聚精丸治疗少精子症的实验研究

Experimental Study on the Effects of Jujingwan on Oligospermia

目的：观察聚精丸对少精子症患者精子超微结构和生精细胞凋亡的影响，探讨聚精丸对精子生成的作用机制。方法：50例少精子症患者口服聚精丸5g／次，3次／d，3个月为1个疗程，连续服用1—4个疗程，分别于治疗前、治疗1、3、6、12个月后，通过透射电镜和流式细胞仪（FCM）观察精子超微结构和生精细胞的凋亡、生精细胞倍体比例的变化。结果：①精子超微结构治疗6个月后顶体基质密度有所增加，治疗12个月后顶体膜形态完整性有明显改善；核的病理改变和尾部异常改变不明显。②生精细胞凋亡治疗后细胞碎片和凋亡细胞减少，治疗3个月后与治疗前比较差异有显著性（P〈0．05），治疗12个月后与治疗前比较差异有极显著性（P〈0．01）。⑧生精细胞倍体比例经聚精丸治疗3个月后，单倍体成熟精子增多，与治疗前比较差异有极显著性（P〈0．01）；脱落的精母细胞减少，与治疗前比较差异有显著性（P〈0．05）。结论：聚精丸可改善少精子症患者精子顶体基质密度和顶体膜结构形态的病理性改变，提高顶体膜和顶体酶的质量；降低生精细胞及精子凋亡速率，提高单倍体精子的百分率，降低二倍体细胞的百分率。

Objective： To investigate the effects of Jujingwan on the spermatozoal ultrastructure and apoptosis of germ cells in oligospermia patients. Methods ： We treated 50 oligospermia patients with Jujingwan and observed the spermatozoal ultrastructure, the apoptosis of germ cells and the changes in the DNA ploidy proportion of spermatogenic cells by electron microscopy and FCM before the treatment and 3, 6, 9 and 12 months after it. Results： Jujingwan increased sperm acrosome base density 6 months after the treatment and remarkably improved the integrity of acrosome membrane 12 months after it, with no obvious pathological changes in the nuclei and tails. Three months after the treatment, cell debris and apoptotic cells decreased significantly as compared with pre-treatment （P 〈 0.05 ） , and very significantly 12 months after the treatment （ P〈0.01 ）. The proportion of haploid spermatozoa increased very significantly （P 〈 0.01 ）, and the lost primary spermatocytes decreased significantly （P 〈 0.05 ） compared with pre-treatment. Conclusion ： Jufingwan can increase the density of sperm acrosome base and improve the pathological changes of acrosome membrane in oligopermia patients ; it can improve the activity of acrosome enzyme and the integrity of acrosome membrane, decrease the apoptosis rate of germ cells and sperm and increase the percentage of haploid spermatozoa; it can also reduce the percentage of apoptotic bodies and diploid sperm cells. It is indicated that Jujingwan can inhibit the apoptosis of germ cells and sperm and improve spermatogenesis in oligospermla patients.