填精通络方及其拆方对糖尿病性勃起功能障碍大鼠性激素及性功能的影响
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摘要
目的观察填精通路方及其拆方对糖尿病性勃起功能障碍大鼠的性功能、血清性激素、血糖以及阴茎海绵体组织病理学的影响。方法将50只SD雄性大鼠随机分为模型组、对照组、填精通络组、填精组以及通络组,每组10只,应用链脲佐菌素(streptozotocin,STZ)进行模型制备。模型成功后,模型组给予高脂高糖饮食,阳性药对照组给予他达拉非,其余各组给予相应中药进行治疗,用药4周后,进行相关指标的检测,包括各组大鼠性功能的检测(舔嗅次数、首次爬背时间、骑跨次数、插入次数)、血清性激素水平(睾酮、黄体生成素、卵泡刺激素释放激素)、血糖水平以及阴茎海绵体组织病理学检测。结果通过对舔嗅次数、首次爬背时间、骑跨次数、插入次数的比较,其他各组与模型组比较差异均有统计学意义(P<0.05);填精通络组与填精组和通络组比较差异有统计学意义(P<0.05);对照组与填精通络组比较差异无统计学意义(P>0.05)。对照组、填精通络组、填精组、通络组治疗后血糖均低于治疗前,但差异无统计学意义(P>0.05)。填精组、通络组及填精通络组的血清睾酮(testosterone,T)要明显高于模型组(P<0.05);填精通络组的血清T含量(6.71 nmol/L)明显高于对照组(4.67 nmol/L)(P<0.05);填精通络组的血清T含量(6.71 nmol/L)明显高于填精组(5.76 nmol/L)和通络组(5.1 nmol/L)(P<0.01)。黄体生成素(Luteinizing Hormone,LH)与卵泡刺激素释放激素(Follicle Stimulating Hormone Releasing Hormone,FSH)在各组外周血液中浓度均无明显变化(P>0.05)。各组阴茎海绵体血管内皮细胞减少,提示血管破坏,红细胞数目减少,可见大量结缔组织增生。对照组、填精组、通络组以及填精通络组阴茎海绵体血管中红细胞数目较模型组增多,但结缔组织差异不明显。结论填精通络方在大鼠性功能、血清性激素等方面的作用均优于单纯的填精组或通络组,中医药治疗糖尿病性勃起功能障碍,应坚持填精通络的综合治疗原则。
Objective To observe the impacts of tianjing tongluo formula and its herbal compositions on sexual function,serum sexual hormone,blood glucose and the corpus cavemous histopathology in the rats with diabetic erectile dysfunction(ED).Methods A total of 50 SD male rats were randomized into a model group,a control group,a tianjing tongluo(filling-up essence and promoting circulation) group,a tianjing(filling-up essence) group and a tongluo(promoting circulation) group,10 rats in each one.Streptozotocin(STZ) was used to prepare model.After modeling success,in the model group,the diet of high lipid and high glucose was fed.In the positive drug control group,tadalafil was used.In the rest medication group,the corresponding herbal medicines were prescribed.After medication for 4 weeks,the relevant indexes were determined,including the sexual function(licking and sniffing times,the first back climbing time,the straddling time,insertion frequency),serum sexual hormone levels(testosterone,luteinizing hormone,follicle-stimulating hormone,releasing hormone),blood glucose and corpus cavemous histopathology.Results Compared with the model group,the differences were significant in licking and sniffing times,the first back climbing time,the straddling time and insertion frequency in the rest groups(P<0.05).The differences were significant statistically in the tianjing tongluo group as compared with the tianjing group and tongluo group respectively(P<0.05).The differences were not significant between the control group and the tianjing tongluo group(P>0.05).After treatment,the difference was not significant statistically in blood glucose in the control group,the tianjing tongluo group,tianjing group and tongluo group after treatment(P>0.05).The level of serum testosterone(T) in the tianjing group,tongluo group and the tianjing tongluo group was higher than the model group obviously(P<0.05).The serum T level(6.71 nmol/L) in the tianjing tongluo group was higher obviously than 4.67 nmol/L in the control group(P<0.05),and higher obviously than 5.76 nmol/L in the tianjing group and 5.1 nmol/L in the tongluo group respectively(P<0.01).The blood peripheral concentration of luteinizing hormone(LH) and follicle stimulating releasing hormone(FSH) did not change obviously in each group(P>0.01).The count of vascular endothelial cells of corpus cavemosa was reduced in each group,suggesting angiolysis and reduced red blood cells(RBC).A large amount of connective tissue was proliferated visibly.In the control group,the tianjing group,the tongluo group and the tianjing tongluo group,WBC count in the penile cavemosa was increased as compared with the model group,but the difference was not obvious in the connective tissue.Conclusion The tianjing tongluo formula presents the superior effect on sexual function and serum sexual hormones as compared with the simple tianjing group or tongluo group in the rats.The comprehensive treatment principle for tianjing tongluo(filling-up essence and promoting circulation) should be followed in treatment of diabetic ED with TCM.
Objective To observe the impacts of tianjing tongluo formula and its herbal compositions on sexual function,serum sexual hormone,blood glucose and the corpus cavemous histopathology in the rats with diabetic erectile dysfunction(ED).Methods A total of 50 SD male rats were randomized into a model group,a control group,a tianjing tongluo(filling-up essence and promoting circulation) group,a tianjing(filling-up essence) group and a tongluo(promoting circulation) group,10 rats in each one.Streptozotocin(STZ) was used to prepare model.After modeling success,in the model group,the diet of high lipid and high glucose was fed.In the positive drug control group,tadalafil was used.In the rest medication group,the corresponding herbal medicines were prescribed.After medication for 4 weeks,the relevant indexes were determined,including the sexual function(licking and sniffing times,the first back climbing time,the straddling time,insertion frequency),serum sexual hormone levels(testosterone,luteinizing hormone,follicle-stimulating hormone,releasing hormone),blood glucose and corpus cavemous histopathology.Results Compared with the model group,the differences were significant in licking and sniffing times,the first back climbing time,the straddling time and insertion frequency in the rest groups(P<0.05).The differences were significant statistically in the tianjing tongluo group as compared with the tianjing group and tongluo group respectively(P<0.05).The differences were not significant between the control group and the tianjing tongluo group(P>0.05).After treatment,the difference was not significant statistically in blood glucose in the control group,the tianjing tongluo group,tianjing group and tongluo group after treatment(P>0.05).The level of serum testosterone(T) in the tianjing group,tongluo group and the tianjing tongluo group was higher than the model group obviously(P<0.05).The serum T level(6.71 nmol/L) in the tianjing tongluo group was higher obviously than 4.67 nmol/L in the control group(P<0.05),and higher obviously than 5.76 nmol/L in the tianjing group and 5.1 nmol/L in the tongluo group respectively(P<0.01).The blood peripheral concentration of luteinizing hormone(LH) and follicle stimulating releasing hormone(FSH) did not change obviously in each group(P>0.01).The count of vascular endothelial cells of corpus cavemosa was reduced in each group,suggesting angiolysis and reduced red blood cells(RBC).A large amount of connective tissue was proliferated visibly.In the control group,the tianjing group,the tongluo group and the tianjing tongluo group,WBC count in the penile cavemosa was increased as compared with the model group,but the difference was not obvious in the connective tissue.Conclusion The tianjing tongluo formula presents the superior effect on sexual function and serum sexual hormones as compared with the simple tianjing group or tongluo group in the rats.The comprehensive treatment principle for tianjing tongluo(filling-up essence and promoting circulation) should be followed in treatment of diabetic ED with TCM.
引文
[1]Papaharitou S,Athanasiadis L,Nakopoulou E,et al. Erectile dysfunction and premature ejaculation are the most frequently self-reported sexual concerns:Profiles of 9,536 men calling a helpline[J]. Eur Urol,2006,49(3):557-563.
[2]Bacon CG,Hu FB,Giovannucci E,et al. Association of type and duration of diabetes with erectile dysfunction in a large cohort of men[J]. Diabetes Care,2002,25(8):1458-1463.
[3]El AY,Berraho M,Benslimane A,et al. Diabetes and erectile dysfunction in Morocco:epidemiological study among outpatients[J].East Mediterr Health,2008,14(5):1090-1100.
[4]Shamloul R,Ghanem H. Erectile dysfunction[J]. Lancet,2013,381(9861):153-165.
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[7]Van den Oever I A,Raterman HG,Nurmohamed MT,et al. Endothelial dysfunction,inflammation,and apoptosis in diabetes mellitus[J].Mediat Inflamm,2010(2010):792393.
[8]林贤仁,袁卓珺.勃起功能障碍中医病机探讨[J].云南中医中药杂志,2012,33(4):9-11.
[9]张敏建,常德贵,贺占举,等.勃起功能障碍中西医结合诊疗指南(试行版)[J].中华男科学杂志,2016(8):751-757.
[10]岳增宝,马文君,秦茂,等.补肾活血方治疗大鼠糖尿病性勃起功能障碍的机理[J].北京中医药大学学报,2015(7):462-466.
[11]戴宁,吴宗传.中医药治疗糖尿病性勃起功能障碍研究进展[J].中医药临床杂志,2011(2):114-117.
[12]盛文,张耀圣,李宪锐,等.填精通络法在治疗糖尿病性勃起功能障碍中的理论探讨[J].世界中西医结合杂志,2018,13(4):578-584.
[13]Roth A,Kalterleibovici O,Kerbis Y,et al. Prevalence and risk factors for erectile dysfunction in men with diabetes,hypertension,or both diseases a community survey among 1,412Israeli men[J]. Clin Cardiol,2010:26(1):25-30.
[14]Wang C,Cunningham G,Dobs A,et al. Long-term testosterone gel(AndroGel)treatment maintains beneficial effects on sexual functionand mood and fat mass,and bone mineral density in hypogonadalmen[J]. J Clin Endocrinol Metab,2004,89(5):2085-2098.
[15]Chamness SL,Ricker DD,Crone JK,et al. The effect of androgen onnitric oxide synthase in the male reproductive tract of the rat[J].Fertil Steril,1995,63(5):1101-1107.
[16]Reilly CM,Stopper VS,Mills TM. Androgens modulate the alphaadrenergic responsiveness of vascular smooth muscle in the corpus cavernosum[J]. J Androl,1997,18(1):26-31.
[2]Bacon CG,Hu FB,Giovannucci E,et al. Association of type and duration of diabetes with erectile dysfunction in a large cohort of men[J]. Diabetes Care,2002,25(8):1458-1463.
[3]El AY,Berraho M,Benslimane A,et al. Diabetes and erectile dysfunction in Morocco:epidemiological study among outpatients[J].East Mediterr Health,2008,14(5):1090-1100.
[4]Shamloul R,Ghanem H. Erectile dysfunction[J]. Lancet,2013,381(9861):153-165.
[5]Nehra A,Moreland RB. Neurologic erectile dysfunction[J]. Uro Clinical North America,2001(28):288-308.
[6]田二坡,龙廷,秦达念.雄性大鼠交配实验模型的建立[J].中国男科学杂志,2008,22(1):710.
[7]Van den Oever I A,Raterman HG,Nurmohamed MT,et al. Endothelial dysfunction,inflammation,and apoptosis in diabetes mellitus[J].Mediat Inflamm,2010(2010):792393.
[8]林贤仁,袁卓珺.勃起功能障碍中医病机探讨[J].云南中医中药杂志,2012,33(4):9-11.
[9]张敏建,常德贵,贺占举,等.勃起功能障碍中西医结合诊疗指南(试行版)[J].中华男科学杂志,2016(8):751-757.
[10]岳增宝,马文君,秦茂,等.补肾活血方治疗大鼠糖尿病性勃起功能障碍的机理[J].北京中医药大学学报,2015(7):462-466.
[11]戴宁,吴宗传.中医药治疗糖尿病性勃起功能障碍研究进展[J].中医药临床杂志,2011(2):114-117.
[12]盛文,张耀圣,李宪锐,等.填精通络法在治疗糖尿病性勃起功能障碍中的理论探讨[J].世界中西医结合杂志,2018,13(4):578-584.
[13]Roth A,Kalterleibovici O,Kerbis Y,et al. Prevalence and risk factors for erectile dysfunction in men with diabetes,hypertension,or both diseases a community survey among 1,412Israeli men[J]. Clin Cardiol,2010:26(1):25-30.
[14]Wang C,Cunningham G,Dobs A,et al. Long-term testosterone gel(AndroGel)treatment maintains beneficial effects on sexual functionand mood and fat mass,and bone mineral density in hypogonadalmen[J]. J Clin Endocrinol Metab,2004,89(5):2085-2098.
[15]Chamness SL,Ricker DD,Crone JK,et al. The effect of androgen onnitric oxide synthase in the male reproductive tract of the rat[J].Fertil Steril,1995,63(5):1101-1107.
[16]Reilly CM,Stopper VS,Mills TM. Androgens modulate the alphaadrenergic responsiveness of vascular smooth muscle in the corpus cavernosum[J]. J Androl,1997,18(1):26-31.