| ObjectiveMale infertility, a critical disease involving human health and the generations of descendants, often shows oligospermia and asthenospermia, and the key pathophysiology mechanisms may refer to excessive oxidation and dysfunction of energy metabolism. At present, the effective drugs for oligospermia and asthenospermia are lack. Previous studies revealed that Qianjing decoction, a Chinese prescription performing to invigorate spleen and kidney, inhibits apoptosis of spermatogenic cells in rats with spermatogenic dysfunction and recovers the function, but the potential mechanisms remain unclear. Based on the interpretation of asthenia of both the spleen and kidney for oligospermia and asthenospermia according to traditional Chinese medicine (TCM) and the previous researches, the present study aimed to investigate the curative effects of Qianjing decoction on the patients with oligospermia and/or asthenospermia who were consistent with asthenia of both the spleen and kidney, and on the sperm quality in ornidazole-induced rats with oligospermia and asthenospermia. Moreover, the study was conducted to observe the effects of the decoction on the testicle and epididymal tissue pathology, ultrastructure, antioxidation, energy metabolism, and the gene expression of SDH and Nrf2which involve in antioxidation and energy metabolism respectively in rats with oligospermia and asthenospermia, which would reveal the mechanisms of Qiangjing decoction in treating the disease.Methods1. Clinical trial:One hundred and twenty patients with oligospermia and/or asthenospermia who were consistent with asthenia of both the spleen and kidney according to TCM were randomly assigned to the control (Huangzanyu capsule, n=60) and the treated(Qiangjing decoction, n=60) groups. The former was received Huangzanyu capsule, while the latter was given Qiangjing decoction. The course lasted3months. After treatment, the indexes including sperm concentration, motility and viability, the rate of teratosperm, and antisperm antibody were checked, and the safety was also evaluated.2. Animal experimental design:One hundred SPF male rats were randomly divided into5groups:the normal group (n=20) receiving saline solution by intragastric administration, the model group (n=20) receiving ornidazole (800mg/kg.d), the huangjingzanyu capsule group (n=20) receiving ornidazole (800mg/kg.d) and huangjingzanyu capsule (200mg/kg.d), the levocarnitine group (n=20) receiving ornidazole (800mg/kg.d) and levocarnitine (100mg/kg.d), and the Qiangjing decoction group (n=20) receiving ornidazole (800mg/kg.d) and Qiangjing decoction (10g/kg.d). The treatment continued4weeks. After treatment, the pathology and ultrastructure of testis and epididymal tissue were investigated, sperm concentration and motility were detected, and the indexes including superoxide dismutase (SOD), malonaldehyde (MDA), glutathione peroxidase (GSH-Px), lactate dehydrogenase (LDH), a-glucosidase, and fructose in the epididymal homogenate were also determined.Moreover, the mRNA levels of Nrf2and SDH in the epididymal tissue were measured using Real-time PCR.Results1. Clinical trial:1) Compared to the control group, Qiangjing decoction efficiently enhanced class a and a+b sperm motility and sperm concentration, improved sperm morphology (all P<0.05), and total effective rate in Qiangjing decoction was higher than that in the control group (P<0.05).2) Qiangjing decoction had few side effects and adverse reactions.2. Animal trial:1) Both of sperm concentration and motility in the model group were obvious lower than that in the normal group (P<0.05), while the indexes in the huangjingzanyu capsule group, the levocarnitine group, and the Qiangjing decoction group were significant higher than that in the model group (P＜0.05), and the indexes in the Qiangjing decoction group were similar to the normal group (P>0.05).2) According to the pathology studies, there were different spermatogenic cells which were dropped in the seminiferous tubules of the testis, and a lot of non-sperm cell components in the epididymal lumens with decreased sperm cells in the model group. Compared to the normal group, there were few changes in the testis and epididymis with a great many of sperm cells in the Qiangjing decoction group, the huangjingzanyu capsule group, and the levocarnitine group. In ultrastructure, the epididymal lumens wall was thin with decreased sperm cells in epididymal lumens in the model group, and the epididymal lumens were in disorder, the gap between epididymal lumens were increased. Compared to the model group, the epididymal lumens wall was thick with full sperm cells in epididymal lumens in the Qiangjing decoction group, the huangjingzanyu capsule group, and the levocarnitine group, and the epididymal lumens were in order, the gap between epididymal lumens were smaller, which were all similar to the normal group.3) SOD and GSH-Px in the model group were much lower than that in the normal group (P＜0.05), while MDA higher than normal group (P＜0.05). Compared to the model group, the indexes of SOD and GSH-Px in the huangjingzanyu capsule group, the levocarnitine group, and the Qiangjing decoction group were obviously increased (P<0.05), but MDA was lower than that in the model group (P＜0.05). The three indexes in the Qiangjing decoction group were all similar to the normal group (P>0.05). Real-time PCR revealed that the mRNA level of Nrf2was significantly decreased compared to the normal group (P＜0.05). And the mRNA level in the huangjingzanyu capsule group, the levocarnitine group, and the Qiangjing decoction group was markedly increased when compared to the model group or the normal group (P＜0.05). Moreover, the mRNA level in the Qiangjing decoction group was much higher than that in the huangjingzanyu capsule group or the levocarnitine group (P＜0.05).4) Compared to the normal group, a-glucosidase and fructose in the model group were decreased (P＜0.05), while LDH higher than normal group (P＜0.05). Compared to the model group, the indexes of a-glucosidase and fructose in the huangjingzanyu capsule group, the levocarnitine group, and the Qiangjing decoction group were obviously increased (P＜0.05), but LDH was lower than that in the model group (P＜0.05). The three indexes in the Qiangjing decoction group were similar to the normal group (P>0.05). Real-time PCR revealed that the mRNA level of SDH was markedly decreased compared to the normal group (P＜0.05). And the mRNA level in the huangjingzanyu capsule group, the levocarnitine group, and the Qiangjing decoction group was significantly increased when compared to the model group or the normal group (P＜0.05). Moreover, the mRNA level in the Oiangjing decoction group was much higher than that in the huangjingzanyu capsule group or the levocarnitine group.ConclusionsX.Qiangjing decoction significantly enhances sperm quality, improves the sperm motility and viability, and the rate of teratosperm in the patients with oligospermia and/or asthenospermia.2.Ornidazole induces oligospermia and asthenospermia in rats, which has close relationship with excessive oxidation and dysfunction of energy metabolism.3.Qiangjing decoction improves and even reverses ornidazole-induced oligospermia and asthenospermia in rats.4.Qiangjing decoction improves the pathology structure and ultrastructure of testis and epididymal tissue in ornidazole-induced rats.5.Antioxidation and improvement of energy metabolism are likely the mechanisms of Qiangjing decoction in treating oligospermia and asthenospermia. |
PDF Full Text Request