抑郁症是全球范围内致残的主要原因之一，性激素可能参与抑郁症的发生、发展和情绪调节过程。睾酮水平异常可能不仅是男性抑郁症中的伴随现象，也可能通过神经内分泌、免疫炎症和神经可塑性等途径参与疾病进程。睾酮可通过调控抑郁相关神经内分泌和递质系统、调节神经可塑性和炎症稳态、双向调节和肠道菌群互作参与抑郁症的发生、发展和治疗反应，其作用涉及下丘脑-垂体-肾上腺轴（HPA）-下丘脑-垂体-性腺（HPG）轴串扰、单胺递质稳态、神经炎症、脑源性神经营养因子相关神经可塑性、奖赏环路功能以及肠道菌群介导的类固醇代谢。总结了睾酮治疗抑郁症的作用机制研究进展，有助于更全面地阐明睾酮在抑郁症中的病理意义和治疗价值。

Depression is one of the leading causes of disability worldwide, and sex hormones may play a role in its onset, progression, and emotional regulation. Abnormal testosterone levels may not only be a concomitant phenomenon in male depression but also contribute to the disease process through neuroendocrine, immune-inflammatory, and neuroplasticity pathways. Testosterone can influence the development, progression, and therapeutic response of depression by modulating depression-related neuroendocrine and neurotransmitter systems, regulating neuroplasticity and inflammatory homeostasis, bidirectionally affecting mood, and interacting with gut microbiota. Its mechanisms involve the hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-gonadal (HPG) axis crosstalk, monoamine neurotransmitter homeostasis, neuroinflammation, brain-derived neurotrophic factor-related neuroplasticity, reward circuit function, and steroid metabolism mediated by gut microbiota. This article summarizes research progress on the mechanisms of testosterone in treatment of depression, which helps to more comprehensively elucidate the pathological significance and therapeutic value of testosterone in depression.

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江西中医药大学中药学（新药创制方向）特区建设立项项目（TQ-3）