Clinico-basic And Experimental Study Of Neuroendocrine Changes In Impotence Disease With Abnormal Phlegmatic Syndrome

Objective:(1) To investigate the hormonal changes of neuroendocrine regulatory network in impotent patients with abnormal phlegmatic syndrome by studying the hormonal changes of gonadal axis, adrenal axis and thyroid axis(2) To explore role of HTP axis in impotent rats with abnormal phlegmatic syndrome by studying the hormonal and morphological changes of HTP axis and Yimusakepian’s effect on their HPT axis. Methods:(1) A total of 112 impotent male patients were collected and divided into impotence group with abnormal phlegmatic syndrome(A), impotence group without abnormal phlegmatic syndrome(B), 28 healthy males were collected to be the normal control group(N), clinicopathological parameters were recorded and hormones of gonadal axis, adrenal axis and thyroid axis were detected.(2)10 rats were randomly selected among 70 mature male SD rats for control group and the rest were for model group. After establishing the abnormal phlegmatic syndrome rat model, impotent rats which were screened by APO erectile experiment and mating experiment randomly divided into impotent model group(A1) and treatment group(A3), the rest were randomly devided into abnormal phlegmatic syndrome group(B1) and treatment group(B3). After two weeks of treatment with Yimusakepian, serum hormones of thyroid axis were detected. Hypothalamus, pituitary gland and thyroid gland were extracted and their morphological traits were studied. Results:(1) Changes in clinicopathologic parameters: Compared to group N,IIEF-5 and MSF-4 scores, BMI, waist circumference,systolic pressure and diastolic pressure are significantly higher in group A(P<0.05). Compared to group B, body weight, BMI, waist circumference are significantly higher and pulse rate is significantly lower in group A(P<0.05)(1) Clinical hormonal changes of gonadal axis:Compared to group N, serum T levels were significantly decreased and serum E2, PRL, LH, FSH levels were significantly increased in group A(P<0.05).(3) Clinical hormonal changes of adrenal axis:Compared to group N, COR levels were significantly increased in group A(P<0.05).(4) Clinical hormonal changes of thyroid axis: Compared to group B, FT3 levels in group A was significantly decreased(P<0.05).(4)Hormonal changes of thyroid axis in rat model: Compared to group N, FT4,TT4 levels in group B1 and FT3, FT4, TT3, TT4 levels in group A1 were significantly decreased(P<0.05). Compared to group B1, FT3 and FT4 levels were significantly increased in group B3(P<0.05), TT3 and TT4 were elevated in group B3 but not significcuntly(P>0.05). Compared to group A1, FT3, FT4, TT3, TT4 levels were elevated in group A3, but not significcuntly(P>0.05).(5) Morphological changes of the HPT axis in rat model: Hypothalamus, tissue structures and cell morphology in group N were intact. Microscopic view indicates, matrix was loosen; ultrastructure indicates, mitochondrial matrix density was decreased and rough ER was dilated in group B1 and A1.Tissue structures and cell morphology were restored to a certain level in group B3 and A3. Pituitary gland, tissue structures and cell morphology of pituitary gland in group N were intact. Microscopic view indicates, matrix was loosen and a slight edema occurred; ultrastructure indicates, ER is dilated, mitochondria is vacuolated and deformed in group B1 and A1. Tissue structures and cell morphology were restored to a certain level in group B3 and A3.Thyroid gland, tissue structures and cell morphology of thyroid gland in group N are intact. Microscopic view indicates, an endemic change occurred in thyroid follicular mesenchymal cells and follicular mesenchymal cells were in cubic shape; ultrastructure indicates ER is dilated in group B1 and A1. Tissue structures and cell morphology were restored to a certain level in group B3 and A3. Conclusion:(1) BMI and waiste circumfrance highly relate to the occurance and development of impotence disease with abnormal phlegmatic syndrome and can be an impotence disease with abnormal phlegmatic syndrome-specific paremeters.(2) A neuroendocrine disruption cuased by the functional changes of ‘HPG axis, HPA axis and HPT axis’ might be crucial to the occurance and development of impotence disease with abnormal phlegmatic syndrome in Uyghur medicine.(3) The morphological changes of HPT axis in might be respobsible for its hormonal disruption.(4) Yimusakepian‘s effect on impotent rats with abnormal phlegmatic syndrome might be achieved by restoring the hormonal morphological changes of HPT axis.