基于文献研究，探讨基于调节肠道菌群从脾肾论治男性不育症的思路及可能机制。肠道菌群紊乱是导致男性不育症 发病的重要因素之一，脾肾两脏与肠道菌群在生理与病理方面具有一定的相似性，且补肾健脾类方药可通过扶植有益菌生 长、抑制致病菌繁殖、保护肠道黏膜屏障等调节肠道菌群。由此提出，补肾健脾类方药通过调节肠道菌群以治疗男性不育 症的可能机制如下：抑制炎症因子表达，减轻睾丸组织炎症反应；提高抗氧化能力，缓解氧化应激对精子的损伤；改善不 良情绪，减轻心理应激对生殖系统的影响。基于调节肠道菌群探索从脾肾论治男性不育症的思路，可为现代中医临床治疗 男性不育症提供新的切入点。

Based on the literature study， the thoughts and possible therapeutic mechanism in treating male infertility from the perspective of spleen and kidney by regulating intestinal flora were explored. Disturbance of intestinal flora is one of the important factors leading to the development of male infertility，and the spleen and kidney have certain similarities to intestinal flora in the physiological function and pathological changes. Moreover， tonifying the kidney and strengthening the spleen can regulate the intestinal flora by fostering the growth of beneficial bacteria，inhibiting the reproduction of pathogenic bacteria，and protecting the barrier of the intestinal mucosa. Therefore， the possible therapeutic mechanisms in treating male infertility with the prescriptions for tonifying the kidney and strengthening the spleen to regulate intestinal flora are as follows： inhibiting the expression of inflammatory factors to reduce the inflammatory reaction of testicular tissues； improving the antioxidant capacity to alleviate the damage of spermatozoa caused by oxidative stress， and improving the bad mood to alleviate the impact of psychological stress on the reproductive system. The exploration of the thoughts for treating male infertility from the perspective of spleen and kidney by regulating intestinal flora may provide a new entry point for modern Chinese medicine clinical treatment of male infertility

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国家自然科学基金项目（编号：81973845）；中华中医药学会青年求实项目（编号：2021-QNQS-03）；国家中医药管理局李曰庆 全国名中医传承工作室建设项目（国中医药人教函【2022】75号）