基于“玄府-气血-络脉”轴从“宣、清、通、补”探讨勃起功能障碍用药思路  

Based on the“Xuanfu-Qi and Blood-Collaterals”axis,the medication strategies for erectile dysfunction are explored from the aspects of“dispersing,clearing,unblocking and tonifying”

作　　者：韦一 洪志明[1,2] 邱俊峰 陈子龙 邝浩 王胜杰 黄焕 唐庆祥 WEI Yi;HONG Zhiming;QIU Junfeng;CHEN Zilong;KUANG Hao;WANG Shengjie;HUANG Huan;TANG Qingxiang(The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine,Shenzhen 518033,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033

出　　处：《陕西中医》2025年第5期647-650,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金资助项目(82305229);中国中医科学院科技创新工程重大攻关项目(CI2021A02208);广东省深圳市中医重点专科建设项目[深卫健中医(2019)22号];广东省深圳市科技计划项目(JCYJ20230807094759010,JCYJ20220531092201002)。

摘　　要：勃起功能障碍(ED)是指性交时阴茎勃起困难或勃而不坚、坚而不久以致不能完成性生活的一种病症。依据其临床表现,古今医家将其归入“阳痿”“阴器不用”“筋痿”等范畴。洪志明教授认为“玄府-气血-络脉”三者协同配合是男性阴茎得以正常勃起的生理基础,提出“玄府-气血-络脉”轴失调为本病的发病基础,其中玄府郁闭、阳气不宣是ED的始动病理环节,气血失和、宗筋失用是ED发病的核心要素,络脉虚滞、气虚血瘀是影响ED预后的病理关键。临证施治时贯彻“宣、清、通、补”用药观念,根据不同病理阶段分别施以花类药、清热利湿药、虫类药、藤类药及血肉有情之品,总体注重“以通为用,通补结合”的治疗理念,旨在为ED的临床辨治提供新的视角与借鉴。Erectile dysfunction refers to the difficulty of penile erection during sexual intercourse or erection is not firm,firm and not long enough to complete sexual life a disease.According to its clinical manifestations,ancient and modern doctors classified it into the categories of“impotence”,“non-use of Yin organs”and“impotence”.Professor HONG Zhiming believes that the coordination of“Xuanfu-Qi and Blood-Collaterals”is the physiological basis for the normal erection of the male penis,and proposes that the disorder of the axis of“Xuanfu-Qi and Blood-Collaterals”is the basis for the pathogenesis of ED.Among them,the stagnation of Xuanfu and the lack of Yang qi are the initial pathological links,and the imbalance of qi and blood and the apraxia of meridians are the core elements of the pathogenesis of ED.Qi deficiency and blood stasis are the key pathological factors affecting the prognosis of ED.In the clinical treatment of ED,the drug concept of“dispersing,clearing,unblocking and tonifying”is implemented.According to the different pathological stages,flower drugs,heat clearing and dampness drugs,insect drugs,cane drugs,and blood and flesh and emotional products are used respectively.

关 键 词：勃起功能障碍 玄府 络脉 气血 以通为用 

分 类 号：R697.1[医药卫生—泌尿科学]