【摘要】 “宫寒不孕”作为中医不孕症经典病机，其根本为机体阳气亏虚致胞宫失温，病因源于内生寒邪（素体阳虚、房劳多产耗伤肾阳）与外感寒邪（贪凉饮冷、久居湿地）。现代生物学机制体现为：肾阳虚致下丘脑-垂体-性腺轴紊乱；寒性收引激活内皮素系统，卵巢微循环灌注下降及子宫内膜容受性降低；线粒体功能受损、ATP生成减少引发能量代谢迟滞；寒气生浊伴随炎症因子激活，诱发子宫内膜增生、息肉等病理产物堆积。治疗以“温阳为本、化浊生新”为核心，兼顾健脾培土与理气畅机，恢复胞宫孕育功能，为宫寒不孕中西医结合诊疗提供理论依据与临床参考。基于中医“天人相应”思想与隐喻认知，系统阐述“宫寒不孕”的理论内涵、病因病机、现代生物学机制及治疗策略。更多还原

【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".更多还原