Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins

FU Yuanjie; LI Fuhao; PENG Chenghua; XU Dong; YIN Guoan; HUANG Xiaopeng; CHANG Degui; DONG Liang

doi:10.13422/j.cnki.syfjx.20242494

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Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins

更新时间：2025-03-06

- Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins
  增强出版
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 31, Issue 7, Pages: 141-147(2025)
- 作者机构：
  
  1.成都中医药大学，成都 610075
  2.成都市龙泉驿区中医医院，成都 610100
  3.成都中医药大学附属医院，成都 610072
  4.成都中医药大学医学与生命科学学院，成都 611137
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20242494
  CLC： R259;R256.56;R698+.2
- Received：19 June 2024，
  
  Published Online：16 August 2024，
  
  Published：05 April 2025
- 稿件说明：
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付远杰,李富豪,彭成华等.补肾填精法对肾精亏虚型弱精子症患者的临床疗效及AMPK/mTORC1信号通路相关蛋白表达水平的影响[J].中国实验方剂学杂志,2025,31(07):141-147.

FU Yuanjie,LI Fuhao,PENG Chenghua,et al.Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):141-147.
付远杰,李富豪,彭成华等.补肾填精法对肾精亏虚型弱精子症患者的临床疗效及AMPK/mTORC1信号通路相关蛋白表达水平的影响[J].中国实验方剂学杂志,2025,31(07):141-147. DOI： 10.13422/j.cnki.syfjx.20242494.

FU Yuanjie,LI Fuhao,PENG Chenghua,et al.Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):141-147. DOI： 10.13422/j.cnki.syfjx.20242494.

摘要

目的

观察补肾填精法对肾精亏虚型弱精子症患者的临床疗效及腺苷酸活化蛋白激酶（AMPK）/哺乳动物雷帕霉素靶蛋白复合物1（mTORC1）信号通路的影响。

方法

选取成都中医药大学附属医院2023年2月至2024年1月符合标准的肾精亏虚型弱精子症患者72例，随机分为观察组和对照组，每组各36例。观察组口服龟鹿填精胶囊，对照组口服左卡尼汀口服溶液，两组疗程均为4周。观察治疗前后两组患者精子前向运动（PR）、精子总活力（PR+NP）、精子线粒体膜电位（MMP）正常比例、中医证候评分变化情况，并随访3个月，记录配偶受孕情况。并从符合纳入标准的观察组病例中随机抽取8例，并且纳入4例精液常规检查正常的健康男性作为对照组，采用蛋白免疫印迹法（Western blot）检测观察组治疗前后、正常精液组精子AMPK及磷酸化（p）-AMPK、mTOR调节相关蛋白（RAPTOR）及p-RAPTOR、PTEN诱导激酶1（PINK1）蛋白的表达情况。

结果

观察组配偶受孕率为9.09%（3/33）高于对照组的3.33%（1/30），但差异无统计学意义。观察组总有效率为84.8%（28/33），对照组总有效率66.7%（20/30），观察组高于对照组，但差异无统计学意义。与本组治疗前比较，两组患者PR、PR+NP、MMP、中医证候评分均显著改善（

0.01）。与对照组治疗后比较，观察组患者中医证候评分降低更为明显（

0.05），而两组PR、PR+NP、MMP改善差异均无统计学意义。与正常组比较，观察组患者AMPK、RAPTOR的磷酸化水平及PINK1蛋白水平显著上调（

0.01）。使用龟鹿填精胶囊治疗后AMPK、RAPTOR蛋白的磷酸化水平和PINK1蛋白量水平较治疗前显著下调（

01），而AMPK、RAPTOR蛋白的表达水平与治疗前差异无统计学意义。研究期间，两组患者均未出现明显的不良反应。

结论

龟鹿填精胶囊能有效提高肾精亏虚型弱精子症患者的精子活力、MMP正常比例，其机制可能与下调AMPK/mTORC1信号通路，降低PINK1蛋白水平，抑制过度激活的线粒体自噬有关。

Abstract

Objective

To observe the clinical efficacy of tonifying kidney and replenishing essence on asthenozoospermia patients with the syndrome of kidney essence deficiency and the effects of this method on the adenosine 5′-monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin complex 1 （mTORC1） signaling pathway.

Methods

Seventy-two eligible asthenozoospermia patients with the syndrome of kidney essence deficiency treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from February 2023 to January 2024 were selected and randomly assigned into an observation group and a control group， with 36 patients in each group. The observation group received oral administration of Guilu Tianjing capsules， while the control group received oral administration of L-carnitine oral solution. The treatment course lasted for 4 weeks in both groups. The observed indicators included sperm progressive motility rate （PR）， total sperm motility （PR+NP）， percentage of normal mitochondrial membrane potential （MMP）， and traditional Chinese medicine （TCM） symptom scores before and after treatment in both groups. A three-month follow-up was instituted to record the conception status of the patients’ spouses. Additionally， eight patients were randomly selected from the eligible patients in the observation group， and four healthy males with normal semen routine examination results were included as the control group for the determination of protein expression. Western blotting was conducted to assess the expression of AMPK， phosphorylated （p）-AMPK， regulatory-associated protein of mTOR （RAPTOR） and p-RAPTOR， and PTEN-induced putative kinase 1 （PINK1） in sperms from the observation group before and after treatment， as well as in the sperms of the control group.

Results

The pregnancy rate of spouses in the observation group was 9.09% （3/33）， which was higher than that （3.33%， 1/30） in the control group. The total response rate was 84.8% （28/33） in the observation group and 66.7% （20/30） in the control group， with no statistically significant difference. After treatment， both groups were improved considering PR， PR+NP， MMP， and TCM symptom scores （

0.01）. Moreover， the observation group exhibited more pronounced decreases in TCM symptom scores than the control group （

0.05）， while the changes in PR， PR+NP， and MMP showed no statistical significance between groups. Compared with the control group， the asthenozoospermia group exhibited upregulations in phosphorylation levels of AMPK and RAPTOR and protein level of PINK （

0.01）. The administration of Guilu Tianjing Capsules led to downregulations in the phosphorylation levels of AMPK and RAPTOR and protein level of PINK1 （

0.01）. However， the protein levels of AMPK and RAPTOR demonstrated no significant difference between before and after treatment. During the study period， neither group of patients exhibited any notable adverse reactions.

Conclusion

Guilu Tianjing capsules can enhance the sperm motility and percentage of normal mitochondrial membrane potential in asthenozoospermia patients with the syndrome of kidney essence deficiency by downregulating the AMPK/mTORC1 signaling pathway， lowering the protein level of PINK1， and inhibiting excessive activation of mitophagy.

关键词

Keywords

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