《基于肝郁血瘀肾虚论治阳痿》专家共识

Expert Consensus of Impotence Treatment Based on Liver Depression Blood Stasis and Deficiency of Kidney

鉴于临床论治阳痿疗效不太满意的现实,该共识根据中医基本理论,结合流行病学研究结果和临床实践结局,提出"肝郁血瘀肾虚"是阳痿中医发病学基本病理变化的理论观点。该共识认为,在阳痿发病过程中,肝郁的病理变化具有普遍性而为主要病理特点、血瘀是发病的最终病理趋势、肾虚是发病的主要病理趋势,且三者互为因果,共同作用,影响阴茎的勃起;中青年时期以肝郁血瘀为主、肾虚次之,老年时期以肾虚血瘀为主、肝郁次之。治疗当以疏肝、活血、益肾为基本原则,根据肝郁、血瘀、肾虚轻重程度选用疏肝剂、活血剂、补肾剂加减化裁治疗,也可选用疏肝药、活血药、补肾药组方治疗。具体可选四逆散合秃鸡散、益肾活血汤、柴丹振阳颗粒等方剂加减。

In view of the clinical curative effect on impotence is not satisfied,the consensus according to the basic theory of traditional Chinese medicine,combined with the results of epidemiological studies and clinical practice outcomes,puts forward the syndrome of stagnation of liver Qi and deficiency of kidney and blood stasis is the basic pathological changes of impotent disease of traditional Chinese medicine. The consensus holds opinions that on the pathogenesis of impotence. The pathological changes of the liver has universality and as the main pathological features,blood stasis is the final pathology trend of incidence. The deficiency of kidney is the main pathological trend. The above three factors are cause and effect and interaction effect. During middle age period,liver Qi stagnation and blood deficiency is the main type,and then is kidney deficiency. During old age,deficiency of kidney and blood stasis is the main type,and then is stagnation of liver Qi. The basic treatment principles are smoothing liver,activating blood and tonifying kidney. According to liver Qi stagnation,blood stasis,deficiency of kidney,use smoothing liver formulae,activating blood formulae,Bushen formulae and the drugs for smoothing liver drugs,promoting blood and invigorating kidney. In clinic use we can choose Sini Powder,Yushen Huoxue Decoction,Chaiyang Zhengdan Granules,etc.