从痰瘀浊毒学说探讨男性不育症病因病机与诊治策略  

Thoughts on the Etiology and Pathogenesis of Male Infertility based on the Theory of Phlegm,Stasis and Turbid Toxin

作　　者：郑军状[1,2] 崔云 吴骏 陶方泽 杜宝昕[5] 刘冰 韩铝洲 方腾铎 秦培芝 刘庆华 ZHENG Jun-zhuang;CUI Yun;WU Jun;TAO Fang-ze;DU Bao-xin;LIU Bing;HAN Lv-zhou;FANG Teng-duo;Qin Pei-zhi;LIU Qing-hua(The Third School of Medicine Affiliated to Zhejiang Chinese Medical University,Hangzhou Zhejiang 310053,China;Cixi Hospital of Traditional Chinese Medicine,Cixi Zhejiang 315300,China;Ningbo Hospital of Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Ningbo Zhejiang 315010,China;The Third Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210001,China;Chonqing Hospital of Traditional Chinese Medicine,Chonqing 400021,China;Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou Jiangsu 221000,China;Yuyao Hospital of Traditional Chinese Medicine,Yuyao Zhejiang 315400,China)

机构地区：[1]浙江中医药大学第三临床医学院,浙江杭州310053 [2]慈溪市中医医院,浙江慈溪315300 [3]浙江中医药大学附属宁波中医院,浙江宁波315010 [4]南京中医药大学第三附属医院,江苏南京210001 [5]重庆市中医院,重庆400021 [6]徐州市中医医院,江苏徐州221000 [7]余姚市中医医院,浙江余姚315400

出　　处：《中医药导报》2020年第10期138-142,150,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(81673985);第六批全国老中医药专家学术经验继承工作项目(国中医药人教发[2017]29号);浙江省自然科学基金项目(LY16H270005);浙江省中医药科技计划科研基金项目(2019ZB118,2018ZA031,2017ZA043)。

摘　　要：围绕痰瘀浊毒学说源流、痰瘀浊毒与男性不育症中医病因病机、痰瘀浊毒与男性不育症西医病理关系等进行论述,提出痰瘀浊毒学说指导下的男性不育症诊治新策略:探索男性不育症特异性分子靶向标志物,从精子形态、能量代谢与精浆生化评估精子质量,重视细胞免疫与神经内分泌在男性不育症中的作用;治疗以涤痰化浊、活血化瘀法,清热解毒、导浊化湿法,"症(精)-病-体-证"多元思辨法等。认为亟待加强男性不育症中医体质学、男性不育症中医辨证分型与理化指标关系、男性不育症领域的中医理论创新与实验等方面的研究。Phlegm,blood stasis,turbidity and toxin,as the etiology and pathological products of male infertility,have been emphasized in clinical practice.This paper discusses the origin of the theory of phlegm stasis and turbidity toxin,the relationship between phlegm stasis and turbidity toxin and the pathogenesis of male infertility in TCM,and the relationship between phlegm stasis and turbidity toxin and the pathological mechanism of male infertility,tries to elaborate the new ideas and strategies of TCM treatment on male infertility as follows:exploring specific molecular targeting markers for male infertility,evaluating sperm quality from sperm morphology,energy metabolism and seminal plasma biochemistry,and focusing on role of cellular immunity and neuroendocrinology in male infertility.In detail,the therapies include"Cleanse phlegm and turbid,invigorate blood and remove stasis","clear heat and detoxify,guide turbid and wet"and pattern of"Syptom(sperm)-Disease-Constitution-Syndrome".It is pointed out that it is urgent to strengthen the research on TCM constitution of male infertility,the relationship between TCM syndrome differentiation and physical and chemical indexes,and the theoretical innovation and experiment of TCM in the field of male infertility.

关 键 词：痰瘀浊毒学说 男性不育症 病因病机 诊治策略 

分 类 号：R277.5[医药卫生—中医学]