Abstract:

Gong-han infertility, as a classical pathogenesis of infertility in traditional Chinese medicine(TCM),fundamentally results from the deficiency of yang qi in the body, leading to loss of warmth in the uterus. Its etiology originates from the endogenous cold pathogenic factors (innate yang deficiency, excessive sexual activity and multiple childbirths consuming kidney yang) and the exogenous cold pathogenic factors (indulgence in cold food/drinks, prolonged living in damp environments). The modern biological mechanisms are manifested as follows: kidney yang deficiency causes hypothalamic-pituitary-gonadal axis dysfunction; the astringent property of cold activates the endothelin system, leading to the decreased ovarian microcirculatory perfusion and the reduced endometrial receptivity; mitochondrial dysfunction and the decreased ATP production result in delayed energy metabolism; cold qi generating turbidity accompanied by the activation of inflammatory factors induces the accumulation of pathological products like endometrial hyperplasia and polyps. The treatment focuses on "warming yang as the foundation and resolving turbidity to generate newness", while simultaneously strengthening the spleen to cultivate earth and regulating qi to smooth mechanism, so as to restore the reproductive function of the uterus. This provides a theoretical basis and clinical reference for the integrated traditional Chinese and Western medicine diagnosis and treatment of "Gong-han infertility". Based on the TCM thought of "Heaven-human correspondence" and metaphorical cognition, this paper systematically elaborates the theoretical connotation, etiology, pathogenesis, modern biological mechanisms, and treatment strategies of "Gong-han infertility".

Key words: Syndrome of cold congealing in uterus, Infertility, female, Menstruation, Syndrome differentiation of etiological factor, Therapy