从全生命周期解析天癸的相关物质基础

Analysis on the related material basis of Tiangui from the whole life cycle

天癸是《黄帝内经》认识人类生育能力的物质,基于男性与女性的差异,提出了天癸兴衰在女子表现为“七七理论”、在男子表现为“八八理论”,且天癸兴衰理论对临床具有重要的指导价值。传统中医理论对天癸的认识以定性表述为主,而现代医学善于以量化方式精确认识人类生命现象。基于此,以定性与定量相结合的方式,阐述全生命周期中天癸的相关物质动态变化,并认为:(1)女子卵巢、男子睾丸及肾上腺皮质是天癸发生的重要源泉,女子雌激素与孕酮、男子脱氢表雄酮与睾酮能够较客观地反映全生命周期中天癸的物质基础;(2)性激素在女性“七七”阶段急骤下降,而在男性“八八”阶段仅为渐进式下降,因而临床中女性围绝经期综合征特征显著,而男性几乎不表现出相应的综合征;(3)肾气是调控天癸发生的主要因素,类似于人体高级中枢大脑皮质、下丘脑、垂体功能;(4)以现代科学术语表达与解析传统中医理论概念将有助于初学者更客观、理性地认识中医天癸的学术内涵。

Tiangui is a kind of substance of human reproduction in Huangdi Neijing. Based on the differences between men and women,it is proposed that the rise and fall of Tiangui shows“seven seven theory”in women and“eight eight theory”in men. The theory of Tiangui rise and fall has important guiding value in clinic. Understanding of Tiangui in the classical theory of traditional Chinese medicine(TCM)is mainly qualitative description,while the modern medicine is good at accurately cognizing the human life phenomenon in a quantitative way. Therefore,this paper expounds the dynamic changes of Tiangui related substances in the whole life cycle by combining qualitative and quantitative methods. The results are as follows:(1)The ovary in woman,testicle in man and adrenal cortex are the main source of Tiangui. The female estrogen and progesterone,the male dehydroepiandrosterone and testosterone can objectively reflect the material basis of Tiangui in the whole life cycle.(2)The sex hormone levels in female“seven seven”stage drop sharply,while in male“eight eight”stage only drop gradually,so the clinical characteristics of female perimenopausal syndrome is significant,but the male rarely show the corresponding syndrome.(3) Kidney qi is the main factor to regulate the occurrence of Tiangui,which is similar to the functions of cerebral cortex,hypothalamus and pituitary.(4) It is helpful for beginners to objectively and reasoningly understand the academic connotation of Tiangui using modern scientific terms to express and analyze the theory and concept of TCM.