| 引用本文: |
邱俊峰, 吴丽通, 周文彬, 王全, 游旭军, 王彪, 周青.从“脑心与胆相通”理论探讨早泄的病机证治及生物学基础[J].湖南中医药大学学报,2026,46(5):1025-1030[点击复制] |
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| 从“脑心与胆相通”理论探讨早泄的病机证治及生物学基础 |
| 邱俊峰,吴丽通,周文彬,王全,游旭军,王彪,周青 |
| (湖南中医药大学第一中医临床学院, 湖南 长沙 410007;深圳市中医院, 广东 深圳 518033;广州中医药大学第四临床医学院, 广东 深圳 518033;深圳市宝安区中医院, 广东 深圳 518133;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 早泄（PE）的发病机制复杂，严重影响患者性生活质量及身心健康。精液的藏泄有度依赖于机体精、气、神之间的协调。基于“脑心与胆相通”理论结合现代临床医学相关机制研究探讨PE的病机证治，认为当脑、心、胆功能失常时，可沿“脑-心-肾-精室轴”进行病理传导，引起精室开合失度。或因心胆本虚致脑神失养浮越、肾失封藏，中枢神经递质紊乱而精关失摄；或因胆郁痰扰致动度失序、脑心神摇，心理-内分泌轴失衡而精泄；或因心胆火旺致相火妄动、肾阴耗伤，交感神经过度兴奋而迫精早泄。治疗方面，以复轴之协同、调神之统摄、固精之开合为根本目标进行精准辨治，补心胆之虚以敛脑神、固肾关，改善神经递质紊乱；疏肝胆之郁以化痰浊、调气机，平衡心理-内分泌轴；清泻心胆之火以滋肾阴、制相火，抑制交感神经过度兴奋，重建“脑心神统摄、胆气调达、肾精固密”的正反馈联系。以期为PE的中西医结合防治提供新的理论视角与科学依据，拓宽男性性功能障碍的诊疗思路。 |
| 关键词: 早泄|脑心与胆相通|脑-心-肾-精室轴|心胆同调|病机证治|生物学基础 |
| DOI：10.3969/j.issn.1674-070X.2026.05.022 |
| 投稿时间：2025-12-19 |
| 基金项目:国家自然科学基金青年科学基金项目（82305229）；深圳市科技计划资助项目（JCYJ20230807094759010）。 |
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| The pathogenesis, pattern identification, treatment, and biological basis of premature ejaculation based on the theory of "communication between the brain-heart and the gallbladder" |
| QIU Junfeng, WU Litong, ZHOU Wenbin, WANG Quan, YOU Xujun, WANG Biao, ZHOU Qing |
| (The First Clinical School of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518033, China;The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong 518033, China;Shenzhen Bao'an Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518133, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| The pathogenesis of premature ejaculation (PE) is complex, severely affecting patients' quality of sexual life and both physical and mental health. The balanced release and storage of semen relies on the coordination among the body's essence, qi, and spirit. Based on the theory of "communication between the brain-heart and the gallbladder", combined with relevant mechanism research of modern clinical medicine, this paper explores the pathogenesis, pattern identification, and treatment of PE, proposing that dysfunction of the brain, heart, and gallbladder can be transmitted along the "brain-heart-kidney-essence chamber axis", leading to dysregulation of the opening and closing of the essence chamber. Specifically: (1) Heart-gallbladder deficiency may cause malnourishment and restlessness of the brain spirit, weaken the kidney's storing function, and induce central neurotransmitter disorders, resulting in loss of ejaculatory control. (2) Gallbladder depression with phlegm disturbance may lead to disordered ejaculatory dynamics and agitation of the brain and heart spirit, imbalance of the psycho-endocrine axis, and consequent premature ejaculation. (3) Heart-gallbladder fire hyperactivity may stir the ministerial fire, consume kidney yin, and cause excessive sympathetic nervous system excitation, leading to premature ejaculation. Regarding treatment, the fundamental goals are to restore the synergistic function of the axis, regulate the governing action of the spirit, and consolidate the opening-closing mechanism of essence storage. Precision treatment based on pattern identification includes: tonifying heart-gallbladder deficiency to restrain the brain spirit, strengthen the kidney barrier, and ameliorate neurotransmitter disorders; soothing gallbladder depression to resolve phlegm turbidity, regulate qi movement, and balance the psycho-endocrine axis; clearing heart-gallbladder fire to nourish kidney yin, subdue ministerial fire, and inhibit sympathetic overexcitation, thereby reestablishing the positive feedback loop of "brain-heart spirit governance, gallbladder qi regulation, and kidney essence consolidation." This paper aims to provide new theoretical perspectives and scientific bases for the integrated Chinese and Western medicine prevention and treatment of PE, broadening diagnostic and therapeutic approaches to male sexual dysfunction. |
| Key words: premature ejaculation|communication between the brain-heart and the gallbladder|brain-heart-kidney-essence chamber axis|coordinated regulation of heart and gallbladder|pathogenesis and syndrome-based treatment|biological basis |
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