每月必經的情緒波動？ 中醫調理幫助婦女擺脫經前症候群
2023-06-22 記者 蘇旋/報導
柳營奇美醫院中醫部簡珮珊醫師表示，中醫調理幫助婦女擺脫經前症候群
日前，一名年約三十歲的王小姐至柳營奇美醫院中醫部門診就醫，自述每個月總是有幾天特別容易心情煩躁，情緒莫名沮喪而且很容易生氣，同時伴隨著乳房脹痛、下腹脹痛、頭痛以及四肢水腫等不舒服的症狀。經醫師詳細詢問後，發現這些症狀總是在月經來之前，而隨著月經來了之後，一切又恢復了正常，這就是典型的經前症候群。
柳營奇美醫院中醫部簡珮珊醫師表示，經前症候群的定義是在月經來潮前約一周出現，症狀包含生理上的身體浮腫、肌膚敏感、便秘、脹氣、胸部脹痛、頭暈、腰痛等，以及心理上的焦煩、生氣、易怒、憂鬱、無法集中思想等，嚴重時會使工作及人際關係受到影響，通常症狀在月經來潮後開始消退，並在月經來潮一周內完全消失。根據統計，約47%的女性有經前症候群的困擾，其中更有3~8%的人會嚴重到產生經前不悅症（premenstrual dysphoric disorder, PMDD），表示症狀已經嚴重到對日常生活造成實質影響。
經前症候群的原因錯綜複雜，真正致病機轉目前還不是很清楚，可能是和黃體激素和雌激素比例失調有關。另外，營養不均衡（高脂肪或糖鹽過多）、維他命B6不足、甲狀腺內分泌失調、鈣質缺乏、身心壓力、睡眠不良、環境污染等，都可能影響經前症候群的表現。西醫治療常使用的藥物大致可分為抗焦慮藥物、內分泌調節藥物，以及口服避孕藥等。
簡珮珊醫師：中醫依據不同證型做不同的治療
中醫依據不同證型做不同的治療，最常見的為「肝氣鬱結型」，是指平時容易緊張焦慮，經前焦躁易怒更加嚴重、胸部悶脹、乳房脹痛、胃口不好，治法以疏肝解鬱，理氣散結，處方可選用逍遙散來治療。第二種為「肝腎陰虛型」，症狀常有經前易煩熱、夜睡不安、手足心煩熱、口乾，治法須滋養肝腎，育陰清熱，處方可選用知柏地黃丸加減來治療。
第三種為「氣滯血瘀型」，此類型的人在經前或經期常有頭痛、腹痛、肢體不定處疼痛、經前面貌及肢體腫脹、經色紫黯、血塊多，治法以理氣行滯，活血養血，處方可選用血府逐瘀湯加減治療。第四種為「氣血虛弱型」，可見月經顏色淡質稀、經期時眩暈，或平時腸胃功能欠佳，經前易疲倦、腹瀉、胃口不好，治法須補益氣血，健脾和胃，處方可選用補中益氣湯或六君子湯加減來治療。
另外，根據美國婦產科學院的建議，生活型態的改變也是一個很重要的治療方式，因為經前症候群是一種週期性的症狀，因此到了接近症狀發作的這段期間，應該避免攝取咖啡因、戒菸酒、規律的運動與營養補充如鈣質、維他命B6等，以及保持充足的睡眠，都有助於經前症候群的緩解。
簡珮珊醫師提醒，經前症候群的症狀多樣貌，每個人經歷到的症狀、嚴重程度都不盡相同，也會隨著時間而有所差異。大部分的人症狀輕微，影響不大，會有少數經前不悅症的女性，經前不適程度較嚴重，尤其情緒方面出現憂鬱、焦慮、易怒症狀明顯，或有其他強烈而難以承受的情緒，甚至已嚴重影響生活機能，建議應尋求醫師幫助並積極治療，讓每個月必經的過程不再如此難熬！
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