從中西醫觀點看女性器官生理學

The Viewpoints on Physiology of Female Sex Organs from the Western and Traditional Chinese Medicine

10.6516/TJTCM.202209_25(3).0003

吳思儀(Sih-Yi Wu)；王人澍(Jen-Shu Wang)

生殖軸 ； 天癸 ； 衝任 ； 臟腑 ； Reproductive Axis ； Tiangui ； Thoroughfare and Conception Vessels ； Viscera

中醫藥研究論叢

25卷3期（2022 / 09 / 30）

27 - 37

繁體中文

女性具有獨特的生殖生理現象：經、帶、胎、產。藉由西方醫學對「下視丘－腦下垂體－卵巢軸」的解析，可協助對中醫生理生殖軸：腎－天癸－衝任－胞宮軸，有更多的理解與發展。腎氣充盛則使天癸逐漸發展成熟，兩者功能類似於下視丘、腦下垂體及其所分泌的微量物質。衝任二脈匯集氣血陰精並輸送至胞宮。腎氣與天癸雖源自於先天，但需後天脾胃產生的水穀精微物質不斷的補充，再加上肝、心、肺、腎四臟的功能協調，生理生殖軸便具有週期性的消長現象，最終使卵子成熟排出，並在精卵結合後，能順利在胞宮血海中成長。

Women have unique reproductive physiological functions: Menstruation, Leucorrhoea, pregnancy, and childbirth. The analysis of ＂hypothalamus-pituitary-ovarian axis＂ can help us manage the reproductive axis: kidney-tiangui-chong ren-cytoplasmic axis, with more understanding and development. Enrichment of kidney qi makes Tiangui gradually mature, and the functions of the two are similar to the hypothalamus, pituitary gland, and the trace substances secreted by them. The Chong and Ren two channels (thoroughfare and conception vessels) gather qi, blood, yin, and essence and transport them to the uterus. Although kidney qi and Tiangui are derived from innate, they need to be continuously supplemented by the water and grains produced by the acquired spleen and stomach. Coupled with the coordination of the functions of the liver, heart, lungs and kidneys, the reproductive physiological axis has periodic fluctuations. Finally, it makes the ovum mature and be ovulated. After the combination of the sperm and ovum, the fertilized ovum can grow smoothly in the blood sea of the uterus.

1. (1996).Research on the menopause in the 1990s. Report of a WHO Scientific Group.World Health Organ Tech Rep Ser,866,661-107.
2. （宋）陳自明.婦人良方大全.台北市:集文書局有限公司.
3. （明）張景岳.類經評注.西安:陝西科學技術出版社.
4. （明）張景岳.景岳全書.台北市:台聯國風出版社.
5. （清）吳謙.醫宗金鑑.台南市:世一文化事業股份有限公司.
6. （清）高士宗.黃帝內經素問直解.北京:學苑出版社.
7. Judith M Adams. (2021, March 3). Ultrasound evaluation of the normal menstrual cycle. Retrieved from: https://www.uptodate.com/contents/ultrasound-evaluation-of-the-normal-menstrual-cycle?search=ovulation&source=search_result&selectedTitle=8~150&usage_type=default&display_rank=8
8. Frank M Biro and Yee-Ming Chan. (2020, June 16). Normal puberty. Retrieved from: https://www.uptodate.com/contents/normal-puberty?search=uterus%20development&topicRef=7472&source=see_link
9. Robert F Casper. (2021, September 30). Clinical manifestations and diagnosis of menopause. Retrieved from: https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-menopause?search=menopause&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
10. Nirupama K De Silva. (2021, July 24). Abnormal uterine bleeding in adolescents: Evaluation and approach to diagnosis. Retrieved from: https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-adolescents-evaluation-and-approach-to-diagnosis?search=evaluation-of-the-menstrual-cycle-and-timeing-of-ovulation&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3#H5
11. Emans, SJ.(1986).Vulvovaginitis in the Child and Adolescent.Pediatrics in Review,8(1),12-19.
12. Hefnawi, F,Saleh, A,Kandil, O,El-Sheikha, Z,Hassanein, M,Askalani, H(1979).Fibrinolytic activity of menstrual blood in normal and menorrhagic women and in women wearing the Lippes Loop and the Cu-T (200).Int J Gynaecol Obstet,16(5),400-7.
13. Olaf Hiort. (2021, January 19). Typical sex development. Retrieved from: https://www.uptodate.com/contents/typical-sex-development?search=uterus%20development&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5
14. Mark D Hornstein and Wendy Kuohung. (2021, July 22). Causes of female infertility. Retrieved from: https://www.uptodate.com/contents/causes-of-female-infertility?search=ovary%20oocyte%20number&source=search_result&selectedTitle=6~150&usage_type=default&display_rank=6
15. Andrew M Kaunitz. (2021, October 5). Abnormal uterine bleeding in nonpregnant reproductive-age patients: Evaluation and approach to diagnosis. Retrieved from: https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-nonpregnant-reproductive-age-patients-evaluation-and-approach-to-diagnosis?search=Menstruation%20volume&topicRef=14213&source=see_link
16. Jennifer Knudtson and Jessica E. McLaughlin. (2020, January). Female Internal Genital Organs. Retrieved from: https://www.merckmanuals.com/home/women-s-health-issues/biology-of-the-female-reproductive-system/female-internal-genital-organs
17. National Institutes of Health. (2017, January 31). What are the symptoms of menstruation? Retrieved from: https://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/symptoms
18. Wallace, W. H.,Kelsey, T. W.(2010).Human ovarian reserve from conception to the menopause.PloS one,5(1),e8772.
19. Corrine K Welt. (2021, June 22). Physiology of the normal menstrual cycle. Retrieved from: https://www.uptodate.com/contents/physiology-of-the-normal-menstrual-cycle
20. Corrine K Welt. (2021, June 15). Ovarian development and failure (menopause) in normal women. Retrieved from: https://www.uptodate.com/contents/ovarian-development-and-failure-menopause-in-normal-women?search=ovary%20oocyte&source=search_result&selectedTitle=6~150&usage_type=default&display_rank=6
21. Corrine K Welt. (2021, May 19). Evaluation of the menstrual cycle and timing of ovulation. Retrieved from: https://www.uptodate.com/contents/evaluation-of-the-menstrual-cycle-and-timing-of-ovulation?search=ovulation&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
22. 王繼波,侯麗輝,吳效科(2009)。中西醫衝任與月經關係探賾。遼寧中醫藥大學學報，3(11)，66-68。
23. 古文華,邢玉瑞(2017)。女性生殖軸的古今認識。現代中醫藥，37(1)，56-58。
24. 台灣更年期醫學會（民105年5月27日）。算一算，妳更年期了嗎。取自：http://www.menopause.org.tw/newsdetail.php?title_id=8&ca_id=15&news_id=336
25. 李清瑜,秦佳佳,明婉君,王姝婉,高晶晶(2019)。論促性腺激素釋放激素與天癸的相關性。吉林中醫藥，39(11)，1413-1416。
26. 封鑫宇,曾粵睿,戴欣晴,李子鴻,劉子惠,于倩,田露(2021)。天癸本質與臨床應用的研究進展。中醫藥導報，27(6)，131-133。
27. 夏桂成,談勇(2020)。天癸新解。南京中醫藥大學學報，36(1)，1-4。
28. 張登本（編）(2000).白話通解黃帝內經.西安:世界圖書出版西安公司.
29. 張登本（編）(2000).白話通解黃帝內經.西安:世界圖書出版西安公司.
30. 張鎖,王波,吳效科,侯麗輝(2010)。天癸與臟腑功能調控。中華中醫藥雜誌，25(7)，1018-1020。
31. 許超循(1988).沈氏女科輯要新釋.台北縣:國立中國醫藥研究所.
32. 嘉義長庚婦產科（無日期）。女性生殖系統生理。民 110 年 10 月 15 日，取自：https://www1.cgmh.org.tw/intr/intr5/c6700/OBGYN/%E5%A5%B3%E6%80%A7%E7%94%9F%E6%AE%96%E7%B3%BB%E7%B5%B1%E7%94%9F%E7%90%86.htm

1. (2024)。中醫藥物治療更年期汗出、潮熱症狀病例報告。中醫內科醫學雜誌，22(1)，51-60。