以内质网应激为切入点探讨脾不散精与多囊卵巢综合征合并胰岛素抵抗相关性OA

Insulin resistance in polycystic ovary syndrome(PCOS)represents a condition of root deficiency and superficial excess,with spleen deficiency as the root and phlegm-dampness as the manifestation.The fundamental pathogenesis lies in the failure of the spleen to disperse essence.Enzymes,hormones,and other cellular proteins form the material basis for the spleen's dispersing function.When spleen deficiency impairs this function,the synthesis and transport of large molecular proteins,including cellular enzymes,are disrup-ted,which results in disordered glucose and lipid metabolism,altered intracellular homeostasis,and an imbalance in endoplasmic reticu-lum(ER)homeostasis,triggering ER stress.The spleen's dispersing function is essential for"the normal distribution of fluids and nu-trients into the five meridians of the five-zang organs throughout the body".When this function fails,transportation is hindered,fluids stagnate,and dampness accumulates into phlegm.Persistent accumulation leads to a state of chronic low-grade inflammation,ultimately disrupting glucose and lipid metabolism.Thus,the failure of the spleen to disperse essence is a fundamental contributor to the chronic low-grade inflammation and ER stress associated with PCOS.Treatment should focus on addressing the root cause by banking up earth,invigorating the spleen and dispersing function,complemented by resolving phlegm and eliminating turbidities in order to restore the nor-mal distribution and metabolism of bodily fluids and nutrients,achieving the state of"the normal distribution of fluids and nutrients into the five meridians of the five-zang organs throughout the body".