绝经期泌尿生殖综合征（GSM）是因雌激素水平下降所导致的生殖泌尿道症状，可发生于雌激素水平降低的任何年龄段 女性。GSM下尿路症状以尿频、尿急、排尿困难、尿失禁、反复尿路感染等为主要临床表现，可归属于中医“劳淋”等范 畴，严重影响女性的身心健康及生活质量。李莉教授临证辨治GSM下尿路症状时，结合绝经期女性“天癸竭，冲任虚，诸 脏俱虚”的生理病理特点，认为本病以脾肾阳虚为根本病机，水湿内生、膀胱气化不利为病机之关键；治疗主张以“温补 脾肾，利湿通络”为法，方以桂附理中丸加减，配伍五指毛桃、茯苓等健脾利湿及丹参、鸡血藤、鸡内金等活血通络之品。 治疗需因时、因地、因人制宜；同时，重视身心同治与健康宣教，强调早干预以控制病情进展，并将固本防复的长期健康 管理理念贯穿整个绝经期，可取得较好临床疗效。

Genitourinary syndrome of menopause （GSM） encompasses genitourinary symptoms resulting from the decline of estrogen levels，which occurs in women of any age with decreased estrogen level. Lower urinary tract symptoms （LUTS） of GSM are characterized by frequent urination， urgent urination， dysuria， urinary incontinence，and recurrent urinary tract infections. These symptoms can be categorized into overstrain-induced stranguria in the field of traditional Chinese medicine （TCM）， which seriously impact women’s physical and mental health and their quality of life. Professor Li Li makes syndrome differentiation and treatment of GSM-LUTS by taking the physiological and pathological characteristics of menopausal women into account， which can be described as exhaustion of Tiangui，deficiency of Chong and Ren meridians，and general deficiency of viscera. She considers that spleen-kidney yang deficiency acts as the fundamental pathogenesis of GSM-LUTS， and internal retention of water-dampness and impaired bladder qi transformation serve as the key pathological mechanisms. Professor Li advocates that treatment of GSM-LUTS should focus on warming and tonifying the spleen and kidney，and promoting diuresis and unblocking collaterals. And the modified Guifu Lizhong Pills is used as the basic prescription，often with Fici Simplicissimae Radix and Poria added for strengthening the spleen and draining dampness，and with Salviae Miltiorrhizae Radix et Rhizoma，Spatholobi Caulis，and Galli Gigerii Endothelium Corneum added for activating blood circulation and unblocking collaterals. Treatment is tailored according to season， environment， and individual constitution. Additionally， Professor Li emphasizes the integration of physical management with psychological therapy and the performance of health education， advocates early intervention to control disease progression， and incorporates the long-term health management concept of consolidating the constitution and preventing recurrence throughout the entire menopausal period，which obtain favorable clinical outcomes.

R271.11+ 6

广东省中医药局科研项目（编号：20243005）