周青教授从“虚、滞、瘀”辨治精索静脉曲张性不育经验

Professor ZHOU Qing's experience in differentiating and treating varicocele-induced infertility based on the pathogenesis of"deficiency,stagnation,and blood stasis"

精索静脉曲张性不育即精索静脉曲张(varicocele,VC)所导致的男性不育,为男科常见疾病。周青教授提出从虚、实两端来认识本病的发生:“虚”为先天肾水与后天脾土出现虚损后,其所生之精不能濡养精索静脉、所化之气不能升发精索静脉内血液;“实”则包括“滞”“瘀”两方面,肝气郁滞不能疏通血脉,即为“滞”,而“虚”“滞”可导致精索静脉内血行迟缓,凝而为“瘀”,局部血管因此出现扩张,影响睾丸正常功能,最终导致不育发生。“虚、滞、瘀”相互影响,合而为病。治疗上,周青教授倡导虚、实同调,主张益肾生精、健脾升阳疗其虚,行气活血、化瘀通滞治其实。针对临床常见的肾虚血瘀型精索静脉曲张性不育,自拟益肾填精、活血化瘀之龟鹿桃红方施治,疗效明显。

Varicocele(VC)-induced infertility is a common male disease.Professor ZHOU Qing has proposed to understand the occurrence of the disease based on the pathogenesis of deficiency and excess."Deficiency"means that due to the deficiency of the kidney and spleen,the congenital and postnatal foundation of the human body respectively,the essence generated from them can not nourish the spermatic veins,and qi transformed by them can not promote the blood circulation in the spermatic veins."Excess"includes"stagnation"and"blood stasis"."Stagnation"means that liver qi stagnation can not dredge blood vessels.Meanwhile,"deficiency"and"stagnation"will lead to slow blood flow in the spermatic veins and result in"blood stasis"finally,so local blood vessels dilate,affecting the normal function of the testes,and eventually leading to infertility."Deficiency,stagnation and blood stasis"affect each other and cause the disease together.As to the treatment,Professor ZHOU advocates the joint treatment for both deficiency and excess,that is,treating deficiency with tonifying kidney to produce essence,invigorating spleen and raising yang;treating excess with circulating qi and blood,transforming stasis and resolving stagnation.For the kidney deficiency and blood stasis pattern of varicocele-induced infertility,which is common in clinic,Guilu Taohong Formula has been drafted,with its obvious curative effects of tonifying kidney and filling essence,circulating blood and transforming stasis.