Article(id=1322923285452829147, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923268038078806, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.04.011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339089978, onlineDateStr=2026-10-30, pubDate=1744214400000, pubDateStr=2025-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339089978, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339089978, creator=13701087609, updateTime=1793339089978, updator=13701087609, issue=Issue{id=1322923268038078806, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='4', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1744214400000', pubDateStr='2025-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339085826, creator='13701087609', updateTime=1793340586453, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929562572686061, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923268038078806, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929562572686062, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923268038078806, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=59, endPage=65, ext={EN=ArticleExt(id=1322923285817733596, articleId=1322923285452829147, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of“Zhibian(BL54)-to-Shuidao(ST28)”Acupuncture Method on Reproductive Function of Asthenozoospermia Mice Based on Death Receptor Pathway, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the protective effect of acupuncture on the reproductive function of mice by observing the effect of the“Zhibian(BL54)-to-Shuidao(ST28)”acupuncture method on key factors in the death receptor pathway of testicular tissue in asthenospermia mice.

Methods

Thirty C57BL/6 male mice were randomly divided into a blank group,a model group and an acupuncture group(n=10). The blank group was given an equal volume of 0.9% sodium chloride solution by gavage,while the model group and acupuncture group were given intraperitoneal injection of cyclophosphamide(50 mg·kg-1·d-1)for 5 days. After the completion of modeling,the acupuncture group were given continuous acupuncture treatment with“Zhibian(BL54)-to-Shuidao(ST28)”for 2 weeks,once a day,20 minutes for each time. The other two groups were only fixed,and the samples were taken the next day after treatment. In daily observations,the general condition of mice was assessed,and the changes in body weight and testicular and epididymal indices were recorded. The sperm quality of the mice was evaluated. Enzyme-Linked Immunosorbent Assay(ELISA)was used to measure the levels of testosterone(T),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the serum. Hematoxylin-Eosin(HE)staining was employed to examine the pathological morphology of testicular tissue. Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining was used to observe cell apoptosis in testicular tissue. Fluorescent quantitative polymerase chain reaction(PCR)and Western blot were employed to assess changes in the mRNA and protein expressions of Fas cell surface death receptor(Fas),Fas ligand(FasL),tumor necrosis factor alpha(TNF-α),TNF receptor 1(TNFR1),tumor necrosis factor-related apoptosis-inducing ligand(TRAIL),death receptor 5(DR5),Caspase-8 and Caspase-3 in testicular tissue. Immunofluorescence staining was conducted to detect the positive expressions of cleaved Caspase-3 and PARPin testicular tissue.

Results

Compared with the control group,the model group exhibited a decrease in body weight of male mice(P<0.01),a decrease in testicular and epididymal mass and coefficients(P<0.01),a decrease in total sperm count,sperm motility and sperm viability(P<0.01),a decrease in serum levels of testosterone(T),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)(P<0.01),deterioration in the pathological morphology of testicular and epididymal tissues,an increase in the number of positively stained apoptotic cells(P<0.01),an increase in the mRNA and protein expression levels of FasL,Fas,TNF-α,TNFR1,FADD,Caspase-8 and Caspase-3(P<0.01,P<0.05). There was no significant difference in the expression levels of TRAIL,DR5 mRNA or protein(P>0.05),and an increase in the expressions of cleaved Caspase-3 and PARP(P<0.01). Compared to the model group,the acupuncture group showed no significant change in body weight after treatment(P>0.05). There was an increase in testicular and epididymal mass and coefficients(P<0.01). The levels of total sperm count,sperm motility and sperm viability increased(P<0.01). The serum levels of testosterone(T),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)increased(P<0.01). There was an improvement in the pathological morphology of testicular and epididymal tissues,a decrease in the number of positively stained apoptotic cells(P<0.01),a decrease in the mRNA and protein expression levels of FasL,Fas,TNF-α,TNFR1,FADD,Caspase-8 and Caspase-3(P<0.01,P<0.05). There was no significant difference in the expression levels of TRAIL,DR5 mRNA and protein(P>0.05)or decrease in the expression of cleaved Caspase-3 and PARP(P<0.01).

Conclusion

The“Zhibian(BL54)-to-Shuidao(ST28)”technique can improve spermatogenic cell apoptosis in oligospermia mice and enhance reproductive function,and its mechanism may be associated with the regulation of key factors in the testicular tissue death receptor apoptosis pathway.

, authors=Jianheng HAO1, 2, Jia REN2, Boya CHANG2, Zhen GAO2, Haijun WANG2, Laixi JI1, 2, authorsList=Jianheng HAO, Jia REN, Boya CHANG, Zhen GAO, Haijun WANG, Laixi JI, authorCompany=null, correspAuthors=Laixi JI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923291308077563, articleId=1322923285452829147, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=基于死亡受体途径探讨“秩边透水道”针法对弱精子症小鼠生殖功能的影响, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

通过观察“秩边透水道”针法对弱精子症小鼠睾丸组织死亡受体途径上关键因子的影响,探析针刺对小鼠生殖功能的改善作用。

方法

将30只C57BL/6雄性小鼠随机分成空白组、模型组和针刺组(各10只)。空白组给予等体积的0.9%氯化钠溶液灌胃,模型组和针刺组小鼠给予环磷酰胺(50 mg·kg-1·d-1)腹腔注射5 d,造模完成后针刺组小鼠给予“秩边透水道”连续针刺治疗2周,每日1次,每次20 min,其余两组只进行固定,治疗完成次日进行取材。日常观察小鼠的一般情况并记录体质量变化,检测小鼠睾丸、附睾指数以及精子质量,通过酶联免疫吸附法(enzymelinked immunosorbent assay,ELISA)检测血清中睾酮(testosterone,T)、促卵泡生成素(follicle-stimulating hormone,FSH)、促黄体生成激素(luteinizing hormone,LH)含量,苏木素-伊红(hematoxylin-eosin,HE)染色观察睾丸组织病理形态,脱氧核苷酸转移酶dUTP末端标记(terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling,TUNEL)染色观察睾丸组织细胞凋亡情况,实时荧光定量反转录聚合酶链反应(real-time PCR,RT-PCR)法和免疫印迹法(western blot,WB)分别检测睾丸组织Fas细胞表面死亡受体(fas cell surface death receptor,Fas)、FasL、肿瘤坏死因子α(tumour necrosis factor alpha-like,TNF-α)、TNFR1、肿瘤坏死因子相关凋亡诱导配体(tumor necrosis factor-related apoptosisinducing ligand,TRAIL)、死亡受体5(death receptor 5,DR5)、半胱氨酸蛋白酶(cysteine-aspartic acid protease,Caspase)-8、Caspase-3 mRNA和蛋白表达变化;免疫荧光法检测睾丸组织cleaved Caspase-3和多聚ADP核糖聚合酶[poly(ADP-ribose)polymerase,PARP]阳性表达。

结果

与空白组比较,模型组小鼠体质量减轻(P<0.01),睾丸、附睾质量和系数下降(P<0.01),精子总数、精子活力和精子活率下降(P<0.01),血清T、FSH和LH含量下降(P<0.01),睾丸和附睾组织病理形态变差,阳性细胞凋亡量提高(P<0.01),FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3 mRNA和蛋白表达水平提高(P<0.01,P<0.05),TRAIL、DR5 mRNA和蛋白表达水平差异无统计学意义(P>0.05),Cleaved Caspase-3和PARP阳性表达量提高(P<0.01)。与模型组比较,针刺组小鼠治疗后体质量无明显变化(P>0.05);睾丸、附睾质量和系数提高(P<0.01);精子总数、精子活力和精子活率提高(P<0.01),血清T、FSH和LH含量提高(P<0.01),睾丸和附睾组织病理形态改善;阳性细胞凋亡量降低(P<0.01);FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3 mRNA和蛋白表达水平降低(P<0.01,P<0.05),TRAIL、DR5 mRNA和蛋白表达水平差异无统计学意义(P>0.05),cleaved Caspase-3和PARP阳性表达量降低(P<0.01)。

结论

“秩边透水道”针法可以改善弱精子症小鼠生精细胞凋亡,提高生殖功能,其机制可能与调节睾丸组织死亡受体途径上的关键因子有关。

, authors=郝健亨1, 2, 任佳2, 常博雅2, 高珍2, 王海军2, 冀来喜1, 2, authorsList=郝健亨, 任佳, 常博雅, 高珍, 王海军, 冀来喜, authorCompany=null, correspAuthors=冀来喜, authorNote=

郝健亨(1993-),男,山西孝义人,主治医师,博士在读,研究方向:中医优势治疗技术。

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冀来喜(1964-),男,山西太原人,教授、主任医师,博士研究生导师,博士,研究方向:中医优势治疗技术。E-mail:。
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2.山西中医药大学第二临床学院,山西 晋中 030619, bio={"content":"

郝健亨(1993-),男,山西孝义人,主治医师,博士在读,研究方向:中医优势治疗技术。

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郝健亨(1993-),男,山西孝义人,主治医师,博士在读,研究方向:中医优势治疗技术。

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基因序列(5'-3')长度/(bp)
FasLF:CCTCTAAAGAAGAAGGACCACAACA135
R:ACGGAGTTCTGCCAGTTCCTT
FasF:GGCGGGTTCGTGAAACTGATA96
R:GCTCAGCCTAGTTTTCAGGTTGG
TNF-αF:GTGCCTATGTCTCAGCCTCTTCTC160
R:GTTTGTGAGTGTGAGGGTCTGG
TNFR1F:GGAGAACCAGTTCCAACGCTAC210
R:GGAGGTAGGCACAACTTCATACACT
TRAILF:CAGCTTTAATTCCAATCTCCAAGG200
R:CATCTTGGAAGCGTCTTCAGC
DR5F:TCCGGTAAACGGAAACGACT174
R:ATTTGGTACAGGGCCTCACG
FADDF:CGCGTGAGCAAACGAAAGC227
R:CACACAATGTCAAATGCCACC
Caspase-8F:CTTGAAGGAAGGGAAGAGTTGC94
R:CACTGTCTTGTTCTCTTGGCGA
Caspase-3F:TGGAATGTCATCTCGCTCTGGT298
R:GAAGAGTTTCGGCTTTCCAGTC
GAPDHF:CCTCGTCCCGTAGACAAAATG133
R:TGAGGTCAATGAAGGGGTCGT
), ArticleFig(id=1322923298375479867, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表1, caption=

引物序列

, figureFileSmall=null, figureFileBig=null, tableContent=
基因序列(5'-3')长度/(bp)
FasLF:CCTCTAAAGAAGAAGGACCACAACA135
R:ACGGAGTTCTGCCAGTTCCTT
FasF:GGCGGGTTCGTGAAACTGATA96
R:GCTCAGCCTAGTTTTCAGGTTGG
TNF-αF:GTGCCTATGTCTCAGCCTCTTCTC160
R:GTTTGTGAGTGTGAGGGTCTGG
TNFR1F:GGAGAACCAGTTCCAACGCTAC210
R:GGAGGTAGGCACAACTTCATACACT
TRAILF:CAGCTTTAATTCCAATCTCCAAGG200
R:CATCTTGGAAGCGTCTTCAGC
DR5F:TCCGGTAAACGGAAACGACT174
R:ATTTGGTACAGGGCCTCACG
FADDF:CGCGTGAGCAAACGAAAGC227
R:CACACAATGTCAAATGCCACC
Caspase-8F:CTTGAAGGAAGGGAAGAGTTGC94
R:CACTGTCTTGTTCTCTTGGCGA
Caspase-3F:TGGAATGTCATCTCGCTCTGGT298
R:GAAGAGTTTCGGCTTTCCAGTC
GAPDHF:CCTCGTCCCGTAGACAAAATG133
R:TGAGGTCAATGAAGGGGTCGT
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组别n入组时造模后治疗后
空白组1019.98±0.3321.70±0.3525.40±0.45
模型组1020.08±0.2918.55±0.35**21.25±0.36**
针刺组1019.92±0.3618.58±0.34**21.44±0.30
), ArticleFig(id=1322923298576806461, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表2, caption=

各组小鼠体质量比较(±s)

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组别n入组时造模后治疗后
空白组1019.98±0.3321.70±0.3525.40±0.45
模型组1020.08±0.2918.55±0.35**21.25±0.36**
针刺组1019.92±0.3618.58±0.34**21.44±0.30
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组别n睾丸质量/(mg)睾丸系数/(%)附睾质量/(mg)附睾系数/(%)
空白组10187.8±4.250.74±0.01745.72±1.770.18±0.007
模型组10117.8±3.17**0.55±0.014**33.59±1.70**0.16±0.009**
针刺组10132.1±3.11##0.62±0.018##36.67±1.57##0.17±0.007##
), ArticleFig(id=1322923298748772927, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表3, caption=

各组小鼠睾丸和附睾指数比较(±s)

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组别n睾丸质量/(mg)睾丸系数/(%)附睾质量/(mg)附睾系数/(%)
空白组10187.8±4.250.74±0.01745.72±1.770.18±0.007
模型组10117.8±3.17**0.55±0.014**33.59±1.70**0.16±0.009**
针刺组10132.1±3.11##0.62±0.018##36.67±1.57##0.17±0.007##
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组别n精子总数/(×106/mL)精子活力(a+b级精子)/(%)精子活率/(%)
空白组1064.59±5.8554.29±3.9160.03±5.24
模型组1037.04±5.23**27.35±2.71**33.81±4.30**
针刺组1047.77±4.65##36.93±2.24##42.38±3.31##
), ArticleFig(id=1322923298933322305, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表4, caption=

各组小鼠精子质量比较(±s)

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组别n精子总数/(×106/mL)精子活力(a+b级精子)/(%)精子活率/(%)
空白组1064.59±5.8554.29±3.9160.03±5.24
模型组1037.04±5.23**27.35±2.71**33.81±4.30**
针刺组1047.77±4.65##36.93±2.24##42.38±3.31##
), ArticleFig(id=1322923299042374210, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别nT含量/(ng·mL-1)FSH含量/(IU·L-1)LH含量/(mIU·mL-1)
空白组101.92±0.1412.57±1.1931.70±1.67
模型组101.08±0.18**6.10±0.96**18.56±2.91**
针刺组101.50±0.13##8.97±0.77##25.25±2.00##
), ArticleFig(id=1322923299130454595, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表5, caption=

各组小鼠血清T、FSH和LH含量比较(±s)

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组别nT含量/(ng·mL-1)FSH含量/(IU·L-1)LH含量/(mIU·mL-1)
空白组101.92±0.1412.57±1.1931.70±1.67
模型组101.08±0.18**6.10±0.96**18.56±2.91**
针刺组101.50±0.13##8.97±0.77##25.25±2.00##
), ArticleFig(id=1322923299201757764, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别n阳性细胞凋亡率
空白组55.26±1.01
模型组533.53±4.42**
针刺组514.43±3.59##
), ArticleFig(id=1322923299264672325, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表6, caption=

各组小鼠睾丸组织阳性细胞凋亡率比较(±s)

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组别n阳性细胞凋亡率
空白组55.26±1.01
模型组533.53±4.42**
针刺组514.43±3.59##
), ArticleFig(id=1322923299365335622, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别nFasLFasTNF-αTNFR1TRAILDR5FADDCaspase-8Caspase-3
空白组6111111111
模型组61.66±0.14**1.35±0.09**1.92±0.16**1.17±0.06**0.86±0.160.89±0.091.17±0.13**1.71±0.09**1.79±0.14**
针刺组61.17±0.21##1.17±0.09##1.29±0.24##1.06±0.09#0.89±0.110.93±0.131.04±0.07#1.29±0.14##1.48±0.10##
), ArticleFig(id=1322923299474387527, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表7, caption=

各组小鼠睾丸组织FasL、Fas、TNF-α、TNFR1、TRAIL、DR5、FADD、Caspase-8、Caspase-3 mRNA表达比较(±s)

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组别nFasLFasTNF-αTNFR1TRAILDR5FADDCaspase-8Caspase-3
空白组6111111111
模型组61.66±0.14**1.35±0.09**1.92±0.16**1.17±0.06**0.86±0.160.89±0.091.17±0.13**1.71±0.09**1.79±0.14**
针刺组61.17±0.21##1.17±0.09##1.29±0.24##1.06±0.09#0.89±0.110.93±0.131.04±0.07#1.29±0.14##1.48±0.10##
), ArticleFig(id=1322923299562467912, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别nFasLFasTNF-αTNFR1TRAILDR5FADDCaspase-8Caspase-3
空白组40.34±0.090.17±0.090.50±0.140.32±0.110.71±0.050.90±0.120.46±0.130.33±0.070.43±0.09
模型组41.25±0.25**0.71±0.07**0.96±0.07**0.81±0.11**0.57±0.070.63±0.220.83±0.06**0.82±0.11**1.32±0.14**
针刺组40.61±0.12##0.44±0.04##0.71±0.06#0.48±0.13#0.64±0.060.84±0.060.60±0.07#0.49±0.10##0.88±0.12##
), ArticleFig(id=1322923299629576777, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表8, caption=

各组小鼠睾丸组织FasL、Fas、TNF-α、TNFR1、TRAIL、DR5、FADD、Caspase-8、Caspase-3蛋白相对表达量比较(±s)

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组别nFasLFasTNF-αTNFR1TRAILDR5FADDCaspase-8Caspase-3
空白组40.34±0.090.17±0.090.50±0.140.32±0.110.71±0.050.90±0.120.46±0.130.33±0.070.43±0.09
模型组41.25±0.25**0.71±0.07**0.96±0.07**0.81±0.11**0.57±0.070.63±0.220.83±0.06**0.82±0.11**1.32±0.14**
针刺组40.61±0.12##0.44±0.04##0.71±0.06#0.48±0.13#0.64±0.060.84±0.060.60±0.07#0.49±0.10##0.88±0.12##
), ArticleFig(id=1322923299700879946, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别ncleaved Caspase-3荧光强度PARP荧光强度
空白组59.03±2.4312.22±3.83
模型组528.17±6.50**34.87±7.98**
针刺组516.34±3.15##18.69±4.54##
), ArticleFig(id=1322923299767988811, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923285452829147, language=CN, label=表9, caption=

各组小鼠睾丸组织cleaved Caspase-3、PARP阳性表达比较(±s)

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组别ncleaved Caspase-3荧光强度PARP荧光强度
空白组59.03±2.4312.22±3.83
模型组528.17±6.50**34.87±7.98**
针刺组516.34±3.15##18.69±4.54##
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郝健亨 1, 2 , 任佳 2 , 常博雅 2 , 高珍 2 , 王海军 2 , 冀来喜 1, 2
中华中医药学刊 | 国家项目点击 2025,43(4): 59-65
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中华中医药学刊 |国家项目点击 2025 , 43 (4) : 59 -65
基于死亡受体途径探讨“秩边透水道”针法对弱精子症小鼠生殖功能的影响
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郝健亨(1993-),男,山西孝义人,主治医师,博士在读,研究方向:中医优势治疗技术。

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郝健亨1, 2, 任佳2, 常博雅2, 高珍2, 王海军2, 冀来喜1, 2
作者信息
  • 1.成都中医药大学针灸推拿学院,四川 成都 610075
  • 2.山西中医药大学第二临床学院,山西 晋中 030619
通讯作者:
冀来喜(1964-),男,山西太原人,教授、主任医师,博士研究生导师,博士,研究方向:中医优势治疗技术。E-mail:。
作者简介:

郝健亨(1993-),男,山西孝义人,主治医师,博士在读,研究方向:中医优势治疗技术。

Effect of“Zhibian(BL54)-to-Shuidao(ST28)”Acupuncture Method on Reproductive Function of Asthenozoospermia Mice Based on Death Receptor Pathway
Jianheng HAO1, 2, Jia REN2, Boya CHANG2, Zhen GAO2, Haijun WANG2, Laixi JI1, 2
Affiliations
  • 1.College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, China
  • 2.Second Clinical College, Shanxi University of Traditional Chinese Medicine, Jinzhong 030619, Shanxi, China
出版时间: 2025-04-10 doi: 10.13193/j.issn.1673-7717.2025.04.011
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目的

通过观察“秩边透水道”针法对弱精子症小鼠睾丸组织死亡受体途径上关键因子的影响,探析针刺对小鼠生殖功能的改善作用。

方法

将30只C57BL/6雄性小鼠随机分成空白组、模型组和针刺组(各10只)。空白组给予等体积的0.9%氯化钠溶液灌胃,模型组和针刺组小鼠给予环磷酰胺(50 mg·kg-1·d-1)腹腔注射5 d,造模完成后针刺组小鼠给予“秩边透水道”连续针刺治疗2周,每日1次,每次20 min,其余两组只进行固定,治疗完成次日进行取材。日常观察小鼠的一般情况并记录体质量变化,检测小鼠睾丸、附睾指数以及精子质量,通过酶联免疫吸附法(enzymelinked immunosorbent assay,ELISA)检测血清中睾酮(testosterone,T)、促卵泡生成素(follicle-stimulating hormone,FSH)、促黄体生成激素(luteinizing hormone,LH)含量,苏木素-伊红(hematoxylin-eosin,HE)染色观察睾丸组织病理形态,脱氧核苷酸转移酶dUTP末端标记(terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling,TUNEL)染色观察睾丸组织细胞凋亡情况,实时荧光定量反转录聚合酶链反应(real-time PCR,RT-PCR)法和免疫印迹法(western blot,WB)分别检测睾丸组织Fas细胞表面死亡受体(fas cell surface death receptor,Fas)、FasL、肿瘤坏死因子α(tumour necrosis factor alpha-like,TNF-α)、TNFR1、肿瘤坏死因子相关凋亡诱导配体(tumor necrosis factor-related apoptosisinducing ligand,TRAIL)、死亡受体5(death receptor 5,DR5)、半胱氨酸蛋白酶(cysteine-aspartic acid protease,Caspase)-8、Caspase-3 mRNA和蛋白表达变化;免疫荧光法检测睾丸组织cleaved Caspase-3和多聚ADP核糖聚合酶[poly(ADP-ribose)polymerase,PARP]阳性表达。

结果

与空白组比较,模型组小鼠体质量减轻(P<0.01),睾丸、附睾质量和系数下降(P<0.01),精子总数、精子活力和精子活率下降(P<0.01),血清T、FSH和LH含量下降(P<0.01),睾丸和附睾组织病理形态变差,阳性细胞凋亡量提高(P<0.01),FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3 mRNA和蛋白表达水平提高(P<0.01,P<0.05),TRAIL、DR5 mRNA和蛋白表达水平差异无统计学意义(P>0.05),Cleaved Caspase-3和PARP阳性表达量提高(P<0.01)。与模型组比较,针刺组小鼠治疗后体质量无明显变化(P>0.05);睾丸、附睾质量和系数提高(P<0.01);精子总数、精子活力和精子活率提高(P<0.01),血清T、FSH和LH含量提高(P<0.01),睾丸和附睾组织病理形态改善;阳性细胞凋亡量降低(P<0.01);FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3 mRNA和蛋白表达水平降低(P<0.01,P<0.05),TRAIL、DR5 mRNA和蛋白表达水平差异无统计学意义(P>0.05),cleaved Caspase-3和PARP阳性表达量降低(P<0.01)。

结论

“秩边透水道”针法可以改善弱精子症小鼠生精细胞凋亡,提高生殖功能,其机制可能与调节睾丸组织死亡受体途径上的关键因子有关。

秩边透水道  /  弱精子症  /  针刺  /  死亡受体途径  /  外源性凋亡
Objective

To investigate the protective effect of acupuncture on the reproductive function of mice by observing the effect of the“Zhibian(BL54)-to-Shuidao(ST28)”acupuncture method on key factors in the death receptor pathway of testicular tissue in asthenospermia mice.

Methods

Thirty C57BL/6 male mice were randomly divided into a blank group,a model group and an acupuncture group(n=10). The blank group was given an equal volume of 0.9% sodium chloride solution by gavage,while the model group and acupuncture group were given intraperitoneal injection of cyclophosphamide(50 mg·kg-1·d-1)for 5 days. After the completion of modeling,the acupuncture group were given continuous acupuncture treatment with“Zhibian(BL54)-to-Shuidao(ST28)”for 2 weeks,once a day,20 minutes for each time. The other two groups were only fixed,and the samples were taken the next day after treatment. In daily observations,the general condition of mice was assessed,and the changes in body weight and testicular and epididymal indices were recorded. The sperm quality of the mice was evaluated. Enzyme-Linked Immunosorbent Assay(ELISA)was used to measure the levels of testosterone(T),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the serum. Hematoxylin-Eosin(HE)staining was employed to examine the pathological morphology of testicular tissue. Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining was used to observe cell apoptosis in testicular tissue. Fluorescent quantitative polymerase chain reaction(PCR)and Western blot were employed to assess changes in the mRNA and protein expressions of Fas cell surface death receptor(Fas),Fas ligand(FasL),tumor necrosis factor alpha(TNF-α),TNF receptor 1(TNFR1),tumor necrosis factor-related apoptosis-inducing ligand(TRAIL),death receptor 5(DR5),Caspase-8 and Caspase-3 in testicular tissue. Immunofluorescence staining was conducted to detect the positive expressions of cleaved Caspase-3 and PARPin testicular tissue.

Results

Compared with the control group,the model group exhibited a decrease in body weight of male mice(P<0.01),a decrease in testicular and epididymal mass and coefficients(P<0.01),a decrease in total sperm count,sperm motility and sperm viability(P<0.01),a decrease in serum levels of testosterone(T),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)(P<0.01),deterioration in the pathological morphology of testicular and epididymal tissues,an increase in the number of positively stained apoptotic cells(P<0.01),an increase in the mRNA and protein expression levels of FasL,Fas,TNF-α,TNFR1,FADD,Caspase-8 and Caspase-3(P<0.01,P<0.05). There was no significant difference in the expression levels of TRAIL,DR5 mRNA or protein(P>0.05),and an increase in the expressions of cleaved Caspase-3 and PARP(P<0.01). Compared to the model group,the acupuncture group showed no significant change in body weight after treatment(P>0.05). There was an increase in testicular and epididymal mass and coefficients(P<0.01). The levels of total sperm count,sperm motility and sperm viability increased(P<0.01). The serum levels of testosterone(T),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)increased(P<0.01). There was an improvement in the pathological morphology of testicular and epididymal tissues,a decrease in the number of positively stained apoptotic cells(P<0.01),a decrease in the mRNA and protein expression levels of FasL,Fas,TNF-α,TNFR1,FADD,Caspase-8 and Caspase-3(P<0.01,P<0.05). There was no significant difference in the expression levels of TRAIL,DR5 mRNA and protein(P>0.05)or decrease in the expression of cleaved Caspase-3 and PARP(P<0.01).

Conclusion

The“Zhibian(BL54)-to-Shuidao(ST28)”technique can improve spermatogenic cell apoptosis in oligospermia mice and enhance reproductive function,and its mechanism may be associated with the regulation of key factors in the testicular tissue death receptor apoptosis pathway.

Zhibian(BL54)-to-Shuidao(ST28)  /  asthenozoospermia  /  acupuncture  /  death receptor pathway  /  exogenous apoptosis
郝健亨, 任佳, 常博雅, 高珍, 王海军, 冀来喜. 基于死亡受体途径探讨“秩边透水道”针法对弱精子症小鼠生殖功能的影响. 中华中医药学刊, 2025 , 43 (4) : 59 -65 . DOI: 10.13193/j.issn.1673-7717.2025.04.011
Jianheng HAO, Jia REN, Boya CHANG, Zhen GAO, Haijun WANG, Laixi JI. Effect of“Zhibian(BL54)-to-Shuidao(ST28)”Acupuncture Method on Reproductive Function of Asthenozoospermia Mice Based on Death Receptor Pathway[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (4) : 59 -65 . DOI: 10.13193/j.issn.1673-7717.2025.04.011
不孕不育是世界上仅次于癌症和心血管疾病的第三大疾病,流行病学研究表明,在所有不孕症病例中,约50%的病例与男性因素有关[1]。精子活力是保证正常受精的必要条件,它能使精子从阴道迁移到输卵管并穿透卵子,进而与卵母细胞结合并使其受精。精子活力的降低被称为弱精子症,是导致男性不育最常见的原因之一,其特点是前向运动精子比率低于低线以下(32%)或者精子总活率低于低线以下(40%)[2]。目前该病的发病机制尚未明确,可能与自身免疫、感染、遗传等因素相关[3]。除戒烟和减少酒精消耗等生活方式改变外[4],促性腺激素、皮质类固醇或抗氧化剂等药物是目前该病的主要治疗策略[5]。然而以上治疗方法疗效有限,因此为了提高怀孕率,许多人开始寻求补充和替代手段进行治疗。
针灸是补充和替代医学的重要组成部分,有研究表明针灸可能通过促进局部血液循环、改善氧化应激损伤、提高精子质量等方式帮助提高男性生育能力[6-7]。“秩边透水道”针法来源于内经,是从“秩边”穴向“水道”穴透刺使针感放射至前阴部的一种针法,后经冀来喜教授规范和发展,目前已在多种生殖疾病中得到广泛研究[8-10]。死亡受体途径是一种外源性的细胞凋亡途径,在维护生物体内稳态、免疫应答和清除受损细胞方面具有重要作用[11-12]。研究发现[12],Fas细胞表面死亡受体(fas cell surface death receptor,Fas)/FasL等外源性凋亡关键因子在精子生成、成熟过程中扮演重要角色,能通过调节生殖细胞的增殖能力和分化程度进而影响精子的数量和活性。因此,本研究基于死亡受体凋亡途径探讨“秩边透水道”针法对弱精子小鼠生殖功能的保护机制,以期为“秩边透水道”的临床推广提供实验室依据。
于北京斯贝福公司购买30只鼠龄为6~7周的SPF级健康雄性C57BL/6小鼠[动物生产合格证号:SCXK(京)-2019-0010],体质量为(18±1)g,饲养于山西中医药大学动物实验中心。饲养环境:温度为(25±2)℃、湿度为55%±5%、每日明暗交替为12 h,饮水饮食自由,适应性喂养1周。本研究通过山西中医药大学实验动物伦理委员会批准,伦理审查批件编号:No. AWE202303381。
环磷酰胺(货号:HY-17420,美国MCE);睾酮(testosterone,T)试剂盒(货号:MU30398)、促卵泡生成素(follicle-stimulating hormone,FSH)试剂盒(货号:MU30265)、促黄体生成激素(luteinizing hormone,LH)试剂盒(货号:MU30382)(武汉贝茵莱);苏木素-伊红(hematoxylin-eosin,HE)染色液(货号:DH0006,北京雷根);一步法脱氧核苷酸转移酶dUTP末端标记(terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling,TUNEL)细胞凋亡检测试剂盒(货号:G1504)、核糖核酸(ribonucleic acid,RNA)提取液(货号:G3013)、实时荧光定量反转录聚合酶链反应(Real-time PCR,RT-PCR)逆转录试剂盒(货号:G3337)、FasL抗体(货号:GB11002)、肿瘤坏死因子-α(tumour necrosis factor alpha,TNF-α)抗体(货号:GB11188)、TNFR1抗体(货号:GB115567)、肿瘤坏死因子相关凋亡诱导配体(tumor necrosis factor-related apoptosis-inducing ligand,TRAIL)抗体(货号:GB11413)、半胱氨酸蛋白酶(cysteine-aspartic acid protease,Caspase)3抗体(货号:GB11767C)、Caspase-8抗体(货号:GB11594)、cleaved Caspase-3抗体(货号:GB11532)、多聚ADP核糖聚合酶[poly(ADP-ribose)polymerase,PARP]抗体(货号:GB111500)、β-肌动蛋白(beta-actin,β-actin)抗体(货号:GB11001)、CY3标记山羊抗兔IgG(货号:GB21303,武汉赛维尔);Fas抗体(货号:13098-1-AP)、Fas相关死亡结构域蛋白(fas associated via death domain,FADD)抗体(货号:14906-1-AP,武汉三鹰);死亡受体5(Death Receptor 5,DR5)抗体(货号:A19043,武汉爱博泰克)。
0.25 mm×13 mm一次性无菌针灸针(苏州华佗),低温高速离心机(型号:Pico 21)、超低温冷冻储存箱(型号:Forma 900,德国Thermo Scientific公司);石蜡切片机(型号:RM 2145)、超薄切片机(型号:Leica UC7,德国LEICA);凝胶电泳仪(型号:PowerPac Basic)、凝胶成像分析仪(型号:HOOD-Ⅱ,美国BIO-RAD);荧光显微镜(型号:ECLIPSE Ci-S)(日本Nikon);酶标仪(型号:Spectra Max Plus384,美国Molecular Devices)。
适应性喂养1周后,采用随机数字表法将小鼠随机分为空白组、模型组和针刺组(n=10)。每日上午对模型组雄鼠给予腹腔注射环磷酰胺(50 mg·kg-1·d-1)诱导弱精子症小鼠模型[13];空白组注射等体积0.9%氯化钠溶液,共5 d。当精子总数与活力较空白组下降且具有统计学意义则判定模型制备成功[13]。
针刺组:参照《针刺研究》提供的小鼠腧穴大致范围并结合前期大鼠取穴经验和小鼠解剖学标志进行取穴[14-15]。每日下午固定小鼠,先将小鼠俯卧位固定四肢,然后用75%的酒精进行消毒,选用0.25 mm×13 mm一次性针灸针分别从双侧“秩边”穴(小鼠臀部外侧,股骨大转子与第四荐骨连线中点的骨性缝隙处)斜刺向其同侧“水道”穴(剑突至耻骨联合上缘上2/3与下1/3交界处下约8 mm,正中线旁开约3 mm),进针深度约5 mm,不行提插捻转手法,20 min/次,1次/d,连续2周;空白组和模型组只进行固定,无其他干预。
治疗结束次日,将各组小鼠经异氟烷麻醉后,通过眼球摘除法进行采血,静置2 h,3500 r/min条件下离心15 min后,收集上方血清低温保存;然后脱颈处死,剪取小鼠睾丸和附睾组织,部分置于固定液中避光保存,部分经液氮速冻后置于-80℃条件下保存。
日常记录小鼠精神状态、毛发、活动度变化以及非正常行为表现,同时对入组时和治疗前后的体质量进行记录。
无菌剪取小鼠的睾丸和附睾组织,剪除多余脂肪组织,吸除多余水分,称取双侧睾丸和附睾的质量,并计算得出相应的脏器指数(两侧睾丸或附睾质量/末次体质量)。
取小鼠附睾置于培养皿中,加入适量0.9%氯化钠溶液,用一次性无菌针头轻轻挑破附睾头,使精子充分游离在培养皿中,37℃条件下孵育5 min,然后将精子悬液滴加在精子计数板上,通过精子分析软件进行精子质量检测。
根据ELISA试剂盒说明书依次将标准品、血清样本、样品稀释液添加到96孔板中,然后进行封板、孵育、洗涤、显色等操作,最后利用酶标仪观察记录各实验孔在450 nm波长处的吸光度值,并参照标曲计算对应的T、FSH和LH浓度。
将小鼠睾丸和附睾组织固定48 h,行常规脱水、透明、浸蜡、包埋后,制备成5 μm石蜡切片。将石蜡切片脱蜡至水,先将切片入苏木素中染色3~5 min,后进行梯度脱水,再入伊红中染色5 min,最后脱水封片,镜下观察睾丸和附睾病理改变。
取睾丸组织石蜡进行切片,逐级脱蜡至水,蛋白酶K修复,破膜,室温平衡,加反应液37℃恒温箱孵育1 h,用4'6-二胺-2-苯基吖啶(4',6-diamidino-2-phenylindole,DAPI)复染细胞核,抗荧光淬灭封片剂封片,最后进行镜检拍照,计算阳性细胞凋亡率(%)=凋亡细胞面积/总细胞面积×100%。
按试剂盒说明书提取总RNA,后将总RNA反转录合成cDNA,并将此cDNA作为模板,进行PCR扩增(设定条件为:95℃×30 s,1次循环;95℃×15 s,60℃×30 s,40个循环)。反应结束后,通过PCR仪读取各个反应孔Ct值,结果以GAPDH为内参,通过2-△△CT公式计算目的基因mRNA相对表达量。引物由武汉赛维尔设计。见表1。
提取小鼠睾丸组织总蛋白溶液,通过BCA法测定蛋白浓度,配胶后每孔加入5 μL蛋白样本进行电泳操作,湿转法转运2 h后用5%脱脂奶粉封闭2 h,洗膜后加入所需一抗放入冰箱4℃过夜(FasL、Fas、TNF-α、TNFR1、TRAIL、DR5、FADD、Caspase-8、Caspase-3稀释比均为1∶1000,β-actin稀释比为1∶3000)。隔天先洗膜5×5 min,然后室温条件下加入二抗孵育1 h(稀释比为1∶5000),再次洗膜3×10 min,滴加显影液后适当摇匀上机显影,拍照保存并应用Image J软件测定条带灰度值,以目的蛋白与内参蛋白灰度值的比作为目的蛋白的相对表达量进行组间比较。
取睾丸组织石蜡切片脱蜡至水,抗原修复,组化笔画圈后,放入3%双氧水溶液封闭25 min,滴加BSA封闭30 min,将cleaved Caspase-3和PARP一抗按1∶300稀释比混合,4℃条件下孵育过夜,复温后加入两种二抗共同孵育50 min,然后DAPI复染细胞核10 min,加入自发荧光淬灭剂5 min后封片,最后进行镜检(DAPI发蓝光,cleaved Caspase-3和PARP阳性表达分别发红光和绿光)。
本研究应用GraphPad Prism8软件进行分析,计量资料采用均值±标准差()表示,组间比较通过单因素方差进行分析,进一步两两比较时,方差齐采用LSD检验,方差不齐选用Tamhane检验。P≤0.05时,差异有统计学意义。
与空白组相比,模型组小鼠精神变差,毛发粗糙,饮食与活动量减少,多蜷缩角落;针刺组小鼠精神、饮食与活动度均得到不同程度改善。
造模前(入组时),空白组、模型组和针刺组之间体质量差异无统计学意义;造模后,与空白组相比,模型组和针刺组体质量明显下降(P<0.01),模型组和针刺组体质量差异无统计学意义(P>0.05);治疗后,与空白组相比,模型组体质量明显下降(P<0.01),模型组和针刺组体质量比较差异无统计学意义(P>0.05)。见表2。
与空白组相比,模型组睾丸质量、睾丸系数、附睾质量和附睾系数明显下降(P<0.01),与模型组相比,针刺组睾丸质量、睾丸系数、附睾质量和附睾系数显著提高(P<0.01)。见表3。
与空白组相比,模型组精子总数、精子活力和精子活率下降(P<0.01),与模型组相比,针刺组精子总数、精子活力和精子活率提高(P<0.01)。见表4。
与空白组相比,模型组小鼠血清T、FSH和LH含量不同程度下降(P<0.01),与模型组相比,针刺组小鼠血清T、FSH和LH含量不同程度提高(P<0.01)。见表5。
与空白组相比,模型组小鼠睾丸组织内生精小管部分形态异常、排列紊乱,管壁厚薄不均,管腔内生精细胞数量减少且排列松散,正常精子数量减少,同时分布于生精小管之间的睾丸间质细胞数量减少,胞体形态变差;与模型组相比,针刺组小鼠睾丸组织病理学形态得到改善。见插页ⅩⅢ图1。
与空白组相比,附睾组织内部分附睾小管形态变差、层次紊乱,管壁厚薄不均,伴有空泡现象,腔内少见正常精子,同时分布于附睾小管之间的附睾间质受损。与模型组相比,针刺组小鼠附睾组织病理学形态得到改善。见插页ⅩⅢ图2。
绿色荧光代表阳性凋亡细胞,主要分布在生精小管内。与空白组相比,模型组小鼠睾丸组织中生精细胞凋亡率提高(P<0.01);与模型组相比,针刺组小鼠睾丸组织中生精细胞凋亡率降低(P<0.01)。见插页ⅩⅣ图3、表6。
与空白组相比,模型组小鼠睾丸组织FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3 mRNA表达水平不同程度提高(P<0.01),TRAIL和DR5 mRNA表达水平比较差异无统计学意义(P>0.05);与模型组相比,针刺组小鼠睾丸组织FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3 mRNA表达水平不同程度降低(P<0.01,P<0.05),TRAIL和DR5 mRNA表达水平比较差异无统计学意义(P>0.05)。见表7。
与空白组相比,模型组小鼠睾丸组织FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3蛋白相对表达量不同程度提高(P<0.01),TRAIL和DR5蛋白相对表达量比较差异无统计学意义(P>0.05);与模型组相比,针刺组小鼠睾丸组织FasL、Fas、TNF-α、TNFR1、FADD、Caspase-8、Caspase-3蛋白相对表达量降低(P<0.01,P<0.05),TRAIL和DR5蛋白相对表达量比较差异无统计学意义(P>0.05)。见图4、表8。
红色荧光为cleaved Caspase-3表达,绿色荧光为PARP表达,两者主要分布在生精小管周围。与空白组相比,模型组小鼠睾丸组织cleaved Caspase-3和PARP阳性表达量提高(P<0.01);与模型组相比,针刺组小鼠睾丸组织cleaved Caspase-3和PARP阳性表达量降低(P<0.01)。见插页ⅩⅣ图5、表9。
环磷酰胺是一种烷化剂,目前已广泛用于多种肿瘤疾病的急性治疗和自身免疫性疾病的慢性治疗。然而研究发现[16],环磷酰胺会损伤正常组织,尤其是对睾丸、附睾、卵巢等多种生殖器官造成毒性。环磷酰胺的毒性效应是通过其活性代谢物介导的,其中磷酰胺芥主要通过与DNA不可逆结合导致DNA损伤和细胞死亡,而丙烯醛则主要贡献其细胞毒性[17]。环磷酰胺对快速分裂细胞的细胞毒性使得高度增殖的睾丸成为该药物破坏作用的目标,因此环磷酰胺对人类和动物生育能力会产生不利影响[18-20]:研究表明服用环磷酰胺相关药物的男性患者会促进睾丸损伤以及血液中多种激素紊乱,导致少精症和无精症的发生;给予部分啮齿动物环磷酰胺会导致精原细胞DNA合成和精子细胞蛋白质合成减少,造成促性腺激素分泌异常,干扰正常的精子形成和发育,导致生育能力的下降。因此,本研究采用环磷酰胺建立小鼠弱精子症模型,发现相较于正常组,模型组小鼠睾丸和附睾指数降低,精子质量显著下降,睾丸和附睾组织发生明显的病理损伤,血清中FSH、LH和T含量不同程度降低,表明弱精子症小鼠模型的成功建立。
弱精子症的中医病名目前尚无记载,根据其临床症状,弱精子症可以归为中医的“不孕”“精少”“精稀”等多个范畴。中医理论认为,肾虚是弱精子症的主要病机。病情亦累及脾胃或合并情志等因素[21]。肾主生殖,为先天之本,精子的产生需要依赖于肾精的滋养,因此男性生殖功能与肾精的充盈程度密切相关。若肾精充足,则生殖功能旺盛,精子数量和活力充沛;若肾气不足,则生殖之精生发无力,会导致精子数量减少和质量下降。脾为后天之根,肾无后天之气则不能生。因此脾胃功能失会影响到对营养物质的吸收,从而可能影响到精子的发育成熟。此外,中医强调情志对身体健康的影响,长期的精神紧张、焦虑和抑郁等负面情绪也可能对生殖系统产生负面影响。因此弱精子症的治疗应注重脾肾同治,兼以心理暗示。“秩边透水道”针法来源于《内经》,后经冀来喜教授规范和发展,目前已应用于多种男女性生殖系统疾病的治疗当中[22]。“秩边”位于骶臀部,为足太阳膀胱经腧穴,与肾经相表里,有活络通经,调经益肾之功。“水道”位于下腹部,为足阳明胃经腧穴,与脾经相表里,有通调水道,补肾填精之效。从“秩边”向“水道”方向斜刺,可以刺激盆丛神经与阴部神经使经气“气至病所”,对睾丸等生殖器官产生调节作用;同时,患者会自觉针感放射至前阴部,对患者起到积极的心理暗示作用。本研究发现,相比于模型组,使用“秩边透水道”针法干预后的小鼠的睾丸和附睾指数提高,睾丸和附睾病理形态不同程度改善,精子质量提高,血清中FSH、LH和T含量不同程度提高,表明“秩边透水道”针法可能通过纠正血清激素水平紊乱和修复受损睾丸和附睾组织,有效提高弱精子症小鼠的精子活力。
死亡受体凋亡途径是一种外源性的细胞凋亡途径,它始于死亡受体的激活,通常由外部因素触发。初始事件包括FasL、TNF-α和TRAIL的释放或表达,这些配体会与细胞表面的死亡受体Fas、TNFR1和DR5等结合形成受体复合物;然后适配器蛋白FADD被引入到受体复合物中,进而招募和激活Caspase-8;Caspase-8的激活标志着外源性凋亡途径的启动,它通过自我切割产生活性形式,然后引发Caspase级联反应,其中最重要的是Caspase-3的激活。剪切活化后的cleaved Caspase-3是细胞凋亡的关键执行者之一,它导致细胞内关键蛋白质的切割,其中PARP是一个DNA修复和细胞凋亡相关的关键蛋白,切割后的PARP失活,释放出由PARP降解产生的DNA片段,标志着细胞已经进入凋亡状态。这一复杂的信号传导网络将外部信号转化为细胞内的凋亡过程,对于维持组织和器官的正常生长、发育和维护以及在免疫系统中清除异常或受损细胞具有重要作用[23]。研究发现,FasL、TNF-α和TRAIL信号通路在睾丸细胞凋亡的调控中起着关键作用,对早期睾丸的发育和后续的维持睾丸细胞稳态均具有重要意义。宾彬等[24]在环磷酰胺所致的生精功能障碍小鼠的睾丸组织中观察到Fas和FasL在间质细胞、睾丸支持细胞和各级生精细胞表达显著,强精煎可能通过下调睾丸组织中的Fas和FasL蛋白的表达进而抑制生精细胞凋亡。朱庆均等[25]研究发现,金匮肾气丸可能通过降低Fas/FasL表达,抑制肾阳虚小鼠睾丸生殖细胞的凋亡。OTHMAN E M等[26]研究发现环磷酰胺会导致雄鼠睾丸内TNF-α的浓度显著提高;WANG Y等[27]发现大黄素可能通过调节TNF-α的水平减轻环磷酰胺诱导的睾丸毒性。殷骏等[28]实验证明低氧诱导睾丸生殖细胞凋亡与DR5的表达增多有关。COUREUIL M等[29]实验发现γ辐射可能通过TRAIL/DR5途径诱导小鼠精原细胞凋亡。本研究中,我们发现与空白组相比,模型组小鼠睾丸中TRAIL/DR5的表达水平变化无显著差异,与前期射线和缺氧诱导的模型中的表达上升趋势不同。大量研究表明[30-31],TRAIL诱导凋亡主要通过与其受体相互作用来实现的,在肿瘤细胞中,这些受体通常高度表达,使TRAIL能够有效地激活凋亡通路。然而在正常细胞中,这些TRAIL受体通常表达水平较低,因此TRAIL对正常细胞的影响较小,解释了本研究中TRAIL表达变化不明显的可能原因。同时,本研究证明,相比于空白组,模型组小鼠睾丸组织阳性细胞凋亡数量增加,FasL/Fas、TNF-α/TNFR1、FADD、Caspase-8、Caspase-3 mRNA和蛋白表达水平不同程度提高,cleaved Caspase-3和PARP阳性表达量提高,提示TRAIL途径并不能触发环磷酰胺诱导的睾丸内生精细胞的凋亡,生殖细胞外源性凋亡水平的增加可能是由FasL和TNF-α共同补偿作用所致。课题组前期研究发现[32],使用“秩边透水道”干预可以有效改善环磷酰胺诱导的早发性卵巢功能不全大鼠卵巢功能,减少卵巢颗粒细胞凋亡,表明该针法对生殖系统的调节有积极作用。本研究发现,经“秩边透水道”针刺治疗后,小鼠睾丸组织内阳性细胞凋亡数量降低,FasL/Fas、TNF-α/TNFR1、FADD、Caspase-8、Caspase-3 mRNA和蛋白表达水平不同程度降低,cleaved Caspase-3和PARP阳性表达量降低,提示“秩边透水道”针法可能通过调节FasL和TNF-α通路上的关键因子,抑制睾丸组织内生精细胞凋亡,进而提高弱精子症小鼠的生殖功能。见插页ⅩⅤ图6。
综上,“秩边透水道”针法可以有效调节弱精子症小鼠血清性激素水平的紊乱,修复受损睾丸和附睾组织,进而提高精子活力,其潜在机制可能与调节睾丸组织死亡受体途径上部分关键因子,进而抑制生精细胞凋亡有关。该研究不仅为针刺治疗弱精子症治疗提供了新的思路,同时也对“秩边透水道”针法的应用推广有积极意义。
  • 国家自然科学基金面上项目(82074549)
  • 山西省自然基金面上项目(201901D111399)
  • 山西中医药大学师怀堂新九针学术流派传承工作室基金项目(2020PY-LP-03)
  • 山西中医药大学博士科研启动基金项目(2023BK17)
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2025年第43卷第4期
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doi: 10.13193/j.issn.1673-7717.2025.04.011
  • 首发时间:2026-10-30
  • 出版时间:2025-04-10
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基金
国家自然科学基金面上项目(82074549)
山西省自然基金面上项目(201901D111399)
山西中医药大学师怀堂新九针学术流派传承工作室基金项目(2020PY-LP-03)
山西中医药大学博士科研启动基金项目(2023BK17)
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    1.成都中医药大学针灸推拿学院,四川 成都 610075
    2.山西中医药大学第二临床学院,山西 晋中 030619

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冀来喜(1964-),男,山西太原人,教授、主任医师,博士研究生导师,博士,研究方向:中医优势治疗技术。E-mail:。
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2种不同金属材料的力学参数
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属
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species
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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