CAJ | 학술논문

目的：基于现代文献报道分析、总结精液不液化所致男性不育的中医辨证、治疗规律。方法：通过检索CNKI中文期刊全文数据库，获取2002-2012年间发表的与精液不液化所致男性不育症中药有效治疗相关的文献报道，建立数据库，分析涉及的证候及用药分布情况，归纳、总结其辨证、治疗规律。结果：纳入分析的39篇文献中，属辨证论治者19篇，专方治疗者15篇，中西医结合治疗者5篇。1）辨证论治的文献中，共计出现辨证结果16个，排在前五位的是肾阴虚证，下焦湿热证，肾阳虚证，痰瘀阻滞证及肾阴虚、下焦湿热证，但从用药看不单纯是针对所辨证候，而是兼顾了疾病的复杂病机；从运用专方或专方结合西医手段治疗用药情况看，以滋阴清热、凉血化瘀及清热利湿、软坚散结的药味出现频率为高，且均有以淫羊藿为代表的补阳药物的较高出现频率，反映了20个专方的药物构成是针对虚实夹杂的复杂病机的。2）基于辨证的用药及专方用药特点，体现了辨病与辨证相结合及补中有泻，补而不滞，泻中有补，顾护正气的补清相兼与阴中求阳、阳中求阴的阴阳平衡的基本治疗原则和用药特点。结论：本病存在虚实夹杂、错综复杂的病机，虚主要表现为肾阴虚、肾阳虚，实主要表现为下焦的湿热（毒）及瘀血、痰浊；临床治疗时当根据患者的具体情况，明辨其虚与实的孰轻孰重以及阴虚、阳虚和湿热（毒）、瘀血、痰浊的不同与侧重。
목적：기우현대문헌보도분석、총결정액불액화소치남성불육적중의변증、치료규률。방법：통과검색CNKI중문기간전문수거고，획취2002-2012년간발표적여정액불액화소치남성불육증중약유효치료상관적문헌보도，건립수거고，분석섭급적증후급용약분포정황，귀납、총결기변증、치료규률。결과：납입분석적39편문헌중，속변증론치자19편，전방치료자15편，중서의결합치료자5편。1）변증론치적문헌중，공계출현변증결과16개，배재전오위적시신음허증，하초습열증，신양허증，담어조체증급신음허、하초습열증，단종용약간불단순시침대소변증후，이시겸고료질병적복잡병궤；종운용전방혹전방결합서의수단치료용약정황간，이자음청열、량혈화어급청열리습、연견산결적약미출현빈솔위고，차균유이음양곽위대표적보양약물적교고출현빈솔，반영료20개전방적약물구성시침대허실협잡적복잡병궤적。2）기우변증적용약급전방용약특점，체현료변병여변증상결합급보중유사，보이불체，사중유보，고호정기적보청상겸여음중구양、양중구음적음양평형적기본치료원칙화용약특점。결론：본병존재허실협잡、착종복잡적병궤，허주요표현위신음허、신양허，실주요표현위하초적습열（독）급어혈、담탁；림상치료시당근거환자적구체정황，명변기허여실적숙경숙중이급음허、양허화습열（독）、어혈、담탁적불동여측중。
Objective:To analyze and summarize the characteristics of TCM syndromes and treatment in male patients with infertility at -tributing to non-liquefaction semen based on TCM literatures review .Methods:Literatures on TCM syndrome of male patients with infer-tility attributing to non-liquefaction semen published from 2002 to 2012 were retrieved from CNKI database .The selected literatures were recruited in a new database .The characteristics of TCM syndromes and treatment in male patients with infertility were further analyzed and summarized.Results:Among the recruited 39 literatures, 19 articles were on syndrome differentiation and treatment , 15 articles were on special prescription treatment , 5 articles were on integrated treatment of CTM and western medicine .In 19 articles on syndrome differentiation and treatment , top 5 of syndrome type with frequency were as follows: deficiency of kidney yin , damp-heat diffusing down, deficiency of kidney yang , phlegm-accumulation stasis , deficiency of kidney yin and damp-heat diffusing down .The given treat-ment was considered as the syndrome differentiation and the complex pathogenesis .The high frequency of traditional Chinese medicine category in the 15 articles on TCM special prescription and 5 articles on integrated TCM and western medicine were as follows , nouris-hing yin and clearing heat , cooling blood to remove blood stasis , clearing heat and removing dampness , resolving hard lump .Among all the prescriptions , it indicated that the complex mechanism for infertility male attributing to non-liquefaction semen targeted on notifying yang .The characteristics for the treatment to combine differentiation of TCM sydrom and diseases revealed that it is necessary to reinforce insufficiency and reduce excessiveness , keep balance between Yin and Yang .Conclusion:The mechanism of male infertility attributing to non-liquefaction semen is complex , mingled with excess and deficiency syndromes .The scheme of treatment on this disease is deter-mined on the situation of patients .It is necessary to weigh and consider balance between insufficiency and excessiveness .