Purpose We aim to explore expression profiles of genes in SCDH of CPPS model rat relevant to pain and inflammation by RNA-Seq and to investigate the mechanism of anti-inflammatory and analgesic of EA. Methods Thirty-six SD male rats were randomly divided into three groups (n = 12): sham operation, model, and EA. The rat CPPS model was established by injecting CFA into the ventral lobes of the prostate. The rats in EA group were treated at Guanyuan (CV4), Zhongji (CV3), Sanyinjiao (SP6) and Huiyang (BL35) for a total of 20 times, with a frequency of 2/100Hz. Mechanical allodynia, H&E staining and ELISA were used to detect the changes of pain threshold and tissue inflammation; RNA-Seq technique was used for profiling gene changes in SCDH and qRT-PCR was used for further validation. Results Persistent mechanical allodynia and severe tissue inflammatory reaction both occurred in CPPS rats. After EA therapy, the pain sensitivity and inflammatory response of CPPS rats decreased significantly. RNA-Seq identified that a total of 46 DEGs were significantly up-regulated and 65 DEGs down-regulated after EA. GO enrichment showed that EA was mainly reflected in the regulation of the immune system by participating in the regulation of leukocyte, neutrophil cellular processes and cytokine metabolism. KEGG enrichment demonstrated that signal transduction and immune system were the most significant pathways. We further identified that the expressions of Pik3r2, Akt1, and Casp9 were significantly up-regulated and Jak2 and Stat3 down-regulated in the PI3K-AKT/JAK-STAT signal pathway. Conclusion Our study revealed that immune and inflammatory responses are the main biological events that induce chronic pelvic pain in rats, and EA can exert anti-inflammatory and analgesic effects by regulating the expression of related genes on PI3K-AKT/JAK-STAT signal pathway in SCDH. This study provided putative novel targets of EA, which may have anti-inflammatory and analgesic effects of CPPS.

目的 初步评价灵泽片联合盐酸坦索罗辛治疗良性前列腺增生症的临床疗效、安全性及有效性.方法 选择2019年12月到2021年5月就诊于北京中医药大学东方医院、北京中医药大学第三附属医院的良性前列腺增生症患者,共320例.将患者按照随机数字表法分为试验组和对照组,每组160例.试验组口服灵泽片和盐酸坦索罗辛缓释胶囊,对照组仅口服盐酸坦索罗辛缓释胶囊.疗程均为12周.以国际前列腺症状评分表(iPSS)、生活质量评分(QOL)、中医证候积分为主要疗效评价指标;观察并比较两组治疗前后前列腺增生症患者的评分情况.结果 共307例患者完成随访,治疗前后两组IPSS评分、QOL评分、膀胱残余尿量、最大尿流率差异有统计学意义(P＜ 0.05),且试验组评分降低更显著(P＜ 0.05);与治疗前比,试验组及对照组中医证候积分均降低,有统计学差异(P＜0.05);治疗12周后,试验组总有效率为85.71％(132/154),对照组总有效率为73.21％(112/153).结论 灵泽片联合盐酸坦索罗辛胶囊治疗BPH有效,下尿路症状、生活质量、膀胱残余尿量、最大尿流率及中医证候积分得到改善,可以作为治疗BPH的一种选择.

提要对于泌尿系结石,现代医家多采用手术及中药治疗,虽然治疗效果明确,但容易复发是困扰众多医家的难题.中医理论认为泌尿系结石的生成以脾肾阳虚为本,可用"阳化气,阴成形"理论阐释发病机理,"阳化气"不足导致精血津液无法正常生成及运行;痰浊、水饮、瘀血等病理产物为标,精血精微生成异常化生痰浊,运行不畅化生水饮瘀血,造成"阴成形"太过的局面.治疗上当扶阳化气为主,同时兼顾化痰活血通淋之法,以期提高临床疗效的同时,避免泌尿系结石的反复发作.

OBJECTIVE:To investigate the mechanism of Xianfang Huoming Decoction (XHD) improving sperm motility in mice with asthenospermia (AS).METHODS:Thirty normal BALB/c mice were randomly divided into six groups, blank control, AS model control, low-dose XHD, medium-dose XHD, high-dose XHD and levocarnitine + vitamin E (LC+VE). The AS model was established in the latter five groups by injection of methotrexate at 0.5 mg/kg once a week, and the mice in the blank control group were injected with the same volume of normal saline, all for 8 weeks. From the ninth week, the animals in the blank control and AS model control groups were treated with PBS at 0.1 ml/d, those in the low-, medium- and high-dose XHD groups with XHD at 7.13, 14,2 and 28.52 g/kg/ d respectively, and those in the LC+VE group with LC+VE (30:1) at 0.55 g/kg/d, all for 4 weeks. Then, the bilateral epididymides were harvested from all the mice for preparation of a sperm suspension and observation of the total numbers of sperm and motile sperm. The testis tissues were obtained for to determination of the expressions of Nrf-2- and HO-1-related mRNA and proteins by fluorescence staining, RT-PCR and Western blot.RESULTS:Compared with the AS model controls, the mice treated with low-, medium- and high-dose XHD showed dramatically increased sperm concentration (［22.36 ± 16.02］ vs ［39.04 ± 4.50］, ［40.76 ± 6.57］ and ［41.04 ± 8.39］ ×10⁶/ml, P < 0.01) and motility (［22.89 ± 14.96］% vs ［47.98 ± 4.74］%, ［48.53 ± 6.03］% and ［49.31 ± 6.24］%, P< 0.01), decreased level of reactive oxygen species (ROS) (［16.82 ± 14.96］% vs ［12.08 ± 3.26］%, ［10.77 ± 2.21］% and ［9.56 ± 2.08］%, P< 0.01), and up-regulated expressions of Nrf-2- and HO-1-related mRNA and proteins in the testis tissue (P < 0.05 or P < 0.01).CONCLUSION:Xianfang Huoming Decoction inhibits the development of oxidative stress by up-regulating the expressions of Nrf-2- and HO-1-related mRNA and proteins in the testis tissue, which has provided theoretical evidence for its clinical application in the treatment of asthenospermia.

目的:探讨二仙解毒方对弱精子症模型大鼠精子微环境的改善作用及可能机制.方法:使用奥硝唑法构建SPF级SD远交成熟雄性大鼠弱精子症模型,将成功建模的60只体重200～250g大鼠随机分为模型组、二仙解毒方低剂量组、二仙解毒方中剂量组、二仙解毒方高剂量组、左卡尼汀组,每组各12只.模型组:生理盐水10ml/kg体重灌胃;二仙解毒方低剂量组:予二仙解毒方浓缩液,按7.5g生药/kg体重灌胃;二仙解毒方中剂量组:予二仙解毒方浓缩液,按15g生药/kg体重灌胃;二仙解毒方高剂量给药组:予二仙解毒方浓缩液,按30g生药/kg体重灌胃;左卡尼汀对照组:予左卡尼汀口服液0.1g/kg体重灌胃,每日1次,连续灌胃4周后,检测各组大鼠精子浓度、精子活动力、相关氧化应激指标、大鼠睾丸及附睾中DJ-1蛋白表达及mRNA表达.结果:与正常组相比,模型组大鼠精子活动力显著降低(P＜0.01);与模型组相比,各组精子活动力测定-前向运动精子(PR)和前向+非前向运动(NP)精子百分率均高于模型组,差异有统计学意义(P＜0.01).与模型组相比,各组SOD、GSH-Px含量显著升高(P＜0.01),MDA含量显著降低(P＜0.01),且剂量越高,氧化应激指标改变越显著.与模型组相比,附睾组织二仙解毒方低、中、高剂量组D J-1蛋白表达升高(P＜0.05),左卡尼汀组DJ-1蛋白表达无统计学差异(P＞0.05);睾丸组织中,二仙解毒方低、中、高剂量组DJ-1蛋白表达升高(P＜0.05,P＜0.01),左卡尼汀组DJ-1蛋白表达无统计学差异(P＞0.05);与模型组相比,附睾组织中各组DJ-1 mRNA表达显著升高(P＜0.01),睾丸组织中各组DJ-1 mRNA表达升高,差异有统计学意义(P＜0.05,P＜0.01).结论:二仙解毒方治疗弱精子症大鼠有较好疗效,可以通过诱导生殖细胞内D J-1蛋白和mRNA表达上调,来改善弱精子症大鼠精液氧化应激状态,提高精子活动力.

目的:探讨中药灌肠对直肠癌术后吻合口瘘的治疗效果.方法:选取直肠癌术后吻合口瘘患者116例,随机分成试验组和对照组.试验组给予中药灌肠治疗,对照组给予常规甘油灌肠剂.结果:试验组对直肠癌术后吻合口瘘的治疗效果明显高于对照组,对吻合口瘘出现后避免二次造瘘转流术手术(P<0.01)、减轻排尿障碍、降低肛周脓肿发生率都具有重要的临床意义,通过Logistics多因素回归分析发现淋巴结转移和术前合并肠梗阻是直肠癌术后吻合口瘘的二次手术的独立预测因子.结论:中药灌肠对直肠癌术后吻合口瘘疗效显著,值得临床推广.

君火即心火,可主持神明以协调各脏运行;相火寄于肝肾,在肝为雷,在肾为龙,为推动人体内部运动的基础之火、动力来源,运行周身以平秘阴阳,与君火共同保持人体内在机理稳定.慢性前列腺炎发病的重要机理是"君不惟神,相不惟力".君不惟神则君火亢盛;相不惟力则相火妄动.治疗慢性前列腺炎时,若属君火旺盛导致者,以清为主,可选黄连清心饮、导赤散为主方;若属相火妄动导致者,以补为主,可以柴胡类方为主方.

目的 基于Nrf2信号通路研究二仙解毒方对弱精子症模型大鼠精子微环境的改善作用及可能机制.方法 使用奥硝唑法构建成熟雄性大鼠弱精子症模型,随机分为模型组、二仙解毒方低剂量组、中剂量组、高剂量组、左卡尼汀组,每组各12只,连续灌胃4周后,检测各组大鼠精子浓度、精子活动力、相关氧化应激指标、大鼠睾丸及附睾中基于Nrf2蛋白表达及mRNA表达.结果 二仙解毒方可增强弱精子症模型大鼠精子活动力,剂量越高,氧化应激指标改变越显著,二仙解毒方高剂量组可将模型组大鼠的精液抗氧化能力恢复至正常大鼠水平;二仙解毒方可促进大鼠附睾、睾丸组织Nrf2基因转录与蛋白表达.结论 二仙解毒方确有提高精子活动力的作用,其可能的作用机制为通过诱导上调生殖细胞内Nrf2 mRNA和蛋白表达,以改善弱精子症大鼠精液氧化应激状态,从而提高精子活动力.

中医认为肝郁、血瘀、肾虚是阳痿发病的三大主要病机,多从肝、肾方面论治阳痿.又以肝阴虚、肝血虚为多,而易于忽略肝阳虚之证候.本文基于肝之生理病理特性,提出肝阳乃维系男子性功能的重要生理基础,肝阳虚是导致阳痿的重要病机之一.肝阳虚所致阳痿的治疗要以温补肝阳为主,注重平调寒热、权衡阴阳,以恢复肝阳之舒达、敷和之性,打破了以"补肾疏肝"为主治疗阳痿的传统方法.乌梅丸酸苦辛并进,为肝阳虚之主方,也是治疗肝阳虚型阳痿的重要方剂.乌梅丸治疗阳痿患者多有寒热错杂、脉弦按之减、易成瘀血等临床表现,临证根据阴阳虚实及寒热轻重,调整酸苦辛甘四味比重,配合临床症状加减用药,使肝阳得以升发舒启,兼清相火虚热,为临床肝阳虚所致阳痿的辨证施治提供新思路.

目的:观察腹部深刺法治疗Ⅲ型前列腺炎(气滞血瘀证)的临床疗效.方法:将60例Ⅲ型前列腺炎(气滞血瘀证)患者随机分为试验组30例和对照组30例.试验组脱落2例,剩余28例;对照组脱落2例,剩余28例.试验组采用腹部深刺疗法,腹部深刺取中极、关元、气海、四满、横骨、水道、归来和冲门(1次/d,3次/周,共6周);对照组口服盐酸坦索罗辛缓释胶囊治疗(1次/d,共6周).6周后观察两组治疗前后患者国际前列腺炎症状(NIH-CPSI)评分、中医症状评分及临床有效率.结果:两组患者治疗后NIH-CPSI及中医症状评分均较治疗前均降低,差异有统计学意义(P＜0.01),且两组患者治疗后上述指标组间比较,差异有统计学意义(P＜0.01);治疗后试验组总有效率为82.14％ (23/28),高于对照组的64.29％(18/28),差异有统计学意义(P＜0.01).结论:腹部深刺法治疗Ⅲ型前列腺炎(气滞血瘀证)疗效显著,可明显降低患者的NIH-CPSI及中医症状评分,疗效优于盐酸坦索罗辛缓释胶囊.

癫痫是一种严重威胁人类健康的神经系统疾病,临床表现为阵发性、暂时性惊厥发作,伴意识、感觉及情感等方面短暂异常.秦国政教授认为癫痫发作与先天因素、骤受惊恐、脑部外伤等有一定关系,主要病位在脑,与心、脾胃、肝、肾关系密切,病机责之于气血瘀阻引起脑络损伤、脾胃虚损致使清阳不升、血虚生风导致肝风内动,基本治法为活血开窍、益气升阳、养血柔肝,采用通窍活血汤合益气聪明汤加小红参为基础方,根据患者实际情况随症加减,临床疗效显著,值得进一步推广应用.

近年来男科疾病的发病率呈现明显增长趋势,而传统的中医学在男科领域未形成完善的理论体系,虽然男科病种相对较少,但机制复杂,因此需要提高和改进男科疾病的临床疗效,以满足患者就诊的需求.为此,中华中医药学会组织中西医男科专家一起进行探讨,邀请中西医临床一线的青年优秀专家,共同针对男科疾病领域探讨中医及中西医结合治疗的临床优势病种,如慢性前列腺炎、男性不育症、良性前列腺增生、勃起功能障碍、早泄等,明确西医诊断,规范中医临床辨证诊疗,制定出中医西医公认的、融合的诊疗方案,提供优势病种的中西医治疗建议,中医哪些疾病有优势,哪些病程有优势,何时适合中医治疗,何时该采用西医治疗、手术治疗等问题,形成专家共识,同时也为中医临床提供参考依据,充分发挥中医药优势,提高男科疾病的诊疗效果,给患者提供精准的、个性化的和最优化的治疗方案,同时把中医的优势发挥淋漓尽致,这样中医也才能立得住,才能创新,才能发展.

[目的]探讨中药坐浴联合坦洛新及前列腺按摩对于Ⅲb型前列腺炎(CP)的临床疗效.[方法]选择2018年10月至2019年5月本院泌尿外科门诊收治的70例Ⅲb型CP患者,根据随机数表法将其分为观察组(中药坐浴联合口服坦洛新,并给予经直肠前列腺按摩治疗)和对照组(温水坐浴联合口服坦洛新,并给予经直肠前列腺按摩治疗),每组各35例.统计两组患者治疗后慢性前列腺炎症状评分(NIH-CPSI)、中医辨证积分改善情况,并比较治疗后两组患者的卵磷脂小体(SPL)计数转为正常比率以及临床医治有效率.[结果]观察组临床疗效有效率为88.6％(31/35),高于对照组的68.6％(24/35),差异有统计学意义(P<0.05).治疗后两组患者NIH-CPSI生活质量评分及其总评分均较治疗前改善,且观察组优于对照组,差异有统计学意义(P<0.05).治疗后两组中医辨证积分均下降,观察组低于对照组,差异有统计学意义(P<0.05).治疗后,观察组前列腺液(ESP)中SPL计数恢复正常25例(71.4％),对照组恢复正常16例(45.7％),差异有统计学意义(P<0.05).治疗3个月后进行随访,观察组复发率为9.4％(3/32),低于对照组的20.8％(5/24),差异有统计学意义(P<0.05).[结论]中药坐浴联合坦洛新、前列腺按摩对于Ⅲb型CP患者(湿热瘀滞证),可较好地改善患者的生活质量,具有临床效果显著,并副作用轻微,安全性高等优点,值得临床借鉴.

扶正托毒理论是中医外科疾病治疗中的重要理论,也是外科疮疡中、后期的主要治法治则.秦国政教授认为慢性前列腺炎和外科疮疡在病因病机及临床表现上具有相似性,将慢性前列腺炎视为内痈发病中后期,并以此为切入点,把握慢性前列腺炎患者往往以正气不足为本、热毒偏盛为标,基于中医扶正托毒的理论思想,运用验方秦氏四妙散治疗慢性前列腺炎,重视辨证论治,标本兼顾,综合施治,取得较好的疗效,为临床防治该疾病提供了新的思路.

ED与高血压经常伴随发生,高血压患者ED发病率远高于正常血压人群.现代中医家比较统一的认识是,勃起功能障碍的病机关键在于本虚标实,并都较为重视脾肾亏虚、肝郁血瘀的相关学说;高血压病机本质上也是本虚标实,虚在脏腑,实在痰瘀.而西医有关研究显示,ED的严重程度与全身性血管功能障碍程度呈正相关关系,其中,心血管/代谢性疾病(CVMD),例如高血压、冠心病、糖尿病和周围血管疾病,与ED的关系最为密切.本文基于系统生物学阐述了NO信号受损、氧化应激和血管内皮功能障碍是阴茎和全身性血管病变的关键机制,认为中、西医对于ED的病因病机都有广泛深入的研究和阐述,并且二者之间存在很强的契合度、共通性和互补性.

目的:探讨超声对主动脉夹层(AD)患者的动脉弹性的应用价值.方法:回顾性分析,抽取2018年1月-2020年1月我院收治的30例AD患者,将其纳入主动脉夹层组,抽取同期性别、年龄与其相匹配的既往无心血管病史的成年人,将其纳入正常成人组.记录两组动脉弹性参数及心肌功能指标、生存质量.结果:正常组动脉内中膜厚度、主动脉僵硬度均低于主动脉夹层组,正常组左心室舒张末期左心房平均峰值应变率(mSRa)、左心室收缩期左心房平均峰值应变率(mSRs)均高于主动脉夹层组,差异有统计学意义(P＜0.05);动脉内中膜厚度与mSRs水平呈负相关(r＜0,P＜0.05),动脉内中膜厚度与主动脉僵硬度(AoSI)呈正相关(r＞0,P＜0.05);AD组患者术后3个月、6个月、12个月的AoSI水平对比,差异无统计学意义(P＞0.05);而mSRa、mSRs、动脉内中膜厚度水平对比,差异有统计学意义(P＜0.05);AD组患者术后6个月的生命质量评价量表(SF-36)评分较术前高;SF-36评分与mSRa、mSRs呈正相关(r＞0,P＜0.05).结论:超声通过斑点追踪技术,可分析AD患者早期心肌损伤、术后改变情况,可及时了解患者心肌功能、动脉弹性的变化情况,利于后续治疗,以提高患者生存质量,改善健康状况.

贾玉森教授提出生殖轴(肾及肾子、精室、精窍)、肝、脾胃、经络气血共同参与构成人体生殖环节的学术观点,并以此指导男性不育症的诊疗,取得疗效.推崇明代岳甫嘉的“生子专责在肾”“种子兼顾脾胃…“求嗣之道,贵在养精”及“毓麟用药,贵乎温和”等观点.在辨治不育症方面,精索静脉曲张性不育采用补益、活血、祛湿化瘀法治疗;免疫性不育采用滋补肾阴、活血化瘀、清解或清利法治疗;感染性不育,初期采用解毒利湿、活血泄浊法治疗,后期加用补肾益精药物;特发性不育以补肾生精及调和肝脾为主;精液不液化围绕“肾虚有湿”核心病机治疗.贾玉森教授认为补肾法应贯穿治疗不育症的全过程,临床上辨病与辨证相结合,治疗以补肾为主线,根据辨证辅以活血化瘀、清热解毒、利湿泄浊等治法,达到阴阳合(精卵)而受孕生子.

目的:观察盆底肌功能训练联合艾灸关元穴治疗女性压力性尿失禁的临床疗效。方法:选取2017年3月至2018年3月北京中医药大学第三附属医院收治的女性压力性尿失禁患者60例作为研究对象,按照随机数字表法分为A、B、C 3组,每组20例。A组采用盆底肌功能训练,B组采用艾灸关元穴,C组采用盆底肌功能训练联合艾灸关元穴。评价3组患者治疗前、治疗8周后国际尿失禁咨询委员会尿失禁问卷简表（ICI-Q-SF）评分、盆底肌肌力的变化,评价3组患者治疗后临床疗效,同时随访6个月后3组患者ICI-Q-SF评分、盆底肌肌力、临床疗效,观察盆底肌功能训练联合艾灸关元穴对女性压力性尿失禁疗效的影响。结果:治疗前3组患者ICI-Q-SF评分、盆底肌肌力差异均无统计学意义（P＞0.05）,治疗后3组患者ICI-Q-SF评分均有所下降（P＜0.05）,盆底肌肌力均有所提高,并且C组效果明显高于A、B组（P＜0.05）,6个月后随访ICI-Q-SF评分、盆底肌肌力、临床疗效C组效果明显高于A、B组（P＜0.05）。结论:盆底肌功能训练联合艾灸关元穴是治疗女性压力性尿失禁的有效方法,值得临床推广。

Objective:To investigate the clinical efficacy of erectile dysfunction treated by press-needling BL31-BL34 combined with Sildenafil. Methods:70 patients were randomly divided into the control group (n = 35) and the treatment group(n =35). The control group was given Sildenafil, 12. 5 mg every other day, and 25 mg plus 1h before sexual intercourse; on which basis, the treatment group was also treated with pressneedling BL31-BL34, the treatment was once every other day for three courses, with the press-needle remained 24 h each time, 6 days was taken as one course. The score of erectile function(IIEF-5) and clinical symptoms were evaluated, and the clinical efficacy was compared between the two groups. Results:In terms of score of IIEF-5, the total effective rate was 88. 57％ in the treatment group and 80％ in the control group. In terms of score of clinical symptoms, the total effective rate was 91. 43％ in the treatment group and 77. 14％ in the control group. It showed ascending trend in IIEF-5 and descending trend in clinical symptoms in the both groups after the treatment, and the treatment group was superior to the control group (P＜0. 05, P ＜ 0. 01). Conclusion:Both therapies have therapeutic effects on erectile dysfunction, and the therapy of press-needling BL31-BL34 combined with Sildenafil was better than simple Sildenafil therapy.

OBJECTIVE:To explore the features of Traditional Chinese Medicine (TCM) syndromes in male infertility using computer-based analyses.METHODS:Latent class analysis was used to analyze the TCM syndrome data from 813 patients with male infertility and establish a latent tree model.RESULTS:A latent tree model with a Bayesian information criterion score of -11 263 was created. This model revealed that the characteristics of basic TCM syndromes in patients with male infertility were kidney Yang deficiency, kidney Qi deficiency, spleen Yang deficiency, liver Qi stagnation, Qi stagnation and blood stasis, and dump-heat; moreover, most patients with male infertility had complex syndromes (spleen-kidney Yang deficiency and liver Qi stagnation) rather than simple single syndromes.CONCLUSION:The hidden tree model analysis revealed the objective and quantitative complex relationships between the TCM symptoms of male infertility, and obtained the quantification and objective evidence of TCM syndromes in male infertility.