| Purpose1.To observe the clinical efficacy and safety of self-designed Chinese medicine xiaokang Liuwei Dihuang Decoction in the treatment of immune infertility,and to provide evidence-based medical evidence for improving the clinical efficacy of immune infertility by nourishing kidney Yin,removing dampness and dredging channels and collaterals.2.To explore the mechanism of self-made prescription Xiaokang Liuwei Dihuang Decoction in reversing LPS-induced inflammatory response in rats with immune infertility,and to provide experimental data support for the treatment of immune infertility with Zishen Jiedu Tongluo method.Methodsl.From May 2017 to November 2020,80 patients with immune infertility who obtained the informed consent of the patients were treated in a single center from the First Affiliated Hospital of Gannan Medical College.The patients were divided into groups by random number table method,and they were respectively given the treatment group treated with self-made prescription Xiaokang Liuwei Dihuang Decoction and the control group treated with prednisone acetate tablets,40 cases in each group.The unified observation form "Immune Infertility Patient Clinical Observation Registration Form" was used to conduct questionnaire observation on all the research subjects,and quality control was carried out from case screening and anti-sperm antibody examination standards.The prepared observation registration form was used to collect the required patient information.After the treatment,the treatment effect was evaluated according to the above criteria,and the effect of the treatment before and after the treatment was objectively analyzed according to the corresponding statistical methods to evaluate the efficacy of the drug.2.LPS induced rat immune infertility model,ELISA was used to detect anti-sperm antibody(AsAb)and Tunel to detect cell apoptosis to judge whether the model was successful or not,and the dosage of self-designed Fang Xiaokang Liuwei Dihuang Decoction was selected.Experimental groups:30 SD male rats were divided into normal control group(n=6),LPS group(n=6),LPS low-dose group(n=6),LPS medium-dose group(n=6)and LPS high-dose group(n=6).Low dose(15.12g/kg),medium dose(30.24g/kg)and high dose(45.36g/kg)of selfdrafted Prescription Xiaokang Liuwei Dihuang Decoction were divided into low,medium and high concentration groups.Samples were taken 24 hours later.HE was used to detect the pathological conditions of testicular tissues in each group,Tunel was used to detect the apoptosis of testicular tissues in each group,ELSIA was used to detect the contents of testosterone,LH,FSH and THE contents of IL-1β,TNFα,AsAb and MDA in testicular tissues in each group,and sperm count under the microscope.Western blot was used to detect the expression of Bax and TLR2 in testicular tissues of each group.Results1.Among the 80 patients included in the study,74 qualified patients completed clinical trials with complete data,including 38 patients in the treatment group,17 patients with negative seminal plasma AsAb and spouse pregnancy,pregnancy rate of 44.74%;The total effective rate was 94.74%in 19 cases.In the control group,there were 36 cases,5 cases of spouse pregnancy,the pregnancy rate was 13.89%.The total effective rate was 69.44%.There were statistical differences in pregnancy rate and total effective rate between the treatment group and the control group(P<0.05).2.The immune infertility model was successfully constructed,and the doses of Selfprepared Xiaokang Liuwei Dihuang Decoction were 15.12g/kg,30.24g/kg and 45.36g/kg as the doses in subsequent experiments.In the normal group,spermatogenic cells were found in the basal membrane of spermatogenic tubules.Spermatogenic cells in LPS treatment group were sparse,the space increased,the number of spermatogenic cells decreased,and spermatogenic cells at all levels dropped off.The morphology of spermatogenic tubules and the number of spermatogenic cells in 15.12g/kg,30.24g/kg and 45.36g/kg intervention groups were gradually improved according to the dose.Compared with the control group,the apoptosis of testicular tissue in LPS group was significantly increased,the relative sperm count was significantly decreased,the contents of testosterone,LH and FSH in serum were significantly decreased,the contents of IL-1β,TNFα,AsAb and MDA in testicular tissue were significantly increased,and the expressions of Bax and TLR2 in testicular tissue were significantly increased.The difference was statistically significant(P<0.05).Compared with LPS group,15.12g/kg,30.24g/kg and 45.36g/kg groups showed significantly decreased apoptosis,significantly increased relative sperm number,significantly increased serum levels of testosterone,LH and FSH,and significantly decreased levels of IL-1β,TNFα,AsAb and MDA in testes.In testes,TLR2 expression was significantly decreased in 15.12g/kg,30.24g/kg and 45.36g/kg groups,and Bax expression was significantly decreased in 30.24g/kg and 45.36g/kg groups,with statistical significance(P<0.05).conclusion1.Clinical validation of nourishing kidney Yin dispel wet poison can dredge the meridian treatment curative effect is used in the treatment of immune infertility and compared with the control group significantly decreased in patients with semen AsAb positive rate,improve the patients’ spouses conception rate,and a little Chinese medicine treatment group adverse reactions,no obvious side effects,safety is higher,This law is worth spreading.2.Xiaokang Liuwei Dihuang Decoction can improve IPS-induced inflammation,increase epididymis sperm count,inhibit apoptosis and improve reproductive function.The expression levels of Bax and TLR2 were decreased,and the semen quality of model rats was improved. |
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