Professor Zeng Qingqi’s Academic Thoughts On The Diagnosis And Treatment Of Male Infertility And Clinical And Experimental Research On The Treatment Of Oligoasthenospermia By Runjing Decoction

ObjectiveThis article first analyzes and summarizes Professor Zeng Qingqi’s academic thoughts and clinical experience in treating male infertility.Based on the previous theory,this article initially explores the clinical effectiveness and safety of Runjing Decoction for patients with idiopathic oligospermia.Based on the male rat model of oligozoospermia induced by Ornidazole,the sperm quality,sex hormone levels,pathological changes of testicular tissue,and testicular tissue cells of oligozoospermia model rats were observed by Runjing Decoction.Apoptosis,testicular vimentin expression,and changes in the expression of ERK signaling pathways,preliminary studies on the target and mechanism of Runjing Decoction in the treatment of oligozoospermia,provide scientific basis for the clinical application of Runjing Decoction.Methods:1.Experience summary:Analyze and summarize Professor Zeng Qingqi’s academic thoughts and clinical experience in treating male infertility,from the etiology and pathogenesis,clinical differentiation,diagnosis and treatment,prescription compatibility,eugenic pregnancy and preventive care Discussed in detail.2.Clinical study:72 patients with idiopathic oligozoospermia who met the diagnostic criteria and inclusion criteria were randomly divided into a test group(Runjing Decoction)and a control group(Huaishao Capsule).Months,the semen volume,semen concentration,total sperm count,forward sperm motility(PR),total sperm motility(PR+NP),sex hormone levels,TCM symptom scores,and adverse reactions were recorded before and after treatment in both groups.To evaluate the clinical effectiveness and safety of Runjing Decoction.3.Experimental study:32 male rats are divided into four groups using a simple random sampling method,with 8 rats in each group,which are blank group,model group,low dose group and high dose group.The blank group is orally administered with saline every day;the model group is orally administered with ornidazole ORN(400 mg/kg·d);the low-dose group is administered with Runjing Decoction(14g/kg)+ornidazole ORN 400 mg/(kg·d)Gavage;high-dose group is administered with Runjing Decoction(56g/kg)+Ornidazole ORN400 mg/(kg·d)for 4 weeks.After the experiment,rat serum sex hormone indicators(FSH,LH,T),rat semen quality(concentration,proportion of sperm forward movement,total motility,and sperm deformity rate)were measured.Western Blot and immunohistochemical methods are used to determine The expression of vimentin in rat testis and the expression of ERK signal pathway in testis are tested by TUNEL method.Results:1.Clinical research:①Both the test group(Runjing Decoction)and the control group(Huaishao Capsule)can improve sperm quality(semen volume,semen concentration,total sperm count,forward motion ratio of sperm,total sperm motility),and regulating sex hormones Level,increase the spouse’s pregnancy rate,improve the clinical symptoms and clinical effectiveness of Chinese medicine,and the test group(Run Jing Decoction)improved more significantly.②No obvious side effects and adverse reactions were observed in Runjing Decoction.2.Experimental research:① sperm quality:the sperm concentration,total sperm motility,and the percentage of forward sperm motility of the model group rats are lower than those of the blank group(P<0.05),and the sperm deformity rate is higher than that of the blank group(P<0.05);low The total activity of the low-dose and high-dose groups are higher than that of the model group(P<0.05),and the sperm deformity rate is lower than that of the model group(P<0.05).The concentration and percentage of sperm forward movement in the low-dose group are slightly higher than those in the model group.(P>0.05);the concentration and percentage of sperm forward movement in the high-dose group are higher than those in the model group(P<0.05).②Sex hormones:There is no significant change in luteinizing hormone(LH)in each group(P>0.05);follicle stimulating hormone(FSH)in the model group was higher than that in the blank group(P<0.05),and the low-dose and high-dose groups were lower than the model group(P<0.05);testosterone(T)in the model group was lower than that in the blank group(P<0.05),and the low-dose and high-dose groups are higher than the model group(P<0.05).③Pathological changes of testicular tissue:The seminiferous seminiferous epithelium in the testicular tissue of the blank group had regular morphology,regular arrangement and complete structure.The spermatogenic tubule lumen showed active division at all levels,regular morphology,regular arrangement and structure.Intact spermatogenic cells and a large number of normal and mature sperm.The seminiferous seminiferous epithelium in the testis of the model group rats had disordered morphology,irregular arrangement and loose structure,and the spermatogenic cells at all levels in the seminiferous tubules were disorderly arranged,and there was a large reduction,even shedding,sperm and spermatogenesis.The number of cells was significantly reduced,and the morphology was significantly abnormal.A large number of vacuoles were seen in the partial degeneration of the seminiferous epithelium.The regularity,arrangement and structural integrity of seminiferous seminiferous epithelium in the testicular tissue of rats in the low-dose group were improved compared with the model group.The number and morphology of normal spermatogenic cells in the seminiferous tubule lumen were improved.The number of normal and mature spermatozoa also increased compared with the model group,and the number of shed spermatogenic cells decreased.The pathological morphology of testis in the high-dose group was further improved in the lower-dose group,which was closer to the blank group.④Changes of apoptosis in testis tissue:a large number of germ cell apoptosis can be seen in the seminiferous tubules of the model group,and the rate of positive cells in rat testis tissue is significantly higher than that in the blank group(P<0.01).Low-dose and high-dose groups can undergo a small amount of germ cell apoptosis in the seminiferous tubules.The rate of apoptotic positive cells in the testis of rats in the low-dose group is significantly lower than that in the model group(P<0.05).The rate of apoptotic positive cells was significantly lower than that in the model group(P<0.01).⑤ Testicular tissue vimentin expression:The blank testicular tissue vimentin is mainly distributed around the nucleus of testicular sertoli cells and extends from the basal area to the proximal cavity.The vimentin signal and distribution range of the testis tissue in the model group is significantly weakened compared with the blank group,and the expression of vimentin is significantly reduced(P<0.001).The main distribution of vimentin in the testis tissue of the low-dose group and the high-dose group extended from the perinuclear region of the testicular sertoli cells to the inner cavity,and the distribution of vimentin also became normal between the two groups,and the expression of vimentin is significantly higher than that of the model group.(P<0.01).⑥ Changes in testicular tissue ERK signaling pathway:p-ERK protein expression in testis tissue of model group is significantly higher than that in blank group(P<0.001);p-ERK protein expression in testis tissue of rats in low-dose and high-dose groups Significantly lower than the model group(P<0.001).Conclusion:1.Runjing Decoction is an empirical formula for the treatment of idiopathic oligospermia developed by the former teacher based on the theory of refined chambers.The drug composition includes Cuscuta,Polygonatum,Yam,Wolfberry,Fairy Spleen,Leech,Acanthopanax,Rhodiola,Chenpi,and Achyranthes bidentata,all the medicines have the characteristics of "taking care of the liver,spleen and kidney,balance of qi,blood,yin and yang,tonic without greasiness,and pass without damage".It has the effects of nourishing blood and nourishing the liver,promoting blood circulation,collaterals,and regulating qi and dampness.Patients in the Jiangnan area are more suitable.2.Runjing decoction and Huaishao Capsule could improve the quality of semen(total number of sperm,sperm concentration,sperm,sperm activity,sperm forward movement percentage),adjust the sex hormone levels and improve the clinical symptoms of traditional Chinese medicine,thus improve the patients’ spouses and clinical pregnancy rate efficiently,and Runjing decoction improvement is more apparent.So Runjing decoction is safe and effective,and no obvious adverse reaction,has certain clinical value.3.Runjing Decoction can improve the sperm quality,serum sex hormones,and histopathological changes of testicular tissue in ornidazole-induced oligozoospermia rats.Preliminary speculation may be that Runjing Decoction may regulate the function of hypothalamus-pituitary-testicular gonadal axis,Regulate the level of reproductive endocrine hormones,improve testicular microcirculation and the local microenvironment of spermatogenesis;In addition,Runjing Decoction can up-regulate the expression of vimentin and decrease the expression of p-ERK,improve the stability of germ cell structure and inhibit the Apoptosis of rat germ cells and promotion of germ cell proliferation may be related to antioxidant stress.