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中醫對於男性不孕精液分析的中醫微觀辨證與治療

Microscopic Syndrome Differentiation and Treatments of TCM for Male Infertility

摘要


根據WHO世界衛生組織的定義,在沒有避孕的情況下,經過12個月以上的性生活,而沒有成功受孕,即稱為不孕症,不孕症約佔所有夫婦的15%,其中一半以上有男性不孕相關因素與精液參數的異常,臨床上,中醫使用微觀(精液辨證或是內分泌)辨證,可提高傳統宏觀辨證論治的療效。依中醫理論,精子與精液均皆屬於中醫先天腎精的部分,仰賴脾所化生後天精微物質作補充,精液、精子本體皆屬陰,精氣、精子存活率與精子活動力屬陽,此外還需要考慮精道瘀阻等痰濕瘀熱的情況,本文整理男性不孕精液分析的微觀辨證以供臨床參考。

並列摘要


According to the definition of World Health Organization, the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse is defined as infertility, which occurs in about 15% of couples all over the world. In 50% of voluntarily childless couples, a male-infertility-associated factor has been found along with abnormal semen parameters. Clinically, microscopic syndrome differentiation of semen or endocrine syndrome is used with macro-syndrome differentiation in Chinese medicine to improve the accuracy of diagnosis and the efficacy of treatment. In the theory of Chinese medicine, Semen and sperm belong to innate Kidney essence which is supported by food essence derived from the Spleen. Semen and sperm are defined as ying, on the other hand, sperm motility and sperm vitality are defined as yang. Besides, phlegm, dampness, blood stasis, and heat which lead to genital tract obstruction have to be taken into consideration. We organized published reports regarding to the microscopic syndrome differentiation of semen in male infertility for clinical management in the article.

參考文獻


Jungwirth A GA, Tournaye H, Diemer T, Kopa Z, et al. European Association of Urology guidelines on Male Infertility: the 2012 update. . Eur Urol 324-332.
Centola GM, Blanchard A, Demick J, Li S, Eisenberg ML (2016) Decline in sperm count and motility in young adult men from 2003 to 2013: observations from a U.S. sperm bank. Andrology 4: 270-276.
Sengupta P, Borges E, Jr., Dutta S, Krajewska-Kulak E (2018) Decline in sperm count in European men during the past 50 years. Hum Exp Toxicol 37: 247-255.
Wang L, Zhang L, Song XH, Zhang HB, Xu CY, et al. (2017) Decline of semen quality among Chinese sperm bank donors within 7 years (2008-2014). Asian J Androl 19: 521-525.
Li CJ, Tzeng CR, Chen RY, Han BC, Yeh CY, et al. (2016) Decline in semen quality in men in northern Taiwan between 2001 and 2010. Chin J Physiol 59: 355-365.

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