| 引用本文: |
韦一, 洪志明, 邱俊峰, 陈子龙, 王胜杰, 陈文铄, 张廉勤, 陈春秀.基于“玄府-气血-络脉”理论探讨阴茎异常勃起的因机证治[J].湖南中医药大学学报,2025,45(4):719-724[点击复制] |
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| 基于“玄府-气血-络脉”理论探讨阴茎异常勃起的因机证治 |
| 韦一,洪志明,邱俊峰,陈子龙,王胜杰,陈文铄,张廉勤,陈春秀 |
| (广州中医药大学第四临床医学院, 广东 深圳 518033;深圳市中医院, 广东 深圳 518033) |
| 摘要: |
| 阴茎异常勃起指无性兴奋或性高潮后阴茎不能转入疲软，长时间持续呈痛性勃起的一种病症。依据其临床表现，古今医家将阴茎异常勃起归属于中医学“阳强”“阴纵”“阴举不衰”等范畴。“玄府-络脉”作为调控阴茎气血充盈与疏泄的基础结构，参与阴茎勃起与疲软的全过程，是保障阴茎正常勃起的关键。基于“玄府-气血-络脉”理论提出“玄府失调，络脉不通，宗筋失用”为本病核心病机，具体涵盖3个病理阶段：肝胆火炽，玄府闭阻，络脉壅塞；阴虚阳亢，玄府失和，络脉失养；痰瘀痹阻，玄府不利，络脉瘀滞；提出以“调玄通络法”为核心治法，根据不同病理阶段衍生出疏肝泻火，畅络启玄；滋阴降火，润络养玄；祛瘀化痰，通络开玄3种基础治法，总体注重“以通为用”理念，旨在为阴茎异常勃起的临床辨治提供新的视角。 |
| 关键词: 阴茎异常勃起 玄府 气血 络脉 以通为用 辨证论治 |
| DOI：10.3969/j.issn.1674-070X.2025.04.020 |
| 投稿时间：2024-10-28 |
| 基金项目:国家自然科学基金青年科学基金项目（82305229）；中国中医科学院科技创新工程重大攻关项目（CI2021A02208）；深圳市中医重点专科建设项目（深卫健中医〔2019〕22号）；深圳市科技计划资助项目（JCYJ20230807094759010，JCYJ20220531092201002）。 |
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| Etiology, pathogenesis, pattern differentiation and treatment of priapism based on the theory of "mysterious mansion-qi and blood-collaterals" |
| WEI Yi, HONG Zhiming, QIU Junfeng, CHEN Zilong, WANG Shengjie, CHEN Wenshuo, ZHANG Lianqin, CHEN Chunxiu |
| (The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong 518033, China;Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518033, China) |
| Abstract: |
| Priapism refers to a condition in which the penis remains erect and cannot become flaccid after sexual excitement or orgasm, resulting in prolonged and painful erections. According to its clinical manifestations, ancient and modern practitioners of Chinese medicine classify priapism under categories such as "penis rigidity", "prolonged penis erection", and "persistent erection". As the basic structure that regulates the filling and drainage of qi and blood in the penis, "mysterious mansion (a collective term for the minute structures through which qi, blood and body fluids circulate and move)-collaterals" participates in the whole process of penile erection and detumescence, and is the key to ensure the normal erection of the penis. Based on the theory of "mysterious mansion-qi and blood-collaterals", the core pathogenesis of this condition is emphasized as "disorder of mysterious mansion, obstruction of collaterals, and dysfunction of penis." It covers three pathological stages: exuberant fire in the liver and gallbladder causing the blockage of mysterious mansion and collaterals; yin deficiency and yang hyperactivity causing mysterious mansion disharmony and collateral malnutrition; phlegm and blood stasis obstructing mysterious mansion and collaterals. The treatment approach centers on "regulating the mysterious mansion and unblocking the collaterals." According to different pathological stages, it derives three foundational treatment strategies: soothing the liver and reducing fire, unblocking the collaterals and activating the mysterious mansion; nourishing yin and reducing fire, moistening the collaterals and nourishing the mysterious mansion; eliminating stasis and resolving phlegm, unblocking the collaterals and opening the mysterious mansion. Overall, the treatment emphasizes the principle of "applying unblocking as the essential." This paper aims to provide a new perspective for the clinical pattern differentiation and treatment of priapism. |
| Key words: priapism mysterious mansion qi and blood collaterals applying unblocking as the essential pattern differentiation and treatment |
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