北京中医药大学学报2025，Vol.48Issue(6)：821-826,6.DOI:10.3969/j.issn.1006-2157.2025.06.012
从《金匮要略》虚劳理论探讨男性不育症经方辨治规律
Discussion on diagnostic and treatment patterns of male infertility based on the theory of consumption from Synopsis of Golden Chamber
摘要
Abstract
The Synopsis of Golden Chamber(Jinui Yaolue)first identified consumption as the primary pathogenesis of male infertility.The core mechanism underlying infertility owing to consumption lies in the deficiency of bodily fluids(Jin and Ye)and blood,referred to as fluid-blood deficiency.This condition links the overall vitality of the body's righteous qi with fertility,permeating the entire disease course and serving as the central focus for treatment with classical formulas(Jingfang).Although the causes of consumptive disease differ between ancient and modern times—ranging from physical labor and famine in historical contexts to mental stress,disordered dietary and sleep patterns,and delayed marriage or childbearing in contemporary society,the pathogenesis consistently converges on fluid-blood deficiency.Modern patients often present with mild symptoms owing to improved living conditions,which can obscure the underlying consumptive disease.Therefore,accurate diagnosis requires meticulous attention to subtle clinical signs,including specific symptoms,pulse manifestations,and complexion changes.Clinical differentiation of the two stages of fluid-blood deficiency is essential.The first stage,characterized as an early-stage fluid-blood deficiency,presents with middle energizer weakness,impaired pivot function,and upper heat-lower cold patterns.Treatment at this stage emphasizes fortifying the middle energizer(Jianzhong),harmonizing yin-yang,and restoring fluid-blood production,as demonstrated by the use of formulas like Guizhi Decoction and its variants.The second stage is advanced fluid-blood deficiency,marked by triple energizer qi collapse and phlegm-blood stasis obstruction.In accordance with the principle from Jingui Yaolue of"gentle tonification while resolving stagnation"(Huan Zhong Bu Xu),treatment focuses on warming the lower energizer,consolidating fluids-blood,dissolving stasis,and relieving abdominal fullness in the middle energizer.For this stage,Tianxiong Powder is recommended in cases dominated by cold,Dahuang Zhechong Pill in cases dominated by phlegm-stasis,and Shenqi Pill in cases involving dual yin-yang deficiency.关键词
男性不育症/虚劳/金匮要略/经方/津血虚/缓中补虚Key words
male infertility/consumption/Synopsis of Golden Chamber(Jingui Yaolue)/classical formulas/fluid-blood deficiency/gentle tonification while resolving stagnation分类
医药卫生引用本文复制引用
吴维真,鲍丙豪,刘保兴..从《金匮要略》虚劳理论探讨男性不育症经方辨治规律[J].北京中医药大学学报,2025,48(6):821-826,6.基金项目
国家自然科学基金面上项目(No.82274517) （No.82274517）
北京中医药薪火传承"3+3"工程胡希恕名家研究室(No.2019-BJZYJ-002)National Natural Science Foundation of China(No.82274517) （No.2019-BJZYJ-002）
