刘煜 郭军 晏斌 刘胜京 郭俊 赵丰 王福

摘要 男性不育症中，精液分析多种参数异常且无法找到明确病因的称为特发性男性不育症，其发病率不断提高，给国内甚至全球范围内家庭带来精神及经济负担。由于病因不明确，目前现代医学尚无有效治疗方法。传统中医药通过辨证论治在治疗特发性男性不育症时具有优势，郭军教授认为该病以肾脾两虚为本，为体内湿热形成奠定基础，患者久病无子嗣，肝气不畅则郁结，气血津液运行不通则夹血瘀湿热等有形实邪，另外怪病多痰。故对于特发性男性不育症，治法注重补泻兼施，扶正祛邪，补益脾肾为主，对于湿热、痰湿、瘀血则清热祛湿化痰，活血化瘀等，并举验案1例。

关键词  特发性不育症;补虚泄实;辨证论治

Professor GUO Jun′s Experience in the Treatment of Idiopathic Male Infertility

LIU Yu¹，GUO Jun²，YAN Bin²， LIU Shengjing¹，GUO Jun¹，ZHAO Feng²，WANG Fu²

（1 Beijing University of Chinese Medicine，100029，China;2 China Academy of Chinese Medical Sciences，Beijing 100091，China）

Abstract Among male infertility，idiopathic male infertility（IHS）is characterized by abnormal semen analysis parameters and no clear etiology.The incidence of IHS is increasing，which brings spiritual and economic burden to domestic and even global families.Because the cause of disease is not clear，there is no effective treatment in modern medicine.Traditional Chinese medicine has advantages in the treatment of idiopathic male infertility through syndrome differentiation.Professor GUO Jun believes that the disease is based on deficiency of both kidney and spleen，laying a foundation for the formation of damp-heat in the body.The patient has been sick for a long time and has no children.If the liver-qi is not smooth，it will be stagnant.If the operation of qi，blood and body fluid is not smooth，it will be accompanied by visible pathogens such as blood stasis，damp-heat and phlegm.Therefore，for idiopathic male infertility，the treatment focuses on both reinforcing and reducing，strengthening the body and eliminating pathogens，tonifying the spleen and kidney，while for damp-heat，phlegm-dampness and blood stasis，clearing away heat，removing dampness and phlegm，activating blood circulation and removing blood stasis，etc.Examine one case at the same time.

Keywords Idiopathic infertility; Reinforcing deficiency and reducing excess; Syndrome differentiation and treatment

中圖分类号：R242;R711.6 文献标识码：B doi：10.3969/j.issn.1673-7202.2020.08.021

男性不育症指有正常性生活的夫妻未避孕超过1年，因男方因素女方未能受孕者。男性不育症由诸多病因导致，临床中首先要明确病因，根据病因确定治疗方案可取得较好疗效。然而在男性不育症中应用现有手段无法明确不育症病因者，则称为特发性男性不育症，精液分析多种参数异常，表现为原因不明的少、弱、畸、无精子症。在极大影响患者家庭和谐的同时，也给患者带去诸多的经济压力和精神压力[1]。由于无法明确病因，现代医学对其治疗多为经验性用药，如补充微量元素、左卡尼汀、辅酶Q]10等，但此类经验用药尚缺乏相关研究[2]。对于特发性男性不育症的治疗，传统中医药或具备一定优势，临床通过四诊合参、病症结合而确定治法及方药，通过中药、针灸等辨证论治后取得不错的临床效果[3]。……