基于“标本兼治”理论从外泌体途径研究知柏地黄丸干预UU感染性不育症的分子机制

男性不育影响人类健康与繁衍，生殖系统感染是男性不育的重要因素之一，解脲脲原体（UU）感染性不育基本病机为肾阴亏虚、湿热瘀滞，其中肾阴亏虚为“本”，湿热瘀滞为“标”，精子数量及活力下降是其主要表现。基于“标本兼治”理论，我们提出知柏地黄丸治疗UU感染性不育是以恢复精子数量及活力为“治本”，抑制UU的生长、繁殖以“治标”。据此，本项目以支持细胞分泌的外泌体为突破口，研究UU感染性不育（少弱精子症）与支持细胞介导外泌体途径修复生精细胞信息通讯的相关性。同时以知柏地黄丸为施加因素，以UU感染动物及细胞模型为受试对象，运用电镜、流式细胞术、W-B和RT-PCR等技术，研究知柏地黄丸提高UU感染大鼠精子数量及活力是否通过调控支持细胞外泌体，修复生精细胞的信息通讯，进而提高精子数量及活力。本研究将从全新角度阐释和丰富“标本兼治”理论内涵，并为确立“标本兼治”的UU感性不育症中医药治疗策略提供依据。

Male infertility affects human health and reproduction, and reproductive system infection is one of the important factors of male infertility. The basic pathogenesis of infectious infertility caused by ureaplasma urealyticum (UU) is deficiency of kidney Yin, dampness-heat stasis, in which deficiency of kidney Yin is the "origin", dampness-heat stasis is the "standard", and the decrease of sperm quantity and vitality is the main manifestation. Based on the theory of "treating both symptoms and root causes", we put forward that Zhibai Dihuang Pill in the treatment of UU infectious infertility is to "treat the root cause" by restoring the sperm quantity and vitality, and "treat the symptoms" by inhibiting the growth and reproduction of UU. In view of this, this study takes exosomes secreted by supporting cells as a breakthrough point to try to elaborate the correlation between UU infection infertility (oligospermia) and the spermatogenic cell information communication mediated by the supportive cell exosome pathway. Uses the pill for applying factor at the same time, with UU infection animal and cell models as subjects, using electron microscope, flow cytometry, W-B and RT-RCR technique, research the pill improved whether UU infection rat sperm counts and energy through regulating support cells secrete, repair sperm cells of information and communication, and improve sperm count and vitality. This study will explain and enrich the theoretical connotation of "treating both symptoms and root causes" from a new perspective, and provide a basis for establishing the treatment strategy of "treating both symptoms and root causes" of traditional Chinese medicine for UU infertility.