1、第 29 卷第 5 期2023年 3 月中国实验方剂学杂志Chinese Journal of Experimental Traditional Medical FormulaeVol.29，No.5Mar.，2023中医药治疗男性不育症临床优势病种的探讨祝雨田1，王彬2，李卫3，林生2，王景尚4，王福5，柯明辉6，孙大林7，王海8，赵勇9，刘红明10，唐渊11，王晟11，朱勇2，李海松2*，张霄潇12*（1.北京大学 第三医院，北京 100191；2.北京中医药大学 东直门医院，北京 100700；3.中国科学院 动物研究所，北京 100101；4.首都医科大学 附属北京妇产医院，北京 10
2、0026；5.中国中医科学院 西苑医院，北京 100091；6.中日友好医院，北京 100029；7.东南大学 附属中大医院，南京 210009；8.北京协和医院，北京 100730；9.中国人民解放军海军总医院，北京 100048；10.中国人民解放军空军总医院，北京 100142；11.北京大学 第一医院，北京 100034；12.中华中医药学会，北京 100029）摘要 随着生活和社会环境的改变及生活工作压力的增加，我国男性生育能力显著下降，男性不育症发病率逐年增高，给男科医生带来了前所未有的挑战和治疗难题。中医药治疗男性不育症具有明确疗效，临床上应用广泛，为了明确中医药在男性不育症的不
3、同种类及不同阶段做起的作用，中华中医药学会组织邀请了男科临床一线的西医与中医青年优秀专家，围绕特发性少、弱、畸形精子症、精液液化异常、精索静脉曲张、免疫性不育、提高辅助生殖技术成功率、改善抑郁焦虑状态等 6个方面进行了讨论。就中医治疗的优点、特色、短板及优势病种、优势环节进行了深入探讨，针对男性不育症的各种病因及相关环节的治疗进行了梳理与归纳。男性不育症由于病因不完全明确及发病机制复杂等原因，单纯西医治疗不能达到较好的疗效，而中医药以整体观为核心，改善功能性疾病是学科优势，同时可以对应多靶点、多病因，并且有内治外治等综合性疗法，因此中医治疗及中西医医结合治疗男性不育症，在临床上应用广泛。该文总
4、结了纯中医治疗及中西医结合治疗的优势病种和优势环节，罗列了相关病种的中西医治疗建议，以期让更多男科医生了解中医的治疗效应及优势能够实现中西借鉴、沟通融合，在临床实际诊疗中给患者提供优效、个性化的治疗方案，从而提高男性不育症的疗效。关键词 男性不育症；中医药优势病种；专家指导建议中图分类号 R242；R2-0；R2-031；R256.56；R699 文献标识码 A 文章编号 1005-9903（2023）05-0223-06doi 10.13422/ki.syfjx.20230592 网络出版地址 https:/ 2022-08-17 11:20:29Male Infertility Respo
5、nding Specifically to Traditional Chinese MedicineZHU Yutian1，WANG Bin2，LI Wei3，LIN Sheng2，WANG Jingshang4，WANG Fu5，KE Minghui6，SUN Dalin7，WANG Hai8，ZHAO Yong9，LIU Hongming10，TANG Yuan11，WANG Sheng11，ZHU Yong2，LI Haisong2*，ZHANG Xiaoxiao12*（1.Peking University Third Hospital，Beijing 100191，China；2.D
6、ongzhimen Hospital，Beijing University of Chinese Medicine，Beijing 100700，China；3.Institution of Zoology，Chinese Academy of Sciences，Beijing 100101，China；4.Beijing Obstetrics and Gynecology Hospital，Capital Medical University，Beijing 100026，China；5.Xiyuan Hospital of China Academy of Chinese Medical
7、Sciences，Beijing100091，China；收稿日期 2022-05-05基金项目 中华中医药学会青年人才托举工程项目（CACM-2018-QNRC2-C05）；国家自然科学基金青年基金项目（8210151610）第一作者 祝雨田，博士，从事中医外科学研究，E-mail：通信作者 *李海松，博士，主任医师，从事中医药防治男科疾病研究，E-mail：；*张霄潇，博士，从事中医药标准化与产业发展研究，Tel：010-64205923，E-mail： 优势病种 223第 29 卷第 5 期2023年 3 月中国实验方剂学杂志Chinese Journal of Experimental
8、 Traditional Medical FormulaeVol.29，No.5Mar.，20236.China-Japan Friendship Hospital，Beijing 100029，China；7.Zhongda Hospital Southeast University，Nanjing 210009，China；8.Peking Union Medical College Hospital，Beijing 100730，China；9.Naval General Hospital of Chinese Peoples Liberation Army，Beijing 100048
9、，China；10.Air Force General Hospital of Chinese Peoples Liberation Army，Beijing 100142，China；11.Peking University First Hospital，Beijing 100034，China；12.China Association of Chinese Medicine，Beijing 100029，China）Abstract In recent years，with the change in lifestyle and social environment and the inc
10、rease in pressure in both life and work，male fertility has decreased significantly in China，and the incidence of male infertility has increased year by year，which has brought great challenges to andrologists.Traditional Chinese medicine（TCM）has a definite curative effect in the treatment of male inf
11、ertility and is widely applied in clinical practice.In order to clarify the role of TCM in different types and each stage of male infertility，the China Association of Chinese Medicine（CACM）invited outstanding young andrologists in the clinic of TCM and western medicine to discuss topics such as idio
12、pathic oligospermia and teratospermia，abnormal semen liquefaction，varicocele，immune infertility，improving success ratio of assisted reproductive technology，and ameliorating depression or anxiety.They conducted in-depth discussions on the advantages，characteristics，disadvantages，diseases responding s
13、pecifically，and advantageous aspects of TCM treatment.The causes of male infertility and related links of treatment were summarized.Due to the unclear etiology and complex pathogenesis of male infertility，western medicine cannot achieve a good curative effect，while TCM，taking the holistic view as th
14、e core，specializes in improving functional diseases and can correspond to multiple targets and factors，with comprehensive treatments such as internal treatment and external treatment.This study summarized the advantageous diseases and advantageous stages of TCM treatment alone and integrated TCM and
15、 western medicine treatment and put forward suggestions for the treatment of the diseases by TCM and western medicine in order to promote the therapeutic effects and advantages of TCM among andrologists，increase mutual learning and communication between TCM and western physicians，provide patients wi
16、th excellent and personalized treatment plans in clinical practice，and improve the curative effect of male infertility and fertility of males in China.Keywords male infertility；diseases responding specifically to traditional Chinese medicine（TCM）；expert consensus随着社会的飞速发展、工作生活压力的日益增大，以及环境污染的加重，全球范围内的不孕不育患者不断增加。近年来，工业化国家育龄夫妇不孕不育的发病率已达到 15%20%1。在我国，不孕不育问题也越来越严重，根据 中国不孕不育现状研究报告 显示，近 20年来我国不孕不育的发病率，已经从 3%攀升到了 12.5%。存在生育问题的育龄夫妇已超过 2 000万对。而不孕不育原因中 20%是单独由男性因素引起的，其余还有 30%40%与男性因素有关2。有研究显示，我国育龄男性的精液质量自
