中医临床研究2025，Vol.17Issue(25)：88-93,6.DOI:10.3969/j.issn.1674-7860.2025.25.012
基于"上下交病,治其中"探讨勃起功能障碍和睡眠呼吸暂停综合征共病之中医辨治
Treating erectile dysfunction plus sleep apnea syndrome in TCM based on the theory of"regulating middle energizer to treat comorbidity of upper and lower energizers"
摘要
Abstract
The comorbidity of erectile dysfunction and sleep apnea syndrome is common clinical practice,interacting in a vicious cycle.Western medicine classifies diseases and treats them symptomatically,relieving symptoms temporarily but ignoring their internal connection,failing to break the cycle,with many adverse reactions,poor compliance of patients,and limited efficacy.Based on the theory of"regulating middle energizer to treat comorbidity of upper and lower energizers"in TCM,the pathogenesis and diagnostic and therapeutic methods of co-occurring diseases is explored in this study.The onset of erectile dysfunction is mainly related to the disorders of liver and kidney functions,and is related to the heart and spleen.The core lesion sites of sleep apnea syndrome involve heart and lungs of the upper energizer,and are linked to the spleen and kidneys.Their comorbidity present the characteristics of concurrent diseases in both upper energizer and lower energizer,with core pathogenesis of Qi(气)circulation dysfunction.Specifically,the lungs failing to disperse and descend,the liver failing to regulate and dredge,the kidneys failing to store essence,and the heart failing to govern,which interact with each other,leading to the disorder of the ascending and descending of Qi circulation throughout the body.Phlegm-dampness and blood stasis are persistent pathological factors running through the entire disease process.Specifically,spleen dysfunction can generate phlegm and dampness,Qi stagnation can cause blood stasis,and phlegm-dampness and blood stasis can ascend to the airways and aggravate sleep apnea syndrome,while phlegm-dampness and blood stasis descending to block the tendons and muscles can exacerbate erectile dysfunction,jointly forming a pathological closed loop of"phlegm,dampness,blood stasis-Qi circulation disorder-damage to the functions of internal organs".The spleen and stomach are the key links:they are not only the hub of ascending and descending of Qi circulation-the spleen rises and the stomach falls to assist the coordination of the heart,lung,liver,and kidney,but also the source of Qi and blood production,providing nutrients for the viscera.Strengthening the spleen can regulate Qi circulation,eliminate phlegm and dampness,disperse blood stasis,and restore the coordination of Zang-fu(脏腑)organs.Western medicine has confirmed that the connection between the functions of the spleen and stomach and the co-disease mechanism of the two from the aspects of endocrine metabolism,vascular endothelium function,and neural regulation,providing a basis for the principle of"regulating middle energizer to treat comorbidity of upper and lower energizers".Based on the theory of"regulating middle energizer to treat comorbidity of upper and lower energizers",this study breaks through the limitation of symptomatic treatment,and targets middle energizer integration adjustment,with theoretical basis and feasibility.Combined with modern medical optimization scheme,it is expected to improve the therapeutic efficacy and offer a new clinical strategy.关键词
勃起功能障碍/睡眠呼吸暂停综合征/上下交病,治其中/辨证论治Key words
Erectile dysfunction/Sleep apnea syndrome/Regulating middle energizer to treat comorbidity of upper and lower energizers/Syndrome differentiation and treatment分类
医药卫生引用本文复制引用
吴家乐,崔云,金童童,胡家伟,潘志豪,应志康..基于"上下交病,治其中"探讨勃起功能障碍和睡眠呼吸暂停综合征共病之中医辨治[J].中医临床研究,2025,17(25):88-93,6.基金项目
崔云全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号) （国中医药人教函[2022]75号）
国家中医优势专科建设项目(国中医药政函[2024]90号) （国中医药政函[2024]90号）
浙江省中医药科学研究基金项目(2022ZB337,2022ZB311) （2022ZB337,2022ZB311）
浙江省中医药科技计划项目(2023ZF161,2023ZF042). （2023ZF161,2023ZF042）
