摘要
不育症、阳痿、早泄、前列腺炎等男性生殖障碍性疾病是生育力障碍的重要影响因素。中医学认为肾藏精主生殖,为先天之本,脾胃运化水谷精微,为后天之本,先后天相互资生。本文梳理相关研究,认为脾胃失和引起的男性生殖障碍性疾病,可能与肠道菌群紊乱和胃肠激素异常相关。肠道菌群可通过血脑屏障影响5-羟色胺,参与调控射精和勃起,并通过血睾屏障调控脂代谢,调节阴茎血管内皮,介导炎症反应,参与雄激素代谢,影响睾丸微循环;不同胃肠激素可通过介导睾丸炎症和细胞凋亡,调控睾丸微循环,调节性激素分泌及精子发生等,对睾丸生殖具有保护作用和损伤风险。肠道菌群与胃肠激素可能是中医学脾胃论治男性生殖障碍性疾病的潜在生物学基础。
Objective Male reproductive disorders like infertility,erectile dysfunction,premature ejaculation,and prostatitis are significant influencing factors to declining fertility.In Chinese medicine(CM),the Shen is believed to store essence and govern reproduction,forming the foundation of congenital constitution.The Pi and Wei,responsible for the transformation and assimilation of nutrients from water and grains,are considered the foundation of the acquired constitution.This paper reviews relevant studies and suggests that disorders in male reproduction caused by Pi and Wei disharmony might be linked to disturbances in the gut microbiota and abnormalities in gastrointestinal hormones.The gut microbiota can affect serotonin through the blood-brain barrier,regulating ejaculation and erection.It also influences lipid metabolism through the blood-testis barrier,regulating penile vascular endothelium,mediating inflammatory responses,participating in androgen metabolism,and affecting testicular microcirculation.Different gastrointestinal hormones can mediate testicular inflammation and cell apoptosis,regulate testicular microcirculation,and modulate hormone secretion and spermatogenesis,thus having protective and damaging effects on testicular reproduction.The interaction between gut microbiota and gastrointestinal hormones could be the potential biological basis for CM's approach to treating male reproductive disorders through the theory of Pi and Wei.
作者
陈文康
赵家有
CHEN Wen-kang;ZHAO Jia-you(Graduate School of China Academy of Chinese Medicial Sciences,Beijing,100700)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2024年第7期868-873,共6页
Chinese Journal of Integrated Traditional and Western Medicine
基金
国家自然科学基金资助项目(No.82274337)
首都卫生发展科研专项(No.首发2022-2-4271)
中国中医科学院科技创新工程(No.CI2023C018YL,No.CI2021A02207)
中华中医药学会青年求实项目(No.2022-QNQSDEP-20)。
关键词
脾胃
肠道菌群
胃肠激素
生物学基础
男性生殖障碍性疾病
中西医结合
Pi and Wei
gut microbiota
gastrointestinal hormones
biological basis
male reproductive disorders
integrative medicine
