摘要
目的:系统评价益气活血类中药对精索静脉曲张动物模型生精细胞凋亡的干预作用。方法:检索中国知网、重庆维普中文科技期刊数据库、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Embase和Cochrane Library,筛选益气活血类中药干预精索静脉曲张动物模型的实验研究。采用SYRCLE动物实验偏倚风险评估工具对纳入文献的研究方法学偏倚风险进行评估,并用RevMan 5.3软件对结局指标进行Meta分析。结果:共纳入15项研究,研究对象为SD大鼠或Wistar大鼠,均为随机对照实验。Meta分析结果显示,与模型组比较,益气活血类中药可提高精子密度[SMD=2.63,95%CI(1.95,3.32),P<0.000 01]、精子活率[SMD=2.38,95%CI(1.87,2.88),P<0.000 01]、精子活力[SMD=2.88,95%CI(2.38,3.38),P<0.000 01]、B淋巴细胞瘤-2基因(Bcl-2)[SMD=1.29,95%CI(1.02,1.57),P<0.000 01]表达水平,降低凋亡因子(Fas)[SMD=-0.90,95%CI(-1.26,-0.54),P<0.000 01]、凋亡因子配体(FasL)[SMD=-2.74,95%CI(-3.55,-1.94),P<0.000 01]、凋亡指数(AI)[SMD=-1.53,95%CI(-1.88,-1.19),P<0.000 01]含量,改善模型动物Johnson评分[SMD=0.46,95%CI(-1.35,2.26),P=0.01]。与模型组比较,益气活血类中药高剂量组(1.4~2.4 g/mL)、中剂量组(1.0~1.2 g/mL)、低剂量组(0.5~0.7 g/mL)均可提高精子密度、精子活率、精子活力,降低FasL含量,差异均有统计学意义(P<0.05);益气活血类中药中、高剂量组可上调Bcl-2表达水平,降低Fas、FasL表达水平,下调AI,改善Johnson评分,差异均有统计学意义(P<0.05)。结论:益气活血类中药能够有效提高精索静脉曲张大鼠模型的精子密度、精子活率、精子活力、Bcl-2表达水平,并降低Fas、FasL、AI,改善Johnson评分,且存在一定的量效关系。然而受纳入文献质量与数量因素的影响,以上论断有待相关高质量研究予以进一步验证。
O bjective: To systematically evaluate the intervention effect of herbs for replenishing Qi and activating blood circulation on spermatogenic cell apoptosis in animal model of varicocele. Methods: China knowledge Network, Chongqing VIP Chinese Sci-tech periodical Database, Wanfang data knowledge Service platform, Chinese Biomedical Literature Database, PubMed, Embase and CochraneLibrary were searched to screen the animal experimental study on the intervention of traditional Chinese medicine for replenishing Qi and activating blood circulation on the model of varicocele. Data extraction table was made and data extract ion was carried out. SYRCLE animal experiment bias risk assessment tool was used to evaluate the risk of research methodology bias in the literature. The Meta-analysis of the outcome index was carried out with Rev Man 5.3 software. Results:A total of 15 studies were included, the subjects were SD rats or Wistar rats, all of which were randomized controlled trials. Meta-analysis showed that compared with the model group, Chinese herbs for replenishing Qi and activating blood circulation could improve sperm density [SMD=2.63, 95%CI(1.95,3.32), P<0.000 01], sperm viability [SMD=2.38, 95%CI(1.87,2.88), P<0.000 01], sperm motility [SMD=2.88, 95%CI(2.38,3.38), P<0.000 01], B lymphocyte tumor-2 gene(Bcl-2) [SMD=1.29, 95%CI(1.02,1.57), P<0.000 01], decreased apoptosis factor(Fas) [SMD=-0.90, 95%CI(-1.26,-0.54), P<0.000 01], apoptotic factor ligand(FasL) [SMD=-2.74, 95%CI(-3.55,-1.94), P<0.000 01], apoptosis index(AI)[SMD=-1.53, 95%CI(-1.88,-1.19), P<0.000 01], improved Johnson score of model animals [SMD=0.46, 95%CI(-1.35, 2.26), P=0.01]. Compared with the model group, the high-dose group(1.4-2.4 g/mL), medium dose group(1.0-1.2 g/mL) and low-dose group(0.5-0.7 g/mL) of Chinese herbs for replenishing Qi and activating blood circulation could improve sperm density, sperm viability and sperm motility, and reduce FasL content, with statistical significance(P<0.05). The middle and high dose of Chinese herbs for replenishing Qi and activating blood circulation could up regulate the expression level of Bcl-2, effectively reduce the expression level of Fas and FasL, reduce the AI, and improve Johnson score(P<0.05). Conclusion: Chinese herbs for replenishing Qi and activating blood circulation can effectively improve the sperm density, sperm viability, sperm motility and Bcl-2 expression level of varicocele rat model, reduce Fas, FasL and AI, and improve Johnson score, and there is a certain dose effect relationship. However, due to the influence of the quality and quantity of the included literatures, the above conclusions need to be further verified by relevant high-quality studies.
作者
蒋越
蒙帅杰
买鹏宇
陈露
郑翼驰
陈六
王权胜
JIANG Yue;MENG Shuai-jie;MAI Peng-yu;CHEN Lu;ZHENG Yi-chi;CHEN Liu;WANG Quan-sheng(Graduate College,Guangxi University of Chinese Medicine,Nanning Guangxi 530001,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning Guangxi 530001,China)
出处
《中医药导报》
2021年第1期156-162,共7页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金项目(No.81560774)
广西自然科学基金项目(2017JJA10462)
广西中医药大学研究生教育创新计划项目(YCSZ2020013,YCSY2020051,YCSY2020103)。
关键词
精索静脉曲张
益气活血
动物模型
大鼠
生精细胞凋亡
META分析
varicocele
replenishing Qi and activating blood circulation
animal model
rats
spermatogenic cell apoptosis
Meta-analysis
