| Abstract: | 造成男性不孕症的原因有許多種，如果是精蟲方面缺陷的話方面缺陷的話，推就其原因牽涉到精蟲數目與活動力兩項因素推就其原因牽涉到精蟲數目與活動力兩項因素，若有藥物可增加精蟲活動力若有藥物可增加精蟲活動力，就可以用來治療精蟲活動力衰弱症而導致不孕症的男性。
臨床研究對於精蟲活動力的評估，多用顯微鏡觀察精蟲活動利指數的分析法，往往受限於操作者的主觀判斷，缺乏客觀性缺乏客觀性，因此本實驗引用電腦輔助精液分析儀(CASA)，是一種客觀、簡單又能詳細分析精蟲活動力及活動型式的方式。
為了證實Pentoxifylline與補中益氣湯對人類精蟲活動力的影響，本研究篩選精蟲數目每毫升濃度在二千萬之以上，而精蟲活動力在20~40%的病人10例為「異常組」，其精蟲活動力平均值為29.6±4.5%；而任意選擇精蟲正常個案10個為「正常組」，其精蟲活動力平均值為62.1±11.2%，進行實驗進行實驗，將每個個案之精液均勻分成七等份，至於試管中，其中六支試管中分別加入等量預先調配好不同濃度Pentoxifylline(0.1,0.01,0.001 mg/ml)，剩下的一支則只加入HTF培養液作為對照組，然後以電腦輔助精液分析儀，進行對精蟲活動力影響的體外實驗效果評估進行對精蟲活動利影響的體外實驗效果評估。
實驗研究的結果發現，以濃度而言，Pentoxifylline與補中益氣湯對精蟲活動力對精蟲活動力「正常組」的刺激作用，三種濃度彼此之間並無顯著差異，但對「異常組」而言，補中益氣湯高濃度(0.1mg/ml)刺激作用的精蟲活動力增加趨勢最為明顯，精蟲活動力由起始時間的32±6.9%到刺激120分鐘後55.0±11.1%。以時間而言，精蟲於暴露30分鐘的Pentoxifylline刺激作用最強(正常組大約增加14%，異常組大約增加17%)，但隨著時間進行其精蟲活動力卻逐漸減弱。然而補中益氣湯的刺激作用在30分鐘時正常組與異常組大約都增加17%，且可持續影響到120分鐘。
無論正常與異常組，在60分與120分鐘時，不論在何種濃度，以補中益氣湯刺激的精蟲活動力平均值均高於以Pentoxifylline刺激作用的平均值。至於兩種藥物對正常組與異常組織精蟲活動力增加"程度"的比較/ˋ未出現顯著差異。因此本研究結論認為補中益氣湯對正常組與異常組精蟲活動力增加的刺激作用較Pentoxifylline好，建議未來針對補中益氣湯進行更高濃度與更長刺激時間的觀察。
There are dufferent etiologies of male infertility. The major parameters of subfertility is (1) decrease of sperm count( oligozoospermia ) (2) decrease of sperm motility ( asthenozoospermia ). If some medication could improve the above pathology in semen parameter, it might become one of the treatment modalities for the male infertility.
The evaluative method of sperm motility most used microscopic motility index analysis in recent clinic study. Themethod ofen limitied to subject judgement of technician, CASA ( Computer-acided semen analyzer ) was used in our study which was a kind if object, simple, and can detail analysis of sperm motility.
This study is going to use teo kinds of medicine, Pentoxifylline and Bu-Zhong-Yi-Qi-Tang, which has been screened out of in vitro test proved to be the medication of sperm motility promotor. We collected 10 patients with sperm counts > 20*106/ml, sperm motility 20 ~ 40% as "abnormal group", the mean sperm motulity is 29.6 ± 4.5%. Randomized chose 10 normal patients as "normal group", the mean sperm motilitty is 62.1 ± 11.2%. To do our study, we divided each patient's sperm equally into seven tubes, then added equal volumes of Pentoxifylline 0.5, 1.0, 2.0 mg/mi and control group to each tube, Finally we used CASA to evaluate these medical influenece of sperm motility in vitro.
Our data showed : For the normal group, these were no significant difference among the different concentration of Pentoxifylline and Bu-Zhong-Yi-Qi-Tang. But for the abnormal group, Bu-Zhong-Yi-Qi-Tang high concentration ( 0.1 mg/ml) had the remarkable influenece on increasing sperm motility from 32.0 ± 6.9% to 55.0 ± 11.3% in 120 minutes. The maximun effect of Pentoxifylline was 30 minutes.( normal group increased 14%, abnormal group increased about 17% ), but it decreased as time went by Bu-Zhong-Yi-Qi-Tang can last longer to 120 min, and both groups were increasing 17%.
Pentoxifylline and Bu-Zhong-Yi-Qi-Tang had significant difference in increment of the sperm motility in 60 min, and 120 min for both normal and abnormal group. But there were no significant difference in the degree of increment of sperm motility between the normal and abnormal group.
We concluded that the stimulation effects of Bu-Zhong-Yi-Qi-Tang was better than Pentoxifylline in terms of increasing sperm motility on both normal and abnormal group. We will make our effects on Bu-Zhong-Yi-Qi-Tang for higher concnetration and longer periods of observation in the future. |
