男性精子数量少或活力不足是当前不孕症的重要原因之一，核因子E2相关因子2（nuclear factor E2 related factor 2，Nrf2）信号通路在精子发生和成熟过程中具有关键作用。临床研究发现Nrf2在少弱精子症（oligoasthenospermia，OAS）患者精液中的表达量较健康男性显著下调，调控Nrf2通路可能成为改善OAS的重要途径之一。中药多组分、多靶点、多途径的作用特点在治疗OAS方面具有显著优势，研究显示，人参、枸杞子、菟丝子、淫羊藿等中药及其复方所含淫羊藿苷、人参皂苷Rg₁、黄芪甲苷等有效成分可通过调控Nrf2信号通路，进而达到提高睾丸生精功能，增加精子密度与活动率的治疗作用。通过阐述Nrf2信号通路关键靶点与OAS的联系，归纳总结近年来关于中药通过调控Nrf2信号通路治疗OAS的研究现状，为中药及其复方治疗OAS的临床用药与研究思路提供指导和方向。

Low sperm count or lack of viability is one of the most important causes of infertility in men, and nuclear factor E2-related factor 2 (Nrf2) signalling pathway plays a key role in spermatogenesis and sperm maturation. Clinical studies have found that the expression level of Nrf2 in the semen of patients with oligoasthenospermia (OAS) is significantly downregulated compared with that of healthy men. The regulation of Nrf2 pathway may be one of the important ways to improve OAS. The multi-component, multi-target, and multi-pathway effects of traditional Chinese medicines (TCMs) have significant advantages in treatment of OAS. Studies have shown that some TCMs and their compound prescriptions, such as Renshen (Ginseng Radix et Rhizoma), Gouqizi (Lycii Fructus), Tusizi (Cuscutae Semen), Yinyanghuo (Epimedii Folium), and other active ingredients such as icariin, ginsenoside Rg₁, and astragaloside IV, can improve the spermatogenic function of testes, and increase sperm density and motility through the modulation of the Nrf2 signalling pathway. In this paper, the key targets of the Nrf2 signalling pathway and OAS are described, and the current status of research on treatment of OAS by TCMs through the modulation of the Nrf2 signalling pathway is summarized, with the aim of providing guidance and direction for the clinical use of TCMs and their compound prescriptions in treatment of OAS.

R285

2024年兰州市第三批科技计划项目科技撑专项（2024-3-35）；甘肃省药品检验研究院国家药监局中药材及饮片质量控制重点实验室项目（2024GSMPA-KL14）；甘肃省科技计划东西协作专项（鲁甘科技协作项目）（22CX8NA068）