目的:基于高效指纹图谱和网络药理学预测琥珀消石颗粒(HXG)中质量标志物(Q-Marker).方法:构建HXG的高效液相色谱(HPLC)指纹图谱检测手段,指认共有峰和归属;应用网络药理学技术构建HXG的"成分-靶点-通路"网络图,预测其潜在Q-Marker.结果:HXG的指纹图谱结果共指认出5 个共有峰;网络药理学确定了 5 种关键组成、35 个潜在核心靶点和6 条重要通路,初步预测槲皮素-3-O-(2G-α-L-鼠李糖基)-芸香糖苷、山柰酚-3-O-芸香糖苷、β-蜕皮甾酮、槲皮素、山柰素为HXG潜在的Q-Marker.结论:通过高效指纹图谱和网络药理学分析预测了HXG中的Q-Marker,方法科学并且可重复,为HXG的质量标准提供依据,也为今后系统研究其作用机制提供研究基础.

性高潮后综合征(post-orgasmic illness syndrome,POIS)属于男科罕见病,最早由瓦丁格教授在2002年发现并报道,是指男性在射精后几分钟到几小时内出现的严重乏力、疲劳、注意力下降、急躁易怒或情绪低落等全身症状,可持续2～7天,并且可在下次射精发生后再次发生,严重影响男性身心健康,目前国际上暂无公认的定义和指南相关论述[1-2].中医学中根据其症状表现可将本病归属于"房中病""房劳""房事伤"的范畴.李海松教授临床中较早关注本病的诊治,强调肝肾在本病发生的独特地位,提出肝郁肾虚是本病的核心病机,现将其临床经验总结如下.

男性更年期综合征是男科领域常见的疾病之一,传统医学无本病相关病名的记载.李曰庆教授根据多年临床经验认为男性更年期综合征应从"虚""郁""瘀"论治,"虚"为基本病机和病理趋势,可以分为肾气虚、肾阳虚、肾阴虚和气血亏虚;"郁"为关键病机,表现为肝郁;"瘀"为病理产物,可以分为气虚致瘀、肾虚致瘀和肝郁致瘀."虚""郁"与"瘀"互相影响,常相兼为病.临床从"虚""郁""瘀"论治男性更年期综合征收效显著.

The impact of depression on spermatogenic function and protein expression was investigated by reference to a bioinformatics database for the prediction of key targets and pathways. Experimental validation was performed using a rat model established using the chronic restraint stress method. Organ coefficients and semen parameters were measured. Hematoxylin and eosin (HE) staining was performed to compare testicular tissue between model and control rats. Western blotting and RT–qPCR were conducted to evaluate protein and mRNA expression. As a result, depression and male infertility (MI) were found to share 81 common targets, and the PI3K/Akt/FOXO1 signaling pathway was involved in both conditions. Animal experiments showed testis and epididymis coefficients to be lower in the model group. HE staining showed damage to the seminiferous tubules of model rats. PI3K and p-Akt mRNA and protein were present at lower levels and FOXO1 at higher levels in the model group. Depression led to reduced spermatogenic function in rats and might be associated with differential expression of the PI3K/Akt/FOXO1 signaling pathway.

Andritria, with high incidence and complex etiology, lingers and is difficult to heal. Professor Li Yueqing has rich experience in the clinical treatment of male diseases. He believes that andritria takes kidney deficiency as its root, depression as a triggering factor, blood stasis as its core causes, and attaches importance to holistic treatment and to the simultaneous adjustment of both Yin and Yang. This article introduces Professor Li’s experience in the treatment of male diseases from the aspects of tonifying the kidney and filling vital essence for male infertility, tonifying the kidney and soothing the liver for erectile dysfunction, communicating the heart and kidney for spermatozoa, and tonifying the kidney and eliminating hyperplasia for benign prostatic hyperplasia. In addition, this article introduces Professor Li’s diagnosis and treatment ideas and medication characteristics combined with clinical cases.

总结李曰庆教授从虚瘀论治勃起功能障碍(ED)的临床经验.认为虚瘀病机在男科疾病中普遍存在,瘀血阻络是ED核心病机,并贯穿ED始终,肾虚是ED发病内在趋势,虚瘀相互影响,共同致病.临证治疗以活血通络、燮理阴阳为要,倡导本病治疗全程应用活血化瘀药物,并根据患者病情配伍补肾滋阴、疏肝解郁之品,因人制宜,阴阳同调,中西融合,提高临床疗效.

良性前列腺增生(BPH)是泌尿男科的常见疾病,主要表现包括前列腺腺体增大,膀胱出口梗阻和下尿路症状,严重影响中老年男性的生活质量.本病属于中医"癃闭""精癃"的范畴,近年来多位医家根据学术典籍和自身的临床经验提出了对本病的认识,中医药治疗BPH的临床研究也呈现日益丰富的趋势.BPH基本的表现为年老肾气衰弱,膀胱气化不利,血行瘀阻不畅,病位在肾和膀胱,与肺、肾功能失调有关,本虚标实是基本病机特点.大量临床研究证明中医药能够改善BPH患者临床症状,提高生活质量,缩小前列腺体积,减少术后并发症,在临床应用中有确切疗效.此外中医药外治法如针刺疗法、艾灸、热水坐浴、穴位贴敷、肛门栓剂、灌肠疗法等也被广泛应用于临床,证明中医药治疗BPH方法多样.中西医融合治疗BPH优势互补,能够提高临床疗效,减少远期并发症的发生.该文将对近年来BPH中医病因病机和治疗进展进行评述,总结目前中医药临床治疗BPH研究现状,并从产出高质量临床研究、规范中医药临床诊治方案、结合前沿研究探索中医药机制三方面对中医药治疗BPH临床研究提出建议,以期推动中医药在本病治疗中的发展和应用.

《中成药治疗慢性前列腺炎临床应用指南(2021年)》(以下简称《指南》)于2022年5月12日正式发表.《指南》基于临床关键问题,以临床疗效为导向,针对慢性前列腺炎的不同症状,给出8种中成药的推荐意见.本解析主要针对指南的制订背景、方法学和推荐中成药的相关内容,并提出不足与展望.

良性前列腺是中老年男性常见疾病之一,发病率随着世界人口老龄化加剧而日趋增高,该病主要引起中老年男性的排尿障碍,严重影响患者的生活质量,是临床亟需解决的医学难题.虽然中医和西医作为两大不同的医学理论体系,但两者在治疗理念、诊断与治疗标准、治疗目的 等基础理论有许多相同的认识,在证治分型、用药配合以及治疗形式方面也有许多共通之处,因此将中西医对于良性前列腺增生的诊疗策略进行对比,取长补短,优势互补,并加以推广,让中西医双方对彼此有更深入的了解,将会为良性前列腺增生的研究工作打开新的局面,为更多的患者谋求幸福的生活.