男性迟发性性腺功能减退症的中西医认识与中医药干预可能机制探讨  

Discussion of late-onset hypogonadism in male’s understanding of traditional Chinese medicine and western medicine and the possible mechanism of traditional Chinese medicine intervention

作　　者：周兴[1,2] 唐雪 周青 李波男[4] 周海亮 何清湖 ZHOU Xing;TANG Xue;ZHOU Qing;LI Bo-nan;ZHOU Hai-liang;HE Qing-hu(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Jinling Hospital,Nanjing,210002,China;Hunan Provincial TCM Hospital,Changsha 410005,China;Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学第一附属医院,长沙410007 [2]东部战区总医院,南京210002 [3]湖南省中医院,长沙410005 [4]湖南中医药大学,长沙410208

出　　处：《中华中医药杂志》2020年第3期1327-1331,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金(No.81202706,No.81673984);湖南省自然科学基金(No.2018JJ3402);长沙市科技计划项目经费资助-长沙市杰出创新青年培养计划(No.kq1802015);湖南省高层次卫生人才225工程医学学科骨干人才培养对象(No.湘卫函[2019]196号);湖南创新型省份建设专项经费资助-“湖湘青年英才”支持计划(No.2019RS2041);中华中医药学会“青年人才托举工程”。

摘　　要：男性迟发性性腺功能减退症(LOH)是中老年男性常见病、多发病,中、西医对其病因病机、诊治等认识存在差异与统一,以睾酮水平低下为研究关键切入点,睾酮补充治疗(TST)是LOH治疗的重要方法之一,但其剂量、疗程、安全性等问题尚未解决。中医药基于辨证论治理论体系,可以整体改善LOH患者症状,具有一定优势。文章同时从Leydig细胞睾酮合成酶、活性氧簇(ROS)、自噬、旁分泌、雄激素受体(AR)、下丘脑-垂体-睾丸轴等多靶点、多途径对中医药干预LOH的可能机制提供研究思路。Late-onset hypogonadism in male(LOH)is a common and frequently-occurring disease in middle-aged and elderly men,traditional Chinese medicine(TCM)and western medicine have different and unified understandings about the etiology,pathogenesis,diagnosis,and treatment of LOH.Taking the decrease of testosterone level as the key entry point,testosterone supplementation therapy(TST)is one of the important methods for LOH treatment,but its dosage,course safety and other issues have not yet been resolved.The TCM based on syndrome differentiation theory can improve the symptoms of LOH patients as a whole and has certain advantages.This paper also provides research ideas at the same time from Leydig cell testosterone synthase,ROS,autophagy,paracrine,AR,hypothalamus-pituitary-testicular axis and other multi-target,multi-channel possible mechanism of TCM intervention in LOH.

关 键 词：男性迟发性性腺功能减退症 睾酮 中西医结合 干预机制 研究思路 

分 类 号：R697[医药卫生—泌尿科学]