从脾肾两虚夹瘀与铁死亡的相关性探讨无症状性弱精子不育症的发病
Investigating the relationship between dual deficiency of spleen and kidney with congealed blood and ferroptosis in the pathogenesis of asymptomatic oligozoospermia
徐磊 1史孟华 1陈雪松 1王绍年 1马天宇 1李泓莹 1林煦垚 1秦国政2
作者信息
- 1. 云南中医药大学第一临床医学院,昆明 650500
- 2. 云南省中医医院/云南中医药大学第一附属医院,昆明 650021
- 折叠
摘要
无症状性弱精子不育症是一类症状、体征表现不明显或无症状、体征的不育症,其发病机制复杂,临床难以做到精准分证论治.铁死亡是一种以铁依赖性、脂质过氧化蓄积为特征的调节性细胞死亡形式,被认为是新发现的弱精子不育症病因.脾肾两虚夹瘀是无症状性弱精子不育症发病的核心病机.脾虚运化无力在无症状性弱精子不育症铁死亡发病中起主导作用,生理状态下的铁为清,属水谷精微,受脾胃调控;病理状态下的铁为浊,为病理产物,致男性不育.脾生脂膏可导致脂质过氧化,这触发了铁死亡的关键环节."脾-线粒体-铁死亡"与无症状性弱精子不育症关系密切.此外,肾虚不抵浊毒、久病血瘀入络可促进无症状性弱精子不育症铁死亡发病,致病情复杂难治.探讨脾肾两虚夹瘀与铁死亡的相关性及其在无症状性弱精子不育症发病中的作用,有助于丰富脾肾两虚夹瘀理论的科学内涵,也有助于中医药调控铁死亡以破解无症状性弱精子不育症无证可辨的临床辨治困局.
Abstract
Asymptomatic oligozoospermia is a type of infertility characterized by inconspicuous or asymptomatic symptoms and signs,with a complex pathogenesis that makes it difficult for precise diagnosis and treatment.Ferroptosis is a regulated form of cell death characterized by iron-dependent lipid peroxidation accumulation,and it is considered a newly discovered cause of oligozoospermia.The core pathogenesis of asymptomatic oligozoospermia lies in dual deficiency of spleen and kidney with congealed blood.Spleen deficiency-induced transformational incapacity plays a leading role in the pathogenesis of ferroptosis in asymptomatic oligozoospermia,as iron in the physiological state is clear,belonging to the essence of water and grains,and regulated by the spleen and stomach;while iron in the pathological state is turbid,a pathological product leading to male infertility.Spleen-generated lipids can induce lipid peroxidation,triggering a crucial step in ferroptosis.The relationship between'spleen-mitochondria-ferroptosis'and asymptomatic oligozoospermia is close.Additionally,kidney deficiency unable to resist turbidity and prolonged blood stasis can promote the pathogenesis of ferroptosis in asymptomatic oligozoospermia,resulting in complex and challenging treatment.Investigating the relevance of dual deficiency of spleen and kidney with congealed blood and ferroptosis,and their role in the pathogenesis of asymptomatic oligozoospermia,will help enrich the scientific connotation of the theory of dual deficiency of spleen and kidney with congealed blood,and facilitate the regulation of ferroptosis in traditional Chinese medicine to solve the clinical diagnostic and treatment difficulties in asymptomatic oligozoospermia.
关键词
无症状性弱精子不育症/脾肾两虚夹瘀/铁死亡/症状/病机Key words
Asymptomatic oligozoospermia/Dual deficiency of spleen and kidney with congealed blood/Ferroptosis/Symoptom/Pathogenesis引用本文复制引用
基金项目
国家自然科学基金(82060870)
全国名老中医药专家传承工作室建设项目(国中医药发[2022]75号)
云南省教育厅科研项目(2024Y389)
出版年
2024
NETL
NSTL
万方数据