The theory of five-yun and six-qi deduces annual climatic changes based on the heavenly stems and earthly branches, and systematically elucidates the impacts of temporal variations on qi and blood, yin yang, and zang-fu organ functions in the human body. The core pathogenesis of polycystic ovary syndrome (PCOS) lies in the dysfunction of the "kidney-tiangui-chongren-uterus" reproductive axis, presenting as a complex pathological state intertwined with original asthenia (insufficient kidney essence) and superficial asthenia (phlegm-dampness, liver depression and static blood). Its occurrence and progression are closely related to the pattern of year evolutive phase. Based on the traditional Chinese medicine reproductive axis, this paper elucidates the regulatory rules of the theory of five-yun and six-qi on the pathogenesis, syndrome evolution and treatment strategies of PCOS, so as to provide a reference for time-adapted treatment and treatment based on syndrome differentiation.

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