本文選題：男性更年期綜合征　切入點(diǎn)：HGF/c-Met　出處：《湖南中醫(yī)藥大學(xué)》2015年博士論文　論文類型：學(xué)位論文

【摘要】：[目的]1.了解長(zhǎng)沙地區(qū)城鎮(zhèn)男性居民的血清性激素隨增齡變化規(guī)律,以及男性更年期綜合征患病率；2.初步驗(yàn)證“HGF是乙癸同源物質(zhì)基礎(chǔ)”假說(shuō)；3.探討“腎肝同治法”干預(yù)男性更年期綜合征的可能機(jī)制。 [方法]1.采用調(diào)查問卷形式,結(jié)合生化指標(biāo)及性激素水平測(cè)定,logistic回歸分析相關(guān)危險(xiǎn)因素、保護(hù)因素；2.構(gòu)建睪丸間質(zhì)細(xì)胞-肝臟非實(shí)質(zhì)細(xì)胞共培養(yǎng)體系,分別以含藥血漿(雄蠶益腎疏肝方、金匱腎氣丸、逍遙散)稀釋0倍、4倍、8倍、16倍后干預(yù),觀察上清液中HGF.T含量,細(xì)胞中HGF.c-Met.caspase一3等指標(biāo)；3.復(fù)制男性更年期綜合征大鼠模型,隨機(jī)分模型組、丙酸睪酮組、金匱組、逍遙組、雄蠶組,設(shè)立正常對(duì)照組,連續(xù)用藥4周后,觀察大鼠血清T.HGF,睪丸組織T合成酶(StAR.P450scc.3β-HSD)、HGF/c-Met.caspase一3等指標(biāo),HE染色觀察睪丸組織形態(tài)學(xué)變化,電鏡觀察睪丸間質(zhì)細(xì)胞超微結(jié)構(gòu)。 [結(jié)果]1.長(zhǎng)沙地區(qū)城鎮(zhèn)男性居民血清TT.FT.Bio-T.FTI.SHBG水平,均隨增齡出現(xiàn)梯度性變化,其中TT.FT.Bio-T.FTI與年齡、SG呈負(fù)相關(guān)；男性更年期綜合征自我評(píng)定量表篩查陽(yáng)性率為37.29%,男性更年期綜合征臨床總患病率為10.85%；年齡、體重指數(shù)、高血壓病史、吸煙是男性更年期綜合征發(fā)病的危險(xiǎn)因素,每周有規(guī)律鍛煉是其保護(hù)性因素。2.HGF/c-Met信號(hào)通路可能參與介導(dǎo)了睪丸間質(zhì)細(xì)胞-肝臟非實(shí)質(zhì)細(xì)胞共培養(yǎng)中睪丸間質(zhì)細(xì)胞T分泌；雄蠶益腎疏肝方、金匱腎氣丸、逍遙散含藥血漿均能通過(guò)HGF/c-Met信號(hào)通路影響睪丸間質(zhì)細(xì)胞T分泌,以雄蠶益腎疏肝方作用最強(qiáng)。3.男性更年期綜合征大鼠模型睪丸間質(zhì)細(xì)胞T合成能力下降,可能與以下機(jī)制有關(guān)：T合成酶(StAR.P450scc.3β-HSD)表達(dá)下調(diào)、HGF/c-Met表達(dá)下調(diào)、caspase一3表達(dá)上調(diào),睪丸間質(zhì)細(xì)胞凋亡增加；雄蠶益腎疏肝方、金匱腎氣丸、逍遙散均能通過(guò)干預(yù)以上機(jī)制,增加T合成能力,其中以雄蠶益腎疏肝方作用最強(qiáng),金匱腎氣丸偏重于影響T合成酶活性,逍遙散偏重于影響HGF/c-Met信號(hào)通路 [結(jié)論]1.隨著年齡增長(zhǎng),長(zhǎng)沙地區(qū)城鎮(zhèn)男性居民TT.FT.Bio-T水平下降,男性更年期綜合征發(fā)病率較高,有規(guī)律的運(yùn)動(dòng)可有效預(yù)防。2.HGF/c-Met可能是聯(lián)系中醫(yī)肝、腎的關(guān)鍵物質(zhì)基礎(chǔ)。3.對(duì)男性更年期綜合征的中醫(yī)治療,腎肝同治法優(yōu)于單純補(bǔ)腎法、疏肝法。
[Abstract]:[objective] 1. To understand the changes of serum sex hormones with age in urban male residents in Changsha area. And the prevalence rate of male climacteric syndrome 2.The hypothesis that "HGF is the homologous material basis of Edeca" was preliminarily verified. 3. To explore the possible mechanism of intervention of "kidney and liver simultaneous treatment" in male climacteric syndrome. [methods] 1. The risk factors were analyzed by logistic regression analysis in combination with biochemical indexes and sex hormone levels. 2. The co-culture system of testicular interstitial cells and liver non-parenchymal cells was constructed. Plasma containing medicine (male silkworm tonifying kidney and dispersing liver prescription, Jinkui Shenqi pills, Xiaoyao San) was used to dilute 0 times, 4 times, 8 times and 16 times, respectively, to observe the content of HGF.T in supernatant and HGF.c-Met.caspase-3 in cells. The male climacteric syndrome rat model was established. Model group, testosterone propionate group, Jinkui group, free group, male silkworm group were set up as normal control group. After 4 weeks of continuous administration, serum T. HGF, testicular tissue T synthase StAR.P450scc.3 尾 -HSDFc-Met.caspase-3 were stained to observe the morphological changes of testis. The ultrastructure of interstitial cells in testis was observed by electron microscope. [results] 1. The serum TT.FT.Bio-T.FTI.SHBG levels of urban male residents in Changsha area showed gradient changes with age, in which TT.FT.Bio-T.FTI was negatively correlated with age and SG; The positive rate of male climacteric syndrome self-rating scale was 37.29. The total clinical prevalence of male climacteric syndrome was 10.85. Age, body mass index, hypertension history, smoking were the risk factors of male menopausal syndrome. Weekly regular exercise is its protective factor. 2. HGF / c-Met signaling pathway may be involved in mediating T secretion of testicular interstitial cells in co-culture of non-parenchymal cells of the testis, male silkworm Yishen Shugan prescription, Jinkui Shenqi Pill, The plasma of Xiaoyao Powder can affect the T secretion of interstitial cells of testis through HGF/c-Met signal pathway, and the male silkworm Yishen Shugan recipe has the strongest effect. 3. The T synthesis ability of testis interstitial cells in male climacteric syndrome rats is decreased. It may be related to the following mechanisms: the down-regulation of T: synthase StAR.P450scc.3 尾 -HSD-expression and down-regulation of the expression of HGFc-Met up-regulate the expression of caspase-3 and increase the apoptosis of testicular interstitial cells; the male silkworm Yishen Shugan prescription, Jinguishen Qi Pill and Xiaoyao Powder can all intervene through the above mechanisms. Increase the ability of T synthesis, in which male silkworm Yishen Shugan prescription has the strongest effect, Jingui Shenqi Pill focuses on the influence of T synthase activity, and Xiaoyao Powder focuses on affecting HGF/c-Met signal pathway. [conclusion] 1. With the increase of age, the level of TT.FT.Bio-T in urban male residents in Changsha area decreased, and the incidence of male climacteric syndrome was higher. The regular exercise can effectively prevent. 2. HGF / c-Met may be associated with traditional Chinese medicine liver. The treatment of male climacteric syndrome by traditional Chinese medicine is superior to the simple method of tonifying the kidney and soothing the liver.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2015
【分類號(hào)】：R697.22

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本文編號(hào)：1633737