基于泛命门理论对肝肾阴虚型绝经生殖泌尿 综合征的干预探讨

Exploration of Intervention Based on the Theory of Pan-Life Gate for Genitourinary Syndrome of Menopause of Liver and Kidney Yin Deficiency Type

摘要: 绝经生殖泌尿综合征(Genitourinary Syndrome of Menopause, GSM)是绝经后女性常见的慢性疾病，以阴道干涩、灼热疼痛、性交不适、尿频尿急、反复泌尿系感染等为主要临床表现，严重影响患者身心健康与生活质量。现代医学以局部雌激素、润滑剂、盆底康复等为主要治疗手段，短期缓解症状效果明确，但存在适用人群受限、长期应用安全性争议等不足。中医将本病归属于“经断前后诸证”“阴痒”“带下过少”“淋证”等范畴，肝肾阴虚为临床最主要证型，其核心病机与天癸渐竭、肾阴亏虚、水不涵木、下焦失于濡润密切相关。泛命门理论突破传统命门单脏定位，强调命门为一身阴阳之根本，统摄肝肾、联动冲任、主司下焦气化与二阴濡养，是阐释绝经后泌尿生殖系统病变的重要理论依据。本文以泛命门理论为指导，系统梳理肝肾阴虚型GSM的病因病机、辨证要点与治疗原则，从中药内服、外治、针灸、生活调摄等方面构建一体化干预方案，并结合现代药理与临床研究进行佐证，旨在为中医药防治绝经生殖泌尿综合征提供新的理论思路与临床实践依据。

Abstract: Genitourinary Syndrome of Menopause (GSM) is a common chronic disease among postmenopausal women, characterized by vaginal dryness, burning pain, sexual discomfort, urinary frequency and urgency, recurrent urinary tract infections, and other major clinical manifestations, which seriously affect patients’ physical and mental health as well as their quality of life. Modern medicine primarily treats this condition with local estrogen, lubricants, and pelvic floor rehabilitation, achieving clear short-term symptom relief. However, these treatments have limitations such as restricted applicability to certain populations and safety concerns regarding long-term use. Traditional Chinese Medicine (TCM) categorizes this disease under “various syndromes before and after menopause”, “vaginal itching”, “excessively scanty vaginal discharge”, and “drenching syndrome”, with deficiency of both liver and kidney yin being the most prevalent clinical syndrome type. The core pathogenesis is closely related to the gradual depletion of menstrual blood, kidney yin deficiency, water not nourishing the wood, and the lower energizer failing to moisturize. The Pan-Life Gate theory breaks through the traditional single-organ localization of the Gate of Life, emphasizing that the Gate of Life is the foundation of yin and yang in the body, governing the liver and kidneys, interacting with the Chong and Ren meridians, and being responsible for the qi transformation of the lower energizer and the nourishment of the two yin organs. It serves as an important theoretical basis for explaining postmenopausal urogenital system disorders. Guided by the Pan-Life Gate theory, this article systematically reviews the etiology, pathogenesis, diagnostic points, and treatment principles of GSM of liver-kidney yin deficiency type. It constructs an integrated intervention plan from aspects such as oral administration of traditional Chinese medicine, external treatment, acupuncture and moxibustion, and lifestyle adjustment, and combines modern pharmacological and clinical research to provide evidence. The aim is to provide new theoretical insights and clinical practice basis for the prevention and treatment of postmenopausal urogenital syndrome with traditional Chinese medicine.