基于5-羟色胺调控的翘芍方干预早泄大鼠的实验研究

目的:观察翘芍方对运用5-羟色胺1A(5-HT1A)受体激动剂8-羟基-2-(二丙基氨基)四氢萘氢溴酸盐(8-OH-DPAT)建立的早泄动物模型的干预效果,并探讨其可能的作用机制。方法:将雄性Wistar大鼠72只随机分为空白组、模型组、翘芍方组(高、中、低剂量)和达泊西汀组,各12只,以8-OH-DPAT腰骶脊髓节段蛛网膜下腔囊内注射建立早泄动物模型。造模成功后连续给药干预4周,模型组、空白组每天用生理盐水[10 ml/(kg·d)]灌胃;翘芍方低[5 g/(kg·d)]、中[10 g/(kg·d)]、高[20 g/(kg·d)]剂量组,每天灌胃1次;达泊西汀组合笼前3 h给予300 mg/kg盐酸达泊西汀灌胃。雌性Wistar大鼠45只,摘除双侧卵巢后,于合笼前36 h皮下注射苯甲酸雌二醇20μg/只以诱导雌鼠发情。在第2周和第4周时,分别将雄性大鼠和激素诱导的雌性大鼠合笼,进行交配实验,每次30 min。检测指标:观察和记录雄鼠的交配行为,包括骑跨潜伏期(ML)、插入潜伏期(IL)、射精潜伏期(EL)、骑跨次数(MF)、插入次数(IF)、射精次数(EF)。第4周交配试验后,分离出下丘脑并称重,测定5-羟色胺(5-HT)含量。结果:与空白组相比,模型组5-HT含量923.4 ng/g,ML(8.69±2.48)s、IL(12.08±1.39)s、MF(7.53±1.84)次、EL(502.35±46.72)s分别低于空白组的5-HT含量1 257.1 ng/g,ML(11.22±3.60)s,IL(22.33±2.45)s、MF(13.28±.24)次、EL(712.35±36.77)s,差异均有统计学意义(P<0.05);药物干预后,与模型组比较,翘芍方高剂量组和达泊西汀组的5-HT含量均升高,差异有统计学意义(P<0.05);与模型组比较,翘芍方各剂量组和达泊西汀组EL明显延长,差异有统计学意义(P<0.05)。结论:翘芍方可延长早泄大鼠的射精潜伏期,这可能与其增加了下丘脑5-HT含量有关,具体机制还需进一步研究。

郭军治疗精索静脉曲张患者术后精液参数未改善临床经验

精索静脉曲张(VC)在中青年男性中发病率较高,其中12%~25%患者伴有不育。针对重度VC临床症状明显且伴不育症者可予以手术治疗,精索静脉曲张术后患者精液常规检查改善率可达50%~70%。但VC术后仍有部分患者精液未得到显著改善,郭军教授认为肾虚、血瘀、湿热是精液参数未改善的基本病机,其自拟三藤活络方加减治疗术后精液参数未改善具有显著效果。

基于L-肉碱通路探讨灵归方对弱精子症大鼠生殖系统保护作用的实验研究

目的:探讨灵归方对奥硝唑(ORN)所致弱精子症大鼠生殖系统保护作用及其可能机制。方法:将40只体重200~230 g的雄性SD大鼠随机将其分为空白组、模型组、灵归方组、左卡尼汀组各10只。模型组:予400 mg/kg ORN灌胃;灵归方组:予灵归方浓缩液,按17.5 g生药/kg体重+400 mg/kg ORN灌胃;左卡尼汀组:予左卡尼汀100 mg/kg+400 mg/kg ORN灌胃;空白组:予等量0.5%羧甲基纤维素钠(CMC2Na);均1次/d,连续灌胃4周后,检测各组大鼠精液质量、附睾中L-肉碱的含量,大鼠附睾OCTN2 mRNA的表达并观察睾丸组织病理。结果:与模型组相比,各组精子浓度无统计学差异(P>0.05),前向运动精子(PR)和前向+非前向运动(NP)精子百分率均高于模型组,差异有统计学意义(P<0.01)。与模型组相比,各组附睾的肉碱含量均提高,有统计学差异(P<0.01)。灵归方组、左卡尼汀组OCTN2 mRNA表达量明显高于模型组,有统计学差异(P<0.05)。睾丸病理观察结果发现,与空白组比较,模型组异常结构生精小管明显增多,排列不整齐,生精小管管腔缩小加重,管腔内精子及精子细胞数量减少,空腔型生精小管明显增多,生精小管内部各级生精细胞缺失,排列层次紊乱,上皮部分变性并出现空泡征;左卡尼汀组及灵归方组大鼠睾丸组织结构趋于正常,生精小管中各级生精细胞排列基本规整,生精小管结构基本正常。结论:①ORN可诱导大鼠产生弱精子症,且与降低附睾L-肉碱含量可能有关;②灵归方可以改善奥硝唑诱导的弱精子症大鼠精液活力;③灵归方可以改善ORN诱导睾丸的病理组织结构;④灵归方可以提高附睾中OCTN2 mRNA在附睾中的表达,其可能与提高附睾肉碱浓度有关。

还少胶囊对奥硝唑诱导的弱精子症模型大鼠生殖功能损伤的保护机制研究

目的:探讨还少胶囊对奥硝唑(ORN)诱导的弱精子症模型大鼠生殖功能损伤可能的保护机制。方法:将SD雄性大鼠随机分为4组,每组10只,分别是空白对照组、模型组、还少胶囊组和左卡尼汀组,除空白对照组外,其余3组采用ORN 400 mg/(kg·d)灌胃大鼠28 d,制成弱精子症大鼠模型。并同时连续给药28 d后,处死大鼠,检测大鼠附睾中左卡尼汀的含量,精子浓度、活率,附睾组织中有机阳离子转运子2(OCTN2)mRNA的表达,并观察大鼠睾丸组织病理结构。结果:还少胶囊组、阳性对照药左卡尼汀组与模型组相比,附睾左卡尼汀的含量均可明显提高(6 366.5、6 934.7 mg/L vs 2 880.3 mg/L,P<0.01);改善精子浓度[(46.19±14.23)、(42.25±6.11)×10^6/ml vs(34.58±10.25)×10^6/ml,P<0.01]、活率[(61.34±7.98)%、(61.34±7.98)%vs(42.59±7.54)%,P<0.01];上调附睾OCTN2 mRNA的表达量(27.26、27.15 vs 26.07,P<0.01);同时还少胶囊组能保护ORN造模导致的睾丸生精细胞的病理损伤,使生精细胞在生精小管形态、排列方式、生精细胞的活跃程度上与空白对照组更加接近。结论:还少胶囊对ORN诱导的弱精子症大鼠模型生殖功能损伤具有保护作用,能提高模型大鼠的精子浓度与活率,其机制可能与上调附睾OCTN2 mRNA的表达量、提高附睾左卡尼汀的含量有关。

暖肝温肾活血法治疗ⅢB型前列腺炎寒凝肝脉兼瘀阻证临床观察

目的 观察暖肝温肾活血法治疗ⅢB型前列腺炎(又称慢性前列腺炎/慢性盆腔疼痛综合征,CP/CPSS)寒凝肝脉兼瘀阻证的临床效果。方法 选择2016年12月—2018年12月就诊于中国中医科学院西苑医院男科和首都医科大学附属北京中医医院男科门诊的CP/CPSS寒凝肝脉兼瘀阻证患者78例,采用随机数字表法分为试验组和对照组。试验组服用具有暖肝温肾活血作用之乌茴止痛方,对照组服用盐酸坦洛新缓释胶囊,用药6周、随访2周,每2周评估1次慢性前列腺炎症状积分指数(NIH-CPSI),包括疼痛症状、排尿症状、生活质量积分;同时评估中医症状积分和临床有效率。结果 治疗后2组疼痛症状积分、生活质量积分、NIH-CPSI总分均较治疗前改善(P<0.05),且试验组优于对照组(P<0.05);2组排尿症状积分均较治疗前改善(P<0.05),但2组间差异无统计学意义(P>0.05)。试验组治疗后中医症状积分及临床有效率均优于对照组(P<0.05)。结论 暖肝温肾活血法可明显改善CP/CPPS寒凝肝脉兼瘀阻证患者临床症状。

基于文献研究分析针刺治疗慢性前列腺炎/慢性盆腔疼痛综合征的选穴循经规律

目的通过文献分析探讨治疗慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)的选穴循经规律。方法检索中国期刊全文数据库(CNKI)、维普资源系统(VIP)、万方数据库(WANFANG DATA)以及PubMed数据库。结果①针刺治疗CP/CPPS的全身腧穴共68个,频次共273次,频次最高为关元;②涉及经脉共12条,其中以足太阳膀胱经选穴个数及频次最多;③选择部位以腰背部及四肢为主。结论治疗CP/CPPS以辨证选穴、脏腑辨证为基础佐以温补肾阳及调畅气血,以及远近取穴的选穴循经规律为主。

Effectiveness and Safety Evaluation of Qixiong Zhongzi Decoction (芪芎种子汤) in Idiopathic Asthenozoospermia Treatment:A Randomized Controlled Trial

Objective:To evaluate the clinical effectiveness and safety of the Chinese medicine(CM)Qixiong Zhongzi Decoction(芪芎种子汤,QZD)in the treatment of patients with idiopathic asthenozoospermia.Methods:A total number of 66 patients with idiopathic asthenozoospermia were included and randomly divided into treatment and control groups by SAS-generated code from January 2015 to August 2016,33 patients in each group.Patients in the treatment group were administered with 150 m L of QZD twice a day,whereas those in the control group were given 1 g of levocarnitine oral liquid twice a day.The two groups received the indicated medication for 12 weeks and were then followed up for 4 weeks.The primary outcome was sperm motility,and the secondary therapeutic indices were sperm volume,density,pregnancy probability,and CM syndrome score.The comparison between groups was carried out at 4,8 and 12 weeks,respectively.The safety was determined before and after treatment.Results:(1)Drop-off:5 cases(7.58%)were lost after treatment(2 from the treatment group and 3 from the control group).(2)Primary outcomes:after 8-and 12-week treatment,the progressive sperms in the two groups were significantly higher than the baseline(all P<0.05);however,the treatment group showed greater improvement compared with the control group at 12-week treatment(22.7%±9.0%vs.14.1%±8.8%,P<0.05).The increasement of non-progressive grade sperms at both groups was observed at 8-and 12-week treatment with statistical difference(all P<0.05),however,the treatment group showed remarkable improvement compared with the control group at 12-week treatment(38.7%±14.1%vs.26.2%±15.4%,P<0.05).(3)Secondary outcomes:no significant statistical differences were found in semen volume and density(4,8,and 12-week treatment)and pregnancy probability of patients’wives(12-week treatment)between two groups(all P>0.05),however,the CM syndrome score of the treatment group significantly declined compared with baseline level at each time points(all P<0.05).(4)Safety:no obvious side reactions were found during the treatment in both groups.Conclusions:QZD could improve the progressive and non-progressive grade sperm in the treatment of idiopathic asthenozoospermia.It is safe with no obvious side effects.

Antioxidant Mechanism of Xiaojin Pill(小金丸) for Treatment of Peyronie’s Disease in Rats Based on Matrix Metalloproteinases

Objective: To evaluate the effects of Xiaojin Pill(小金丸) in the treatment of Peyronie’s disease(PD) in a rat model. Methods: Twenty-four male Sprague-Dawley rats were randomly divided into four groups with 6 in each: sham operation, PD model, vehicle control and Xiaojin Pill groups. The rats in the sham operation group received penile tunica albsginea(TA) injection with 50 μL vehicle, while the rats in the other 3 groups received 50 μL penile TA injection of 50 μg transforming growth factor(TGF)-β1. Forty-two days after the injection, rats in the vehicle control and Xiaojin Pill groups received 0.5 mL water and Xiaojin Pill solution(107 mg/kg of body weight), respectively by gavage for 28 days, while those in the sham operation and PD model groups did not receive any intervention. After intervention, the expressions of matrix metalloproteinase 2/9(MMP2/9), nitric oxidesynthase(NOS), superoxide dismutase(SOD) and malondialdehyde(MDA) were measured. Results: Rats in the PD model and vehicle control groups presented obvious fibrosis in corpus cavernosum(CC) and demonstrated a significantly increased expressions of MMP2 and MMP9 in the CC compared with the sham operation group(all P<0.01). In contrast, the expressions of MMP2 and MMP9 in the Xiaojin Pill group were significantly down-regulated(both P<0.01). In addition, the levels of NOS and MDA in CC were significantly increased while the activity of SOD was decreased in the PD model and vehicle control groups compared with the sham operation group(al P<0.01). After Xiaojin Pil treatment, the levels of MDA, NOS and SOD appeared to be corrected(al P<0.01). Conclusions: Xiaojin Pill could reduce fibrosis in the CC by decreasing the expressions of MMPs, NOS and MDA, and by increasing the activity of SOD. Therefore, Xiaojin Pill might be a therapeutic option for PD.