Treatment of male late-onset hypogonadism with depression based on "kidney-liver-<italic style="font-style: italic">Tiangui</italic>"

ZHANG Qi; CAO Dezhong; LUO Chenglong; CHENG Haoyang; ZHANG Sizheng; JIAO Yongzheng

doi:10.16025/j.1674-1307.2025.09.018

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Treatment of male late-onset hypogonadism with depression based on "kidney-liver-Tiangui"

更新时间：2025-11-25

- Treatment of male late-onset hypogonadism with depression based on "kidney-liver-Tiangui"
- Beijing Journal of Traditional Chinese Medicine Vol. 44, Issue 9, Pages: 1173-1176(2025)
- 作者机构：
  
  1.中国中医科学院广安门医院男科，北京 100053
  2.北京市东城区第一人民医院中西医结合科，北京 100077
  3.中国中医科学院眼科医院，北京 100040
- 作者简介：
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.09.018
  CLC：
- Received：25 September 2024，
  
  Published：25 September 2025
- 稿件说明：
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张琪，曹得中，罗成龙，等.基于“肾肝-天癸”论治男性迟发性性腺功能减退症合并抑郁症［J］.北京中医药，2025，44（9）：1173-1176.

ZHANG Qi,CAO Dezhong,LUO Chenglong,et al.Treatment of male late-onset hypogonadism with depression based on "kidney-liver-Tiangui"[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(09):1173-1176.
张琪，曹得中，罗成龙，等.基于“肾肝-天癸”论治男性迟发性性腺功能减退症合并抑郁症［J］.北京中医药，2025，44（9）：1173-1176. DOI： 10.16025/j.1674-1307.2025.09.018.

ZHANG Qi,CAO Dezhong,LUO Chenglong,et al.Treatment of male late-onset hypogonadism with depression based on "kidney-liver-Tiangui"[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(09):1173-1176. DOI： 10.16025/j.1674-1307.2025.09.018.

摘要

迟发性性腺功能减退症（LOH）好发于中老年男性，其临床表现与抑郁症症状重叠，单凭症状难以区分，且LOH常与抑郁症合并出现，是临床治疗的难点。对于本病的治疗，目前睾酮替代疗法（TRT）与抗抑郁药物尚存在局限性，中医药治疗较单一TRT及抗抑郁药物治疗有整体调节、规避西药用药风险与不良反应的优势。结合本病的动态变化特点，从“肾肝-天癸”角度探讨LOH合并抑郁症的核心病机。肾虚精亏、天癸渐衰、神明失养是LOH合并抑郁症的启动环节；肝失疏泄、天癸失调、肝郁气滞是LOH合并抑郁症的演变之枢；脂浊瘀血阻滞是本病的相关病理因素。治疗本病应以补肾益精、疏肝解郁、调补天癸为要，同时应兼顾患者的体质特点，酌情补益气血、活血化脂降浊。

Abstract

Late-onset hypogonadism （LOH） commonly occurs in middle-aged and elderly men. Its clinical manifestations overlap with symptoms of depression， making differentiation based solely on symptoms difficult. Moreover， LOH often coexists with depression， posing a clinical treatment challenge. Currently， testosterone replacement therapy （TRT） and antidepressant drugs have limitations， whereas traditional Chinese medicine （TCM） offers advantages of holistic regulation and avoids the risks and adverse effects associated with Western medications. Considering the dynamic characteristics of LOH， the core pathogenesis of LOH with depression was analyzed from the perspective of “kidney-liver-

Tiangui

”. Kidney deficiency and essence depletion， gradual decline of

Tiangui

， and loss of spirit are the initiating factors. Liver dysfunction and impaired dispersion，

Tiangui

imbalance， and liver depression with

stagnation are the key factors in progression of LOH with depression. Lipid turbidity and blood stasis are relevant pathological contributors. Treatment should focus on tonifying the kidney and replenishing essence， soothing the liver and relieving depression， and regulating and replenishing

Tiangui

. At the same time， the patient's constitution should be considered， with supplementation of

and blood， promotion of blood circulation， and reduction of lipid turbidity as appropriate.

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references

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Treatment of male late-onset hypogonadism with depression based on "kidney-liver-Tiangui"

DOI：10.16025/j.1674-1307.2025.09.018

摘要

Abstract

关键词

Keywords

references