弱精性不育症的氧自由基机理探讨及中医药治疗研究

【作者】 杨文涛；

【导师】 徐福松；

【作者基本信息】 南京中医药大学 ， 中医外科学， 2003， 博士

【摘要】 弱精症所致男性不育占有较大比例。既往有研究表明弱精症与多种因素有关，但是还不是很确切。导师徐福松教授治疗弱精症性不育症临床取得了较好疗效，具体机制尚不清楚。虽然近十年来现代医学在男性不育症的治疗有了长足的进步，现在已经有了ART（人工辅助受孕技术），大大增加了无精子症和高度少精子症病人生育的可能性，但是自然的妊娠还是人人所期望的。中医药治疗虽然取得了较好的效果，机理还不是十分明确，而且还缺乏标准化。近年来，国内外就弱精症与氧自由基的关系进行了初步研究，为了进一步探讨氧自由基在弱精症发病中的作用，观察导师徐福松教授治疗弱精性不育症的疗效。我们进行了以下研究。本课题首先对弱精症相关的中西医文献进行了系统回顾复习。通过文献回顾，对男性（弱精性）不育症的中西医治疗源流发展以及现状有了进一步的认识。确立了对弱精性不育症的研究的必要性。本课题着重对47例弱精性不育症患者建立临床观察表进行了临床观察研究。我们应用伟力计算机辅助精液分析CASA技术研究了患者精子运动活力变化情况，并检测了标志氧自由基状态的超氧化物歧化酶SOD。所有患者随机辨证分为4个证型进行中医药治疗。结果发现经治疗1～3个疗程后，标志精子活力的各项数值均有不同程度的改善。临床治愈率10.6%，显效率17%，总有效率78.7%，经统计学处理，精子活力有显著提高。将SOD数值与精子活力进行的相关性统计学分析结果为精子活力与SOD存在正相关。提示氧自由基是弱精性不育症重要机理之一。中医药治疗观察组的具有SOD完整资料的病例有21份，虽然SOD数值有不同程度改变，但是经统计学分析，尚无显著差异。分析认为可能与病例数量有限有关。本课题通过临床观察研究，从氧自由基角度揭示了弱精性不育症的发病机理，并进一步确定了导师治疗该病的良好疗效。<WP=4>氧自由基如何影响精子的活力尚需进一步应用电镜等更先进研究方法研究。更多还原

【Abstract】 Background:The most part of male infertility is due to astheno-spermia,which is correlated with several factors in the research before.But it is not clear yet.Professor Xufu-song is experienced in treating this disease with TCM,but the mechanism is not known.Although the western medicine had great progress in treating this disease,and the artificial reproductive technology(ART) has improved the chance of fertility due to azoospermatism and severe oligospermia,the natural pregnancy is expected by every couple.TCM is effective in treating this disease,but the mechanism is not clear,and unstandard.Objective:Some research had been undertaken in the relation between oxgen free radical(OFR) and asthenospermia in the recent year.We establish this research to confirm the influence of oxgen free radical and effect of this disease treated by Professor Xufu-song.Method:We first review the documents in treating this disease with TCM and western medicine.More comprehension about the progression of this disease in TCM and western medicine is abtained from the review.It is necessary to carry out an advanced research to this disease from the review.We mainly observed the treatment of 47 cases with this disease in clinic.Computer-asisted sperm analysis(CASA) technology was used to observed the motility change of the sperm. Superoxid dismutase( SOD) in the semen was detected in the laboratory.All the patients were divided into four common syndromes randomizedly according to their symptoms.Results:Several index marked the sperm motility were improved in different level after 1~3 courses of treatment.The cure rate(pregnancy rate)was 10.6%,the significant effective rate was 17%,the total effective rate was 78.7%.The motility of the sperm was significantly improved<WP=6>(P<0.01)from the statistics analysis,and the statistics analysis result suggested that the motility of sperm was correlated with SOD.There were no significant defference of the amount of SOD in the group treated by TCM before and after treatment from the statistics analysis.The possible reason was due to the limited cases.Conclusion:From this research ,we find that the oxgen free radical(OFR) play an important role in the male infertility due to asthenospermia.It is effective treated by Professor Xufu-song,and the experience need advanced research.The pathological process of how the OFR influence the sperm motility need advanced technology to confirm.更多还原