从“正邪分争”探析睾丸辐射损伤的机制和其治疗原则  

Exploring the mechanism and treatment principles of testicular radiation injury from the perspective of"the struggle between vital qi and pathogen"theory

作　　者：陈晓莹 王安 叶一帆 王艳 高源锴 徐晴 王舒冉 赵章弟 胡素敏 CHEN Xiaoying;WANG An;YE Yifan;WANG Yan;GAO Yuankai;XU Qing;WANG Shuran;ZHAO Zhangdi;HU Sumin(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医学院,北京100029

出　　处：《北京中医药大学学报》2025年第3期379-385,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.12075035);北京中医药大学科研发展基金项目(No.2021-ZXFZJJ-014)。

摘　　要：睾丸辐射损伤是由放射线直接或间接引起的睾丸结构和功能异常,从而阻碍精子发生,影响男性生育能力。鉴于睾丸辐射损伤在临床的高发性及其对患者生育能力和整体健康的深远影响,开展有关防治措施的研究非常迫切与重要。“正邪分争”首见于《伤寒论》,是指正气与邪气相争持。一切疾病的发生、发展和转归都是正邪分争的体现。基于此,本文提出将睾丸的正气归纳为化生、封藏生殖之精和抵御外邪的能力,将引起睾丸辐射损伤的邪气分为电离毒和羁留邪。结合“正”“邪”的特点,将睾丸辐射损伤分为损伤期、胶着期和恢复期3个阶段。同时,基于本研究提出睾丸辐射损伤的治疗应以扶正祛邪为基本原则,扶正为主,兼以祛邪。本文拟通过对睾丸辐射损伤过程和治疗原则的阐释,为其中医诊断及防治提供新的视角与策略。Testicular radiation injury is a structural and functional abnormality of the testes caused directly or indirectly by radiation,which disrupts spermatogenesis and compromises male fertility.The development of effective preventive and therapeutic interventions is essential because of the high prevalence of this condition in clinical settings and its profound effect on patients′reproductive health and overall well-being.The concept of"the struggle between vital qi and pathogen"is first seen in the Treatise on Cold Pathogenic Diseases.It denotes the dynamic struggle between vital and pathogenic qi.The occurrence,development,and sequelae of all diseases reflect this ongoing conflict.In this context,this study defines the"vital qi"of the testis as its capacity to generate and preserve the essence of reproduction and to resist damage.The pathogenic qi associated with testicular radiation injury is categorized into two types:ionizing poison and retaining evil.The pathogenesis of testicular radiation damage is delineated into three stages by integrating the characteristics of vital and pathogenic qi:the injury,adhesion,and recovery phases.Based on the theoretical framework advanced by this study,the therapeutic approach for testicular radiation injury should adhere to the fundamental principle ofstrengthening vital qi and eliminating pathogenic factors.Although the primary focus of treatment should be on strengthening vital qi,it should also be complemented by strategies to eliminate pathogenic influences.This paper aims to provide a novel perspective and strategic approach to the traditional Chinese medicine diagnosis,prevention,and treatment of testicular radiation injury.By elucidating the process of testicular radiation injury and its corresponding treatment principles,it seeks to offer valuable insights for clinical practice.

关 键 词：正邪分争 睾丸 辐射损伤 扶正祛邪 生育能力保护 

分 类 号：R277.5[医药卫生—中医学]