文章摘要
戎平安,朱清.从肝论治男科疾病探析[J].浙江中医药大学学报,2022,(5):551-554.
从肝论治男科疾病探析
Analysis on Treatment of Andrological Diseases from the Perspective of Liver
DOI:10.16466/j.issn1005-5509.2022.05.016
中文关键词: 男科疾病    疏泄  藏血  足厥阴肝经  脏腑辨证  肝肾同源
英文关键词: andrological diseases  liver  dredging  storing blood  Jueyin liver meridian of foot  syndrome differentiation of Zangfu viscera  liver-kidney homology
基金项目:
作者单位
戎平安 岱山县中医院 浙江舟山 316200 
朱清 岱山县中医院 浙江舟山 316200 
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中文摘要:
      [目的] 探讨从肝论治男科疾病的临床意义。[方法] 参考《灵枢·经脉》篇对于男科疾病肝失疏泄病机的观点,从疏肝理气、清肝利湿、滋养肝肾等方面论治男科疾病,综合分析心因性勃起功能障碍、功能性不射精症、早泄、静脉曲张性不育四则代表性案例,总结从肝论治男科疾病的临床意义。[结果] 从肝论治男科疾病,其中,心因性勃起功能障碍是因心情不佳、肝失疏泄导致性生活的质量下降,故以疏肝理气、温补肾阳治疗为主;功能性不射精症是肝气郁滞,疏泄失常,导致两肋胀闷,不能射精,故以逍遥散疏利肝气,加炒枳壳、预知子、青皮等加强疏肝之功,丹参、路路通活血通络,再加生地黄、菟丝子补益肾精,可达到良好的疗效;早泄多为肝气郁滞、开阖失度,故拟疏肝理气、固肾封藏之方,加以精神疏导,协同治疗,效果较佳;静脉曲张性不育的主要病因病机为肝郁、血瘀、肾虚,故治疗上以疏肝、活血化瘀、益肾为主。[结论] 肝的疏泄、藏血功能对男性性功能具有广泛影响,以肝脏理论为基础治疗男科疾病具有较好的临床疗效,可为临床提供指导。
英文摘要:
      [Objective] To explore the clinical significance of treatment of andrological diseases from the perspective of liver. [Methods] Referring to the viewpoint of Lingshu·Jingmai(Miraculous Pivot·Meridian Vessel) on the pathogenesis of liver failing to control dispersing in andrological diseases and aiming at the pathogenesis of andrological diseases from the aspects of dispersing the liver and rectifying Qi, clearing the liver fire and removing dampness, and nourishing the liver and kidney, four representative cases of psychogenic erectile dysfunction, functional anejaculation, premature ejaculation and varicose infertility were comprehensively analyzed to summarize the clinical significance of treating andrological diseases from the perspective of liver. [Results] From the perspective of liver to explore the diseases, psychogenic erectile dysfunction was caused by poor mood and liver Qi failing to disperse and dredge which could affect the quality of sexual life, therefore the treatment of dispersing the liver and rectifying Qi and warming and invigorating the kidney Yang was given in priority. Functional anejaculation was due to stagnation of liver Qi and abnormal dredging which resulted in distension and depression of the ribs and inability to ejaculate, so Xiaoyao Powder for soothing the liver Qi, Fructus Aurantii(Chaozhike)+Akebia Fruit(Yuzhizi)+Pericarpium Citri Reticulatae Viride(Qingpi) for strengthening the function of soothing the liver, Salvia Miltiorrhiza(Danshen)+Liquidambar Formosana Hance(Lulutong) for promoting blood circulation to remove meridian obstruction and Rehmannia Glutinosa(Shengdi)+Semen Cuscutae(Tusizi) for replenishing kidney essence could achieve good efficacy. Premature ejaculation was mostly attributed to stagnation of liver Qi and abnormal opening and closing of the kidney, so the prescription of dispersing the liver and rectifying Qi and consolidating the kidney combined with mental counseling collaborative treatment was adopted and achieved good effects. In varicose infertility, liver depression, blood stasis and kidney deficiency were considered to be the main causes of diseases pathogenesis, so the treatment was mainly to soothe the liver, promote blood circulation to remove blood stasis and tonify the kidney. [Conclusion] The functions of dredging and storing blood of the liver have extensive influence on male function. The treatment of andrological diseases based on liver theory has a good clinical efficacy and can provide the clinical guidance.
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