Study Of Shengjing-san Treating Asthenospermia By Activating The Nrf2 Channel To Regulate The Oxidative Stress

Aims: To observe the effect of Shengjing-san on patients with weak sperm disease(asthenospermia).According to the Traditional Chinese Medicine(TCM)symptom assessment,to observe the changes of TCM symptom scores of patients with weak sperm disease before and after treatment with Shengjing-san.To observe the sperm concentration and activity rate of patients using computer assisted sperm analysis(CASA)system;Western Blot test(Western Blot)method is applied d to observe whether Nrf2 channel protein declines compared with normal population in weak sperm disease,such as cut,to observe whether Shengjing-san can enhance the protein expression of Nrf2 channel,reducing ROS damage on sperm,and improving the sperm outside environment,so as to enhance the capacity of sperm motility and super activation,finally has the effect of treatment on weak sperm disease.Then preliminary explore the treatment mechanism for Shengjing-san on weak sperm disease.Methods: Select 40 normal semen samples after analysis with CASA system.In accordance with the included and excluded criteria strictly,the weak sperm disease patients were randomly divided into Shengjing-san treatment group(40 patients,eating Shengjing-san(2.3 g po qd)for 1 month;40 patients in the placebo treatment group(given a placebo,2.3 g po qd)for 1 month;Blank control group of 40 patients with weak sperm disease,just to tell them life intervention for 1 month.Select semen samples from groups of patients before and after the treatment.Collect the TCM symptom scores before and after the intervention of all patients according to the TCM symptom assessment,to observe whether TCM symptoms have improved significantly before and after Shengjing-san treatment in patients with weak sperm disease by comparing the score changes of the patients.Using CASA system according to the "WHO human semen examination and processing laboratory manual(fifth edition)”,to detect the sperm concentration and sperm activity.To detect neutral alpha glycosidase levels in the seminal plasma using improved Cooper method with ELISA,detect ROS levels in the seminal plasma using DCFDA method with ELISA.To observe sperm Nrf2 channel protein expression of sperm in normal patients and weak sperm patients in each group before and after the intervention using the method of Western Blot.Outcomes: In the Shengjing-san group,after treatment,the sperm forward movement percentages were significantly higher than those before treatment(PR: P < 0.0001),rate of sperm activity is significantly higher than before the treatment(PR + NP: P < 0.0001).After one month treatment,the sperm forward movement percentage of Shengjing-san group was obviously higher than that of the placebo treatment group and the blank control group(PR: P = 0.0009 < 0.001),the rate of sperm activity of Shengjing-san group is significantly higher than the placebo treatment group and the blank control group(PR + NP: P < 0.0001).In the Shengjing-san group,after treatment,the TCM symptom scores decreased significantly(P = 0.014 < 0.05).After treatment,the TCM symptom score of Shengjing-san group were improved significantly than placebo treatment group and blank control group,and the difference was statistically significant(P < 0.0001).Quantitative determination of neutral alpha glycosidase: the seminal plasma neutral alpha glycosidase levels were significantly higher than those before treatment in Shengjing-san group,the difference was statistically significant(P = 0.006 < 0.01).And after treatment,the seminal plasma neutral alpha glycosidase levels were significantly higher than the placebo treatment group and the blank control group in Shengjing-san group,the difference was statistically significant(P = 0.005 < 0.01).Quantitative determination of ROS: the ROS levels were significantly lower than theose before treatment in Shengjing-san group(P = 0.007 < 0.01).And after treatment,the ROS levels were significantly higher than the placebo treatment group and the blank control group in Shengjing-san group,the difference was statistically significant(P = 0.007 < 0.01).Nrf2 protein expression index using Nrf2 relative expression(Nrf2 relative expression = Nrf2 grey value/ corresponding internal grey value)to express.Nrf2 protein expression was decreased significantly compared with normal group(P < 0.0001)in weak sperm disease group.Nrf2 relative expression was significantly increased after Shengjing-san treatment in patients with weak sperm disease,the difference was statistically significant(P < 0.0001).Conclusions:1.Shengjing-san drug can improve TCM symptoms in patients with weak sperm disease significantly.2.Shengjing-san may increase neutral alpha glycosidase content in epididymis,thus improve the sperm outside environment,increase sperm motility.3.Nrf2 protein expression decreases may be one of the reasons causing weak sperm disease.4.Shengjing-san has good clinical efficacy in patients with weak sperm disease.The mechanism might be: through increasing Nrf2 protein expression,reduce the production of ROS,and reduce the oxidative stress damage on sperm vitality.