“Xiang (phenomenon⁃based) Thinking” is the core conceptual methodology that shaped the theoretical framework of life and the human body in Traditional Chinese Medicine. The theory of yin⁃yang is a specific manifestation and application of “Xiang (phenomenon⁃based) Thinking” within the field of Traditional Chinese Medicine. Based on the yin⁃yang theory, this paper interprets the pathogenesis of polycystic ovary syndrome from the perspective of the “Xiang (phenomenon⁃based) Thinking” of “yin deficiency⁃yang hyperactivity⁃imbalance of qi and blood”. It posits that the disease foundation of polycystic ovary syndrome lies in “yin deficiency generating internal heat, resulting in disharmony of the Chong and Ren meridians” “yang hyperactivity leading to qi stagnation and damp⁃heat pouring downward”, and “imbalance of qi and blood, leading to hindered follicular development”. The growth of follicles is akin to the rising of yang qi in spring, belonging to yang, while the growth of endometrium is like the nourishing of water and soil, belonging to yin. Therefore, the treatment for inducing ovulation should focus on tonifying qi and supporting yang, aligning with the cyclical changes of heaven and earth’s yin and yang. Using sweet and warm herbs to raise the spleen yin (Ji Earth) and fortify the earth to harmonize the Chong and Ren meridians, thereby regulating qi and blood and balancing yin and yang; furthermore, employing warm and drying herbs to raise the stomach yang (Wu Earth) and dry the spleen yin (Ji Earth), thus resolving phlegm⁃dampness and smoothing qi movement. This provides a medicinal approach for inducing ovulation in polycystic ovary syndrome.

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