基于"脏腑别通"理论探讨男性下尿路症状的证治
Exploring the treatment based on syndrome differentiation of male lower urinary tract symptoms based on the theory of "zang-fu extraordinary connection"
杨九天 1郭军 2高庆和 2赵明 1吴霜 1马东岳 2王安民 2王福2
作者信息
- 1. 北京中医药大学 北京 100029;中国中医科学院西苑医院男科
- 2. 中国中医科学院西苑医院男科
- 折叠
摘要
男性下尿路症状是以尿频、尿急、排尿困难为特征,与下尿路疾病相关的一组症状的统称,其中,常见原因为良性前列腺增生和膀胱过度活动症.随着全球人口老龄化加剧,男性下尿路症状发病率逐年上升.基于"脏腑别通"理论,从肺与膀胱、脾与小肠、肾与三焦3个角度阐释男性下尿路症状,认为肺气郁闭、膀胱气化不利,脾运不及、小肠主液失常,肾阳虚衰、三焦水道不通是男性下尿路症状的基本病机.治疗时当明辨病位,与肺及膀胱相关则提壶揭盖、开宣肺气以利膀胱,方用五苓散加紫苏叶、杏仁等化裁;与脾及小肠相关则升清降浊、健运脾气以通小肠,方用参苓白术散化裁;与肾及三焦相关则阴中求阳、温补肾气以疏利三焦,方用八味肾气丸化裁;同时,根据病情配合针灸、运动等疗法,可为临床辨治男性下尿路症状提供借鉴与参考.
Abstract
Male lower urinary tract symptoms is a collective term for a group of symptoms associated with lower urinary tract disorders characterized by frequent urination, urgent urination, and difficulty of urination, of which the common causes are benign prostatic hyperplasia or overactive bladder. With the aging of the global population, the incidence of male lower urinary tract symptoms is increasing year by year. Based on the theoretical connotation of " zang-fu extraordinary connection", the relationship between the lungs and the bladder, the spleen and the small intestine, and the kidneys and the sanjiao with the formation of male lower urinary tract symptoms is explained from three perspectives. It is believed that lung qi depression and closure, disturbance of qi transformation in bladder, and insufficient spleen transport occur, the small intestine is dysfunctional, kidney yang is exhausted, and obstruction of the sanjiao waterway are the basic pathogenesis of male lower urinary tract symptoms. It is emphasized that the location of the disease should be identified. If it is related to the lungs and the bladder, then the disease should be treated by lifting the pot to lift the lid and diffusing the lung qi to benefit the bladder with Wuling Powder plus perilla leaf and bitter apricot seed; if it is related to the spleen and the small intestines, then the disease should be treated by raising the clear and directing the turbid downward and improving the spleen qi in order to support the small intestines with Shenling Baizhu Powder; if it is related to the kidneys and the sanjiao, then the disease should be treated by seeking the yang within the yin and warming and tonifying the kidney qi in order to dredge up the sanjiao with Bawei Shenqi Pill. According to the patient's condition, treatment can be combined with acupuncture, exercise, and other therapies. This paper can provide reference for clinical treatment of male lower urinary tract symptoms.
关键词
脏腑别通/男性下尿路症状/良性前列腺增生/膀胱过度活动症/辨证论治Key words
zang-fu extraordinary connection/male lower urinary tract symptoms/benign prostatic hyperplasia/overactive bladder/treatment based on syndrome differentiation引用本文复制引用
基金项目
国家自然科学基金青年科学基金(82104880)
中华中医药学会青年求实项目(2023-QNQS-02)
出版年
2024
国家科技期刊平台
NSTL
万方数据