| 夭荣平,魏任雄,王辉,郜都,周俊,史波,崔云.脱敏煎治疗男性免疫性不育对精浆炎症因子表达的影响[J].浙江中西医结合杂志,2017,27(2): |
| 脱敏煎治疗男性免疫性不育对精浆炎症因子表达的影响 |
| Densesitizing decoction treatment effects on seminal plasma inflammatory factor expression with male immune infertility |
| 投稿时间：2016-06-27 修订日期：2016-08-03 |
| DOI： |
| 中文关键词: 脱敏煎 免疫性不育 炎症因子 免疫珠实验 |
| 英文关键词:Densesitizing decoction Immune Infertility Inflammatory factor Immunobead test |
| 基金项目:宁波市自然科学基金(2013A610273)(2016A610200) |
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| 摘要点击次数: 1216 |
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| 中文摘要: |
| 目的：观察脱敏煎治疗男性免疫性不育对精浆白介素-6(IL-6)和可溶性细胞粘附分子-1(sICAM-1)在治疗前后表达的差异,揭示脱敏煎治疗该病的一种可能作用机制,为临床用脱敏煎治疗该病提供实验依据。方法：选取男性免疫性不育症患者67例,依进入研究的时间顺序,采用区组随机化方法分为脱敏煎治疗组34例,醋酸泼尼松治疗对照组33例,选择同期因女方因素不孕前来检查的生育力评估正常的健康男性31例为正常对照组。统计分析各组精浆IL-6、sICAM-1和精液主要质量参数在治疗前后的差异。精液液化时间通过肉眼观察和显微镜进行识别判读,精子浓度及活力用计算机辅助精子分析系统,精子存活率采用低渗膨胀实验,抗精子抗体采用免疫珠试验(IBT),IL-6和sICAM-1的含量测定采用酶联免疫吸附(ELSA)法。结果：治疗前脱敏煎治疗组、醋酸泼尼松治疗对照组及正常对照组3组比较,精子存活率、精子前向运动比率有统计学差异(p<0.05或p<0.01),两治疗组之间比较各参数均无统计学意义(p>0.05)。治疗后两治疗组和正常对照组3组比较各参数均无统计学意义(p>0.05),两治疗组之间比较各参数亦无统计学意义(p>0.05)。两治疗组在治疗前后分别各自比较,精子存活率、精子前向运动比率有统计学差异(p<0.05或p<0.01)。治疗前两治疗组、正常对照组IL-6(ng/l)、sICAM-1(ng/mL)精浆表达水平分别为(41.09±18.35、85.43±41.25),(39.06±20.45、91.51±39.46),(9.47±5.76、19.46±9.77),3组比较均有非常显著性差异(p<0.01)。治疗后两治疗组IL-6(ng/l)、sICAM-1(ng/mL)精浆表达水平分别为(11.87±13.19,38.22±30.37)、(30.97±18.57,56.25±42.70),与正常对照组3组比较,IL-6有显著性差异(p<0.05)、sICAM-1有非常显著性差异(p<0.01)；但脱敏煎治疗组与正常对照组比较,IL-6无统计学意义(p>0.05),sICAM-1有显著性差异(p<0.05),醋酸泼尼松治疗组与正常对照组比较IL-6有显著性差异(p<0.05),sICAM-1有非常显著性差异(p<0.01),两治疗组之间比较IL-6、sICAM-1均有显著性差异(p<0.05)。两治疗组在治疗前后分别各自比较,脱敏煎治疗组IL-6、sICAM-1均有非常显著性差异(p<0.01),醋酸泼尼松治疗组IL-6无统计学意义(p>0.05),sICAM-1有显著性差异(p<0.05)。两治疗组治疗前后免疫珠试验[%,M(P25~P75)]结果分别为[69.2(61.3~79.5)、42.0(33.4~51.6)],[ 68.5(59.3~78.8)、54.2(49.5~66.6)],两治疗组在治疗前无统计学意义(U=544.5,P=0.836),但在治疗后有显著性差异(U=316.8,P=0.018)。脱敏煎治疗组治疗前后有非常显著性差异(U=58.5,P=0.000),醋酸泼尼松治疗对照组治疗前后有显著性差异(U=384.3,P=0.037)。结论：脱敏煎可能在去除免疫复合物和炎症介质方面方面优于醋酸泼尼松,提示在治疗男性免疫性不育方面具有较大的临床优势和潜力。 |
| 英文摘要: |
| Objective Observe IL - 6 and sICAM 1 expression differences before and after treatment of male immune infertility by Densesitizing decoction, reveal a possible role mechanism for treatment with this disease and provide experimental basis for clinical treatment . Methods According to time sequence of enter into this research and block randomization principle, select 41 male immune infertility patients and devide into Densesitizing decoction treatment group 21 cases and Prednisone Acetate treatment group 20 cases. At the same time, choose 31 cases healthy male with fertility evaluation which because of the woman factor lead to infertility as control group. Analysing the differential expression of inflammatory factor in each group and difference of major parameters in seminal plasma. Computer-assisted sperm analysis system was used to analysis routine semen ,sperm-bound antibodies were measured by immune bead test (IBT), Sperm survival rate with hypo-osmotic swelling test , IL-6 and sICAM-1 were were determined by enzyme-linked immunosorbent assay (ELISA)。Results Before treatment, the sperm survival rate and sperm forward movement rate of three groups was statistical difference (p < 0.05 or p < 0.01), two treatment groups have no statistical significance in each parameters (p > 0.05). After treatment, there are not statistical significance in each parameters between two treatment groups and normal control group (p > 0.05). Before and after the treatment, the sperm survival rate and the sperm forward movement rate of two treatment groups was statistically difference in separately compared. (p < 0.05 or p < 0.01). Before treatment, IL - 6 (ng/l), sICAM 1 (ng/mL) seminal plasma expression levels of two treatment groups and normal control group were （41.09±18.35、85.43±41.25），（39.06±20.45、91.51±39.46），（9.47±5.76、19.46±9.77）, two treatment groups compared with normal control group were very significant differences (p < 0.01). After the treatment, IL - 6 (ng/l), sICAM 1 (ng/mL) seminal plasma expression levels of two treatment group were （11.87±13.19，38.22±30.37）、(30.97±18.57,56.25±42.70), compared with normal control group , IL - 6 had significant difference (p < 0.05), sICAM 1 has a very significant difference (p < 0.01),but Densesitizing decoction group compared with normal control group, IL - 6 no statistical significance (p > 0.05), sICAM 1 had significant difference (p < 0.05), Prednisone Acetate treatment group compared with normal control group IL - 6 have significant difference (p < 0.05), sICAM 1 has a very significant difference (p < 0.01), the comparison between two treatment groups IL - 6, sICAM 1 had significant difference (p < 0.05). Two treatment group separately compared before and after therapy, sICAM 1 have very significant difference in two treatment group (p < 0.01), IL – 6 have very significant difference in Densesitizing decoction group ,but no statistical significance in Prednisone Acetate treatment group (p > 0.05).before and after treatment , immune bead test of Two treatment group [%, M (P25 ~P75)] results were [69.2(61.3~79.5)、42.0(33.4~51.6)]，[ 68.5(59.3~78.8)、54.2(49.5~66.6)], two treatment group has no statistical significance before treatment (U = 544.5, P = 0.836), but significant difference after treatment (U = 316.8, P = 0.018). Densesitizing decoction treatment group has a very significant difference before and after the treatment (U =58.5, P =0.000), Prednisone Acetate group had significant difference before and after the treatment (U = 384.3, P =0.037). Conclusion Densesitizing decoction could better than Prednisone Acetate in removal of immune complex and inflammatory mediators, and prompt it on male immune infertility treatment has great clinical advantages and potential. |
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