知柏地黄丸对UU感染不育患者精子膜功能及uPA的影响
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摘要
目的：男性不育症影响着人类健康及家庭幸福,泌尿生殖道解脲脲原体(UU)感染和男性不育密切相关。目前,医学科研及临床工作者已经在用中医药治疗UU感染性不育症方面进行了有益的探索并取得了一些成果,但其机制有待深入研究。前期研究表明,知柏地黄丸能有效抑制UU生长；能下调生精细胞凋亡；具有抗感染和免疫调节功能。本研究在前期研究基础上,通过观察知柏地黄丸治疗UU感染性不育患者的临床疗效,观察精子膜功能完整性和uPA在用药前后的变化情况,探讨知柏地黄丸对UU感染不育患者精子膜功能和uPA的影响机制。
方法：将合并UU感染的精子活力低下症不育患者130例,按就诊顺序随机分为知柏地黄丸治疗组(A组)72例与西药对照组(B组)58例。另选择同期就诊的无UU感染精子活力低下症不育患者50例,作为UU感染组治疗前的比较对象。中西药组均治疗3个月,治疗前后检测精液参数,精子膜功能完整性,顶体酶活性及uPA含量并作对比分析,观察临床疗效。
结果：
1.UU感染不育组精子活率、活力及正常形态精子百分率均低于非UU感染组(P<0.05),而两组精子密度比较没有明显差异(P>0.05)。A、B两组治疗后精子活率、活力及正常形态百分率比较差异有统计学意义(P<0.05),治疗后A组精子密度升高比B组明显,但两组密度比较无统计学意义(P>0.05)。
2.UU感染不育组精子总膨胀率及G型精子膨胀率均较非UU感染不育组低,差异有统计学意义(P<0.05)；A、B两组治疗后总膨胀率及G型精子膨胀率均提高,治疗组总膨胀率及G型精子膨胀率均优于对照组,差异有统计学意义(P<0.01)。
3.UU感染不育组顶体酶活性及精子膜uPA含量均较非UU感染不育组低,差异有统计学意义(P<0.05)；A、B两组治疗后精子顶体酶活性及uPA含量均明显提高,治疗后两组比较差异有统计学意义(P<0.01)。
4.知柏地黄丸治疗组UU转阴率为87.5%,西药组UU转阴率为93.1%,两组无明显差异(P>0.05)。知柏地黄丸组治愈率25.71%,总有效率为88.57%,西药组治愈率为13.79%,总有效率为67.25%,两组治愈率和总有效率比较差异有统计学意义(P<0.01)
结论：UU感染会破坏精子膜完整性,导致精子膜uPA含量降低；知柏地黄丸可以通过抑制UU生长,促进精子膜功能恢复并使精子膜uPA含量上升,提高精子的受精能力,有效治疗UU感染性不育症。
Objective Male infertility affects human health and well-being of families, genitourinary tract Ureaplasma urealyticum (UU) infection is closely related to male fertility. At present, medical researcher and clinical workers have made useful exploration in Chinese medicine for the treatment of UU infection in infertility, and achieved some results, but its mechanism needs further study. Previous studies have shown that, Zhibai Dihuang pill(ZBDHP) can effectively inhibit the growth of UU; can be reduced the apoptosis of spermatogenic cells; anti infection and immune regulation function. In this study, based on previous studies, through the observation of clinical curative effect of ZBDHP treatment of UU infection in infertility patients, to observe the functional integrity of sperm membrane and uPA changes in the situation before and after treatment, To explore the effect of ZBDHP on uPA and the Function of Sperm Membrane in Male Infertility patients with UU-infection.
Methods30cases of male infertility patients with UU infection were randomly divided into2groups:treatment group of72cases (Group A) were given ZBDHP while control group of58cases (Group B) were given antibiotics.50infertility patients without UU infection were blank group to be compared with the UU infection groups. After3months of treatment, semen parameters, uPA and the functional integrity of sperm membrane were analyzed to observe the clinical efficacy.
Results
1. The sperm motility, viability and percentage of normal sperm morphology in UU infection groups were lower than those in non-UU infection group (P<0.05), but the sperm density had no significant differences between groups (P>0.05). After treatment, there were statistically significant differences between Group A and B in sperm viability, vigor and percentage normal morphology difference (P<0.05); the sperm density of Group A was higher than that of Group B but without statistical differences between2groups (P>0.05).
2. The total rate of sperm expansion and G expansion rate in UU infection groups were lower than those of non-UU infection group; the differences were statistically significant (P<0.05). After treatment, the total expansion rate and G sperm expansion rate of Groups A and B were increased; the total rate of expansion and G expansion rate of sperm in Group A were better than in Group B with statistical difference (P<0.01).
3. The acrosin activity and sperm membrane uPA content in UU infection groups were lower than those in non-UU infection group; the differences were statistically significant (P<0.05). The sperm acrosin activity and uPA content of Groups A and B were significantly improved after treatment; there was statistically significant difference between2groups (P<0.01).
4. In ZBDHP group the cure rate was25.71%and the total efficiency was88.57%; in control group the cure rate was13.79%, and the total effective rate was67.25%; the differences between2groups were statistically significant (P<0.01).
Conclusion UU infection can damage sperm membrane integrity, leading to decrease of sperm membrane uPA content; Zhibai Dihuang pill can eliminated UU, protect the function of sperm membrane and make the sperm membrane uPA content return to normal, so ZBDHP is effective in the treating UU infection in infertility..
方法：将合并UU感染的精子活力低下症不育患者130例,按就诊顺序随机分为知柏地黄丸治疗组(A组)72例与西药对照组(B组)58例。另选择同期就诊的无UU感染精子活力低下症不育患者50例,作为UU感染组治疗前的比较对象。中西药组均治疗3个月,治疗前后检测精液参数,精子膜功能完整性,顶体酶活性及uPA含量并作对比分析,观察临床疗效。
结果：
1.UU感染不育组精子活率、活力及正常形态精子百分率均低于非UU感染组(P<0.05),而两组精子密度比较没有明显差异(P>0.05)。A、B两组治疗后精子活率、活力及正常形态百分率比较差异有统计学意义(P<0.05),治疗后A组精子密度升高比B组明显,但两组密度比较无统计学意义(P>0.05)。
2.UU感染不育组精子总膨胀率及G型精子膨胀率均较非UU感染不育组低,差异有统计学意义(P<0.05)；A、B两组治疗后总膨胀率及G型精子膨胀率均提高,治疗组总膨胀率及G型精子膨胀率均优于对照组,差异有统计学意义(P<0.01)。
3.UU感染不育组顶体酶活性及精子膜uPA含量均较非UU感染不育组低,差异有统计学意义(P<0.05)；A、B两组治疗后精子顶体酶活性及uPA含量均明显提高,治疗后两组比较差异有统计学意义(P<0.01)。
4.知柏地黄丸治疗组UU转阴率为87.5%,西药组UU转阴率为93.1%,两组无明显差异(P>0.05)。知柏地黄丸组治愈率25.71%,总有效率为88.57%,西药组治愈率为13.79%,总有效率为67.25%,两组治愈率和总有效率比较差异有统计学意义(P<0.01)
结论：UU感染会破坏精子膜完整性,导致精子膜uPA含量降低；知柏地黄丸可以通过抑制UU生长,促进精子膜功能恢复并使精子膜uPA含量上升,提高精子的受精能力,有效治疗UU感染性不育症。
Objective Male infertility affects human health and well-being of families, genitourinary tract Ureaplasma urealyticum (UU) infection is closely related to male fertility. At present, medical researcher and clinical workers have made useful exploration in Chinese medicine for the treatment of UU infection in infertility, and achieved some results, but its mechanism needs further study. Previous studies have shown that, Zhibai Dihuang pill(ZBDHP) can effectively inhibit the growth of UU; can be reduced the apoptosis of spermatogenic cells; anti infection and immune regulation function. In this study, based on previous studies, through the observation of clinical curative effect of ZBDHP treatment of UU infection in infertility patients, to observe the functional integrity of sperm membrane and uPA changes in the situation before and after treatment, To explore the effect of ZBDHP on uPA and the Function of Sperm Membrane in Male Infertility patients with UU-infection.
Methods30cases of male infertility patients with UU infection were randomly divided into2groups:treatment group of72cases (Group A) were given ZBDHP while control group of58cases (Group B) were given antibiotics.50infertility patients without UU infection were blank group to be compared with the UU infection groups. After3months of treatment, semen parameters, uPA and the functional integrity of sperm membrane were analyzed to observe the clinical efficacy.
Results
1. The sperm motility, viability and percentage of normal sperm morphology in UU infection groups were lower than those in non-UU infection group (P<0.05), but the sperm density had no significant differences between groups (P>0.05). After treatment, there were statistically significant differences between Group A and B in sperm viability, vigor and percentage normal morphology difference (P<0.05); the sperm density of Group A was higher than that of Group B but without statistical differences between2groups (P>0.05).
2. The total rate of sperm expansion and G expansion rate in UU infection groups were lower than those of non-UU infection group; the differences were statistically significant (P<0.05). After treatment, the total expansion rate and G sperm expansion rate of Groups A and B were increased; the total rate of expansion and G expansion rate of sperm in Group A were better than in Group B with statistical difference (P<0.01).
3. The acrosin activity and sperm membrane uPA content in UU infection groups were lower than those in non-UU infection group; the differences were statistically significant (P<0.05). The sperm acrosin activity and uPA content of Groups A and B were significantly improved after treatment; there was statistically significant difference between2groups (P<0.01).
4. In ZBDHP group the cure rate was25.71%and the total efficiency was88.57%; in control group the cure rate was13.79%, and the total effective rate was67.25%; the differences between2groups were statistically significant (P<0.01).
Conclusion UU infection can damage sperm membrane integrity, leading to decrease of sperm membrane uPA content; Zhibai Dihuang pill can eliminated UU, protect the function of sperm membrane and make the sperm membrane uPA content return to normal, so ZBDHP is effective in the treating UU infection in infertility..
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