摘要
良性前列腺增生症(BPH)是中老年男性常见的泌尿系统疾病之一,主要表现为前列腺体积增大、尿道受压梗阻,进而引发小便不利症状。BPH为中医药防治的优势病种之一,通过中医药防治能有效改善患者临床证候表现和提升患者生活质量。本文基于《伤寒杂病论》中对于病因病机的分析描述,进一步提出从气、血、水三分论治BPH思路。中医认为BPH的发生与肾气虚衰、血瘀痰阻、水道不利密切相关,核心病机特点为气虚、血痧、水停。针对BPH的病机特点,提出补肾益气、活血化瘀、利水渗湿的治疗策略。膏方在治疗BPH上展现出独特优势,发挥膏剂缓释长效的特点,既能温补肾阳以固本,又可逐瘀利水以治标,契合中老年患者虚实夹杂、需长期调摄的体质特点。临证方面,从气、血、水辨治不同证候表现上,将肾气丸、桂枝茯苓丸、春泽汤、当归药散等代表性经方巧妙融合。本文旨在通过综合辨识气、血、水病因和病机特点,组合运用上述治法方药,优化完善BPH临证辨治思路和治疗手段,为中医男科治疗BPH提供了新的思路和方法。
Benign prostatic hyperplasia(BPH),a prevalent urinary disorder in middle-aged and elderly men,manifests as prostate enlargement,compression and obstruction of the urethra,which subsequently leads to symptoms of urinary dfficulties..BPH is one of the diseases where Chinese medicine(CM)has a distinct advantage in prevention and treatment,effectively improving the clinical symptoms and enhancing the quality of life of patients.Drawing from the etiological and pathological principles in Shang Han Za Bing Lun(Treatise on Cold Damage and Miscellaneous Diseases),this study advocates pattern-differentiating and therapeutic approaches for BPH targeting the aspects of qi,blood,and water.CM attributes the occurrence of BPH to kidney qi deficiency,blood stasis,phlegm obstruction,and blocked water passages,with core mechanisms involving qi deficiency,blood stasis,and fluid retention.Treatment strategies emphasize tonifying kidney qi circulate blood and transform stasis,and promoting urination and draining dampness.With the sustained-release and long-lasting characteristics,the condensed decoction has demonstrated unique advantages in the treatment of BPH.It not only warms and tonifies kidney yang to strengthen the root but also eliminates blood stasis and promotes urination to address the symptoms.This dosage form aligns well with the mixed deficiency and excess constitution of middle-aged and elderly patients,who require long-term regulation.In clinical practice,by differentiating the patterns of BPH based on the condition of qi,blood,and water within the body,representative classical formulas such as Shenqi Pill,Guizhi Fuling Pill,Chunze Decoction,and Danggui Shaoyao Powder are skilfully integrated.This study aims to optimize the diagnosis and treatment of BPH by comprehensively analyzing the etiological and pathological characteristics of qi,blood,and water,and by combining these ther-apeutic methods and formulas,providing innovative methodologies for andrological management of BPH.
作者
符方智
周青
FU Fangzhi;ZHOU Qing(The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China)
基金
国家中医优势专科(外科)(国中医药医政函[2024]90号)
湖南省一类中医重点专科(男科)(湘中医药函[2023]4号)
湖南中医药大学研究生创新课题(2024CX016)。
关键词
良性前列腺增生症
气血水
小便不利
膏方
benign prostatic hyperplasia
qi,blood,and water
urinary dfficulty
condensed decoction
