Study On The Mechanism Of Bushen Huoxue Decoction In Treating Diabetic Erectile Dysfunction Based On PI3K-AKT Pathway

In recent years, the incidence of diabetic erectile dysfunction is on the rise. The world health organization (WHO) pointed out that 50%～75% of diabetes patients with different degree of erectile dysfunction(ED). And the incidence of diabetes patients ED three times higher than normal. In traditional Chinese medicine, That most physicians believe that based on "five viscera deficiency", and in zaore, shire, yuxue and tanshi as the standard, such as a variety of pathogenic factors work together. The syndrome differentiation and treatment, should be "xu", "shi" and "xushijiaza" three aspects obtains, do not biased. From "bushenhuoxue " of legislation, this paper discusses of Bushenhuoxue formula to improve the mechanism of action and the effect of penile erection.This thesis is divided into two sections-literature review and experimental study. Literature review system that summarizes the ancient TCM physicians theory research status of diabetic erectile dysfunction. Based on predecessors’ theory, to further improve the treatment theory, Chinese medicine treatment, etc. From the perspective of modern medicine expounded the pathogenesis and treatment. And discusses in detail "through PI3K-AKT-Caspase pathway which can reduce the apoptosis of corpus cavernosum smooth muscle cells and improves erectile function, "of the theoretical basis. And "shenxuxueyu" syndrome type put forward the theory basis.Objective:Observe Bushenhuoxue formula the effect for the treatment of diabetic rats erectile function as well as to the pAKT/AKT, ICP, the penis of smooth muscle cell apoptosis expression effect.Methods:40 male SD rats were randomly divided into four groups (each n =10):normal group, model group, low-dose IKAB group (low-dose group)and high-dose IKAB group(high-dose group). The rat model with 2 type of diabet mellitus was induced by intraperitoneal injection of streptozotocin (STZ). Normal group and model group were intragastrically administered (ig.)with normal saline, low-dose group was ig.3 g/kg of IKAB and high-dose group was ig.6 g/kg IKAB for consecutive 8 weeks. The penis viscera index was measured;the intracavernous pressure (ICP)were detected by Biopack electro-physiological instrument; the expressions of pAKT and AKT were detectd by Western blotting; cell apoptosis of corpus cavernosum smooth muscle were measured by using TUNEL method and the pathological changes in penile tissue were observed by using Masson trichrome staining.Results:Compared with model group, the penis viscera index of both IKAB groups had no statistical differences (P>0.05); the expressions of pAKT and AKT increased significantly(P<0.05); although the ratio of cell apoptosis of corpus cavernosum smooth muscle decreased, the statistical differences were not shown (P>0.05). Furthermore, ICP and ICP/MAP increased markedly in high-dose group and the collagen fiber proportion decreased in low-dose group compared with model group (P<0.05).Conclusion:The mechanism of invigorating kidney and activating blood recipe increasing ICP in rat model with DM is related to increasing the expression of pAKT, inhibiting cell apoptosis of corpus cavernosum smooth muscle and reducing collagen fibers formation in penis.