| 徐新宇，彭煜，翟靖，陶方泽，朱文静，囤荣梁.论中医脾与睾丸支持细胞的功能相似性[J].中医药信息,2026,43(6):1-7 |
| 论中医脾与睾丸支持细胞的功能相似性 |
| On the Functional Similarity Between the Spleen in Traditional Chinese Medicine and Testicular Sertoli Cells |
| 投稿时间：2025-12-02 录用日期：2026-01-01 |
| DOI：10.19656/j.cnki.1002-2406.20260601 |
| 中文关键词: 少弱精子症 支持细胞 睾丸微环境 脾肾两虚 中虚精变 |
| 英文关键词: Oligoasthenospermia Sertoli cells Testicular microenvironment Spleen－kidney dual deficiency Spleen deficiency－induced spermatogenic dysfunction |
| 基金项目:国家自然科学基金（82174451）；上海吴孟超医学科技基金会临床医学基础与应用研究专项基金（JHXM-2021018）；第七批全国老中医药专家学术经验继承工作（国中医药人教函[2022]76号）；第五批江苏省中医临床优秀人才研修项目（苏中医科教〔2025〕9号）；南京市中医药青年人才培养计划项目（宁卫中医〔2020〕4号，ZYQ20041）；南京市名中医赵薇工作室建设项目（2023-NJSMZYGZS-ZW） |
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| 中文摘要: |
| 中医学中脾对精室的影响，与睾丸支持细胞对生精细胞的影响存在生理相似性，体现为脾主散精与支持细胞能量供应、脾主肌肉与支持细胞骨架作用、脾主为卫与支持细胞组成血睾屏障、脾主固摄与支持细胞稳定睾酮水平、脾升胃降与睾丸微环境稳态平衡等方面。病理方面，脾虚则散精不能，脾虚及肾、脾肾共病可造成支撑乏力、御邪无力、固摄失职、升降失司，进而精室失濡，且为湿瘀等实邪所阻。这些过程可对应为支持细胞损伤所引发的能量供应障碍、骨架作用异常、血睾屏障损坏、睾酮水平降低、睾丸微环境紊乱，且脾虚与支持细胞功能障碍存在病理演变的时空关联性，最终造成精子数量和活力下降，甚至出现无精子症和唯支持细胞综合征等。基于脾与支持细胞的生理和病理相似性，本文提出“睾丸微环境脾肾相关”假说，认为脾虚或脾肾两虚可通过影响支持细胞功能，破坏睾丸微环境稳态，最终引发生殖障碍；健脾补肾法较单纯补肾法在构建更全面的生精支持、增强物质代谢和消化吸收功能等方面具有明显优势。 |
| 英文摘要: |
| The influence of the spleen in traditional Chinese medicine on the semen chamber exhibits physiological similarities with the role of Sertoli cells in supporting spermatogenic cells. These parallels are reflected in the spleen's function of distributing essence and the Sertoli cells' provision of energy， the spleen's governance of muscles and the structural support offered by Sertoli cells， the spleen's defensive role and the blood－testis barrier formed by Sertoli cells， the spleen's ability to retain and control and the regulation of testosterone levels by Sertoli cells， as well as the harmony between spleen ascension and stomach descension and the maintenance of testicular microenvironment homeostasis. Pathologically， spleen deficiency may lead to failure in essence distribution， while spleen deficiency involving the kidney or dual disease of the spleen and kidney can result in weakened structural support， impaired defense， loss of retention， and dysregulation of ascension and descension. Consequently， the semen chamber becomes inadequately nourished and obstructed by substantial pathogenic factors such as dampness and stasis. These processes correspond to impairments in energy supply， abnormal cytoskeletal function， damage to the blood－testis barrier， decreased testosterone levels， and disruption of the testicular microenvironment caused by Sertoli cell injury. Moreover， a temporal and spatial correlation exists in the pathological progression between spleen deficiency and Sertoli cell dysfunction， ultimately leading to reduced sperm count and motility， or even azoospermia and Sertoli cell－only syndrome. Based on these physiological and pathological similarities， this paper proposes the hypothesis of a “spleen－kidney correlation in the testicular microenvironment”， suggesting that spleen deficiency or spleen－kidney dual deficiency may disrupt testicular microenvironment homeostasis by impairing Sertoli cell function， ultimately resulting in reproductive disorders. Compared with the solely tonifying kidney method alone， the fortifying the spleen and tonifying the kidney therapy demonstrates clear advantages in providing comprehensive spermatogenic support， enhancing material metabolism， and improving digestive and absorptive functions. |
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