熱，分別用八珍湯、丹槴逍遙散治療；無月經在中醫屬於經閉範疇，根據《醫宗金鑑．婦科心法》的證型分析，屬於：胃熱所致的血虧經閉，合併類似師尼室寡經閉所提到的肝鬱現象，吳謙建議使用玉燭散清胃熱，逍遙散疏肝開鬱。綜合高泌乳激素血症的症狀，歸納出其證型為：氣血虛、肝胃熱，筆者建議處方：八珍湯合清胃散，加減疏肝理氣藥物，提供日後中醫治療參考。

關鍵字

高泌乳激素血症；中醫證型

並列摘要

Hyperprolactinemia that leads to galactorrhea and amenorrhea is a frequently overlooked problem in female. According to the description of breast in Huangdi Neijing, galactorrhea is not only attributed to the imbalance of liver meridian, spleen meridian, kidney meridian, penetrating vessel and conception vessel, but also attributed to Qi and Blood Deficiencies; those are produced by the transportation and absorption of the Spleen. In professor Lieh-Der Chen's opinion, the Chinese medicine patterns for galactorrhea are Qi and Blood Deficiencies and Liver and Stomach Fire; therefore, he prescribes Ba Zhen Tang and Jia Wei Xiao Yao San. Another symptom of hyperprolactinemia is amenorrhea, described as the Blood-Deficiency pattern with Liver Qi Stagnation in Yi Zong Jin Jian. And because the author of this book considered that Stomach Fire causes the Blood-Deficiency pattern, he prescribed Yu Zhu San for clearing Stomach Heat. In conclusion, the Chinese medicine patterns of infertile women with hyperprolactinemia are Qi and Blood Deficiencies and Liver and Stomach Fire with Liver Qi Stagnation, so my prescriptions are Ba Zhen Tang, Qing Wei San and some drugs for dispersing the Liver and regulating Qi.

並列關鍵字

hyperprolactinemia ； Chinese medicine patterns

參考文獻

WHO Technical Report Series. Recent Advances in Medically Assisted Conception Number 820, 1992, pp 1-111

Google Scholar

Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, Wass JA. Diagnosis and Treatment of Hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. The journal ofclinical endocrinology and metabolism 2011 ; 96(2): 273.