中医药在男性生殖内分泌疾病中的应用  

Application of Chinese Traditional Medicine in Male Reproductive Endocrine Diseases

作　　者：孙大林[1,2] 金保方[1,2] 

机构地区：[1]南京中医药大学第三附属医院男科 [2]南京中医药大学男科学研究所,210001

出　　处：《国际生殖健康／计划生育杂志》2014年第6期458-461,共4页Journal of International Reproductive Health/Family Planning

摘　　要：男性生殖内分泌疾病主要表现为下丘脑-垂体-睾丸轴的异常,睾丸是这一病变的中心环节,具有合成雄激素和精子发生的功能。中医药基本理论认为"肾藏精,主生殖","肝主疏泄",对肾、天癸和肝的认识与现代生殖内分泌的理论相类似。近年来,中医药在男性生殖内分泌疾病的治疗得到了较为广泛的应用,并取得了一定的疗效。现分别从中医药在青春期发育异常(包括性早熟和青春期发育延迟)、迟发性性腺功能减退症以及高泌乳素血症等常见内分泌疾病中的应用予以综述和分析,探讨中医药在男性生殖内分泌疾病治疗中的重要地位,并认为肾主生殖,主持统领人体的生殖机能,有类似下丘脑-垂体-睾丸轴的作用,是生殖内分泌的核心,肾气及肾精的盛衰体现了人体生殖内分泌的功能状态和生殖能力的盛衰。补肾疏肝为多数生殖内分泌疾病的共用治法,可通过调控下丘脑-垂体-睾丸轴,调节睾酮的合成,进而治疗疾病。但总体仍缺乏大样本的循证医学报道和机制研究,有待进一步深入探索。Male reproductive endocrine disorders mainly manifest the abnormalities of hypothalamic-pituitary-testicular axis,in which testicular lesion is the central position because of testicular functions of androgen synthesis and sperm production. The basic theory of traditional Chinese medicine that ＂the kidney essence leads reproduction＂ and ＂Liver leads dispersion＂, and that the ＂kidneys＂, ＂tiangui＂ and ＂liver＂ were newly understood in Chinese medicine, is similar to the theoretical understanding on modern reproductive endocrinology. In recent years,Chinese medicine has been generally used in male reproductive endocrine disorders with a certain efficiency. In this paper,we reviewed the application of Chinese medicine in disorders of adolescent development（including precocious and delayed puberty）,late-onset hypogonadism and hyperprolactinemia. We emphasized that ＂kidney＂ in Chinese medicine,the core of reproductive endocrinology,presides over reproduction which is similar to the reproductive axis. ＂Kidney Qi＂ and ＂kidney essence＂ predict the function of reproductive endocrinology and fertility. The methods of ＂reinforcing kidney＂ and ＂soothing liver＂ by regulating reproductive axis with Chinese medicine is the most common therapeutic methods to regulate androgen level.However, it is necessary in future to do more study on evidence-based medicine with large samples and intensive study on mechanism.

关 键 词：医学 中国传统 内分泌系统疾病 青春期发育 青春期 延迟 性腺功能减退症 高催乳素血症 

分 类 号：R277.5[医药卫生—中医学]