补肾方药治疗肾虚所致男性生殖功能衰减的药效和机制研究进展  

Research Progress in the Pharmacological Actions and Mechanism of Kidney-Supplementing Prescriptions for the Treatment of Male ReproductiveFunction Decline Caused by Kidney Deficiency

作　　者：张露娜 陈迪新 王启鹏 彭子倫 刘永俊 陈艳芬[1] 贾丹 ZHANG Lu-Na;CHEN Di-Xin;WANG Qi-Peng;PENG Zi-Lun;LIU Yong-Jun;CHEN Yan-Fen;JIA Dan(Guangdong Pharmaceutical University,Guangzhou 510006 Guangdong,China;Guangzhou General Pharmaceutical Research Institute,Guangzhou 510240 Guangdong,China)

机构地区：[1]广东药科大学,广东广州510006 [2]广州医药研究总院有限公司,广东广州510240

出　　处：《广州中医药大学学报》2024年第9期2499-2508,共10页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(编号:82304904);中国博士后面上项目(编号:2022M710905)。

摘　　要：有关高龄育子和少子化的现状表明,男性生殖功能衰减带来不育风险的防治问题日益突出。男性生殖功能衰减与下丘脑-垂体-性腺轴、氧自由基、血睾屏障、生精细胞凋亡等因素有密切关系。中医认为,肾藏精,主生殖,生殖功能衰减与肾之阴阳失衡密切相关,运用补肾法可治疗肾虚导致的生殖功能衰减。补肾类方药通过系统调节下丘脑-垂体-性腺轴的功能,可显著延缓生殖功能的衰退;补肾类方药可清除体内过多的氧自由基,保护细胞免受氧化损伤;补肾类方药可通过维持血睾屏障而改善生精功能,并能调控生精细胞的凋亡。通过补肾改善肾虚所致生殖功能衰减的代表性方剂有五子衍宗丸、肾气丸、右归丸、六味地黄丸、左归丸及龟鹿二仙膏。这些方剂并非只针对单一机制产生效果,而是通过多途径、多环节、多靶点发挥治疗作用,综合调节机体内环境,以达到改善男性生殖功能的目的。中医补肾疗法在男性生殖功能衰减的治疗中发挥着不可替代的作用。深入研究其作用机制,可更好地指导临床实践,为改善男性生殖功能衰减提供理论依据。The current situation of childrearing in the elderly and low birth rate showed that the prevention and treatment of infertility risk caused by the decline of male reproductive function are increasingly becoming prominent.The decline of male reproductive function is closely related to the hypothalamic-pituitary-gonadal axis,oxygen free radicals,blood-testis barrier,and the apoptosis of spermatogenic cells.Traditional Chinese medicine believes that the kidney stores essence and is in charge of reproduction,and the decline of reproductive function is closely related to the imbalance of yin and yang of the kidney.Therefore,kidney-supplementing method is helpful for treating the decline of reproductive function caused by kidney deficiency.Kidney-supplementing prescriptions were effective on systematically regulating the function of the hypothalamic-pituitary-gonadal axis,thus to significantly delay the decline of reproductive function,were effective on removing excessive oxygen free radicals in the body and protecting cells from oxidative damage,and were effective on improving spermatogenesis by restoring the blood-testis barrier and regulating the apoptosis of spermatogenic cells.The representative kidney-supplementing prescriptions for improving the decline of reproductive function caused by kidney deficiency include Wuzi Yanzong Pills,Shenqi Pills,Yougui Pills,Liuwei Dihuang Pills,Zuogui Pills and Guilu Erxian Soft Extract.The above formulas presented no single therapeutic mechanism but multiple-way,multiple-level and multiple-target mechanism,and the formulas can comprehensively regulate the internal environment of the body,so as to achieve the purpose of improving male reproductive function.The kidney-supplementing therapy of traditional Chinese medicine plays an irreplaceable role in the treatment of male reproductive function decline.The in-depth study of its therapeutic mechanism will provide guide for clinical practice and will supply theoretical basis for improving male reproductive function decline.

关 键 词：补肾方药 男性生殖功能衰减 下丘脑-垂体-性腺轴 氧自由基 血睾屏障 生精细胞凋亡 五子衍宗丸 肾气丸 右归丸 六味地黄丸 综述 

分 类 号：R285.5[医药卫生—中药学]