从“天癸-肝肾”论治男性迟发性性腺功能减退症  

Treating late onset hypogonadism in male based on "Tian Gui-liver and kidney"

作　　者：吴悔 宁港 李波男 石若冰 周兴[1] WU Hui;NING Gang;LI Bonan;SHI Ruobing;ZHOU Xing(The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China;Graduate School of Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学研究生院,湖南长沙410208

出　　处：《湖南中医药大学学报》2023年第2期354-358,共5页Journal of Hunan University of Chinese Medicine

基　　金：国家自然科学基金项目(82074444,81673984);湖南省教育厅重点项目(20A368);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项目(kq1802015);湖南中医药大学中西医结合一流学科开放基金项目(2020ZXYJH64)。

摘　　要：男性迟发性性腺功能减退症(late onset hypogonadism, LOH)临床症状多样,影响广泛,患病率较高,对中老年男性身心健康危害重大。基于天癸理论,从中医视角辨治LOH具有重要临床价值。天癸源于肾精,受肝脏疏泄而发挥正常功能,天癸竭、肾虚、肝郁三者相互作用共同导致LOH发病。在此过程中,“天癸渐竭”是LOH发病的根本因素;“肾虚肝郁”是LOH发病的主要因素,其中,“肾虚”导致天癸化生乏源而亏虚更甚;“肝郁”则导致天癸疏泄失司而功能失调。“天癸渐竭、肾虚肝郁”构成LOH发病的中医核心病机,因此,治疗上强调未病调天癸,既病调肝肾,以期为LOH的论治提供新思路。Late onset hypogonadism(LOH) in male manifests various clinical symptoms with high prevalence rate, and it brings great harm to the physical and mental health of middle-aged and elderly males. It is of clinical value to differentiate and treat LOH from the perspective of Chinese medicine. Tian Gui is derived from kidney essence and plays its normal function by the free flow of qi governed by the liver. Thus, Tian Gui decline, kidney deficiency, liver depression can interact with each other to cause LOH. To sum up, "Tian Gui gradually declines" is the root cause of LOH;"kidney deficiency and liver depression" is the main factor of LOH, among which "kidney deficiency" results in the poor generation of Tian Gui, leading to more serious deficiency of it;"liver depression" fails Tian Gui in draining and thus leads to dysfunction;"gradual decline of Tian Gui, and kidney deficiency and liver depression" constitute the core pathogenesis of LOH in Chinese medicine. Therefore, it is emphasized to regulate Tian Gui before the onset of disease, and regulate liver and kidney when being diseased in Chinese medicine. This study could provide new ideas for the treatment of LOH.

关 键 词：男性迟发性性腺功能减退症 病机 天癸 肾虚 肝郁 

分 类 号：R259[医药卫生—中西医结合]