摘要
精索静脉曲张性不育症(VCI)是临床常见的男科疾病,氧化应激是精索静脉曲张致男性不育的主要机制。中药治疗具有多靶点、多成分、多系统、多途径的作用特点,在VCI治疗领域取得了较好的效果。本文对VCI的氧化应激机制及相关信号通路进行总结,并通过综述中药单体、活性部位、中药复方及相关制剂调控上述信号通路干预氧化应激进而改善VCI的研究现状发现,核转录因子红系2相关因子2(Nrf2)、促分裂原活化的蛋白激酶(MAPK)、缺氧诱导因子1α(HIF-1α)信号通路与VCI的发生发展密切相关;中药单体及活性部位(菟丝子黄酮、黄芪多糖、淫羊藿苷、姜黄素、人参皂苷Rg1、金丝桃苷、松果菊苷)、中药复方及相关制剂(加味大黄䗪虫颗粒、生精活血方、加味天雄散、通精灵、补肾活血方、脉络舒通丸、滋肾育胎丸、丹红通精方)可通过激活Nrf2信号通路和抑制MAPK、HIF-1α信号通路来缓解氧化应激、减轻脂质过氧化损伤、改善线粒体能障碍、减少精子DNA断裂、抑制细胞凋亡,从而改善生育能力。
Varicocele-induced infertility(VCI)is a common andrological disease in clinical practice.Oxidative stress represents the primary mechanism through which varicocele causes male infertility.Traditional Chinese medicine(TCM)treatment,characterized by its multi-target,multi-component,multi-system,and multi-pathway actions,has achieved favorable outcomes in the field of VCI treatment.This paper summarizes the underlying oxidative stress mechanism of VCI and the relevant signaling pathways involved.By reviewing the current research status on how monomers,active fractions,compound formulas,and related preparations of TCM can intervene in oxidative stress through the regulation of these signaling pathways to improve VCI,it is found that the nuclear factor-erythroid 2-related factor 2(Nrf2)signaling pathway,the mitogen-activated protein kinase(MAPK)signaling pathway,and the hypoxia-inducible factor-1α(HIF-1α)signaling pathway are closely related to the development of VCI.TCM monomers and active fractions(flavonoids from Cuscutae Semen,polysaccharides from Astragali Radix,curcumin,ginsenoside Rg1,hyperin and echinacoside),as well as compound formulas and related preparations of TCM(modified Dahuang zhechong granules,Shengjing huoxue formula,modified Tianxiong san,Tongjingling,Bushen huoxue formula,Mailuoshutong pill,Zishen yutai pill,Danhong tongjing formula)can alleviate oxidative stress,reduce lipid peroxidation damage,improve mitochondrial dysfunction,decrease sperm DNA fragmentation,and inhibit apoptosis by activating the Nrf2 signaling pathways and inhibiting the MAPK and HIF-1αsignaling pathways,thereby improving reproductive function.
作者
李胜男
陈洪延
陈腾飞
高博贤
仲崇副
LI Shengnan;CHEN Hongyan;CHEN Tengfei;GAO Boxian;ZHONG Chongfu(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Dept.of Urology,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Dept.of Andrology,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)
出处
《中国药房》
北大核心
2025年第12期1536-1541,共6页
China Pharmacy
基金
国家自然科学基金面上项目(No.82374455)。
关键词
精索静脉曲张
不育
中药单体
中药活性部位
中药复方
氧化应激
varicocele
infertility
traditional Chinese medicine monomer
traditional Chinese medicine active fraction
traditional Chinese medicine compound formula
oxidative stress
