Treating obese and non-obese polycystic ovary syndrome based on the theory of dynamic and static in Chinese medicine

This study examined the pathogenesis and treatment of obese and non-obese polycystic ovary syndrome based on the theory of dynamic and static in traditional Chinese medicine. The pathogenesis of this disease involves spleen and kidney deficiency, liver qi stagnation, qi disorder, water-dampness accumulation, phlegm retention, obstruction of the thoroughfare and conception channels, and impaired ovulation, resulting in irregular menstrual cycles. Clinically, the pathogenesis of patients with obesity and those of normal weight differs. In patients with obesity, phlegm-dampness stagnation predominates and is considered "static." In non-obese patients, the internal movement of thunder and fire is a key pathogenic factor, and the pathogenesis is considered "dynamic." Therefore, the disease demonstrates both dynamic and static characteristics. Patients with obesity are characterized by phlegm accumulation resulting from spleen and kidney yang deficiency and phlegm stagnation. Patients with normal weight are characterized by emotional depression, reflecting liver qi depression and thunder fire delusion. Treatment should incorporate syndrome differentiation based on body constitution, allowing for an understanding of the interaction between dynamic and static aspects. For the obese type, therapy should focus on warming and tonifying the spleen and kidney, supporting fire and yang, warming water and dampness, eliminating uterine fat, facilitating ovulation, and promoting pregnancy. For the non-obese type, treatment should emphasize nourishing and softening the liver for regulation, supplementing the kidneys and spleen, and tonification to subdue thunder and fire and dredge qi and blood. By distinguishing the dynamic and static features of pathogenesis and clinical presentation between the two types, a dynamic and static syndrome differentiation and treatment system for gynecological diseases was established, providing insights for the clinical classification and treatment of polycystic ovary syndrome.