雷公藤对男性生殖影响的研究

STUDIES ON THE EFFECT OF TRIPTERYGIUM WILFORDII ON THE REPRODUCTION OF MEN

雷公藤多甙(GTW)为市售中成药,长期以来用于类风湿关节炎、慢性肝炎和一些皮肤病的治疗。不久前表明本品对雄大鼠,也可能对男子有抗生育作用。才研究在26名轻型银屑病人,用小剂量(20ms/日)GTW治疗,同时观察精子数据、精浆生化、血清激素及生化、血象、尿常规以及有关免疫及遗传指标。结果表明,服药1月后精子密度,特别是活率,明显下降,2月后降至不育水平;连服5～6月除少数人有暂时性上腹不适外,无其他明显副作用,性功能如常。停药二月后精子恢复。服药时精浆中游离左旋肉毒碱明显下降,停药后恢复,提示作用部位之一为附睾。所观察的其他指标均无明显影响。

The multiglycosides of Tripterygium wilfordii Hook,f.(hereafter GTW),a Chinese herbal drug available in the market as tablets,has been used for long in the treatment of rheumatoid arthritis and certain skin diseases.It was found to cause reversible infertility in male rats,and possibly in men as well.In the present study,26 fertile men suffering from mild psoriasis requiring GTW treatment were recruited.GTW 20 mg/day(1/3 of the regular therapeutic dose)were given orally for 4-6 months.Semen indices,seminal plasma free 1-carnitine,fructose and acid phosphatase,serum testosterone,FSH and LH,SGPT, BUN,haematology,urine routine analysis,and certain genetio and immunological indices were determined before,and regularly during and after treatment for up to 12 months.One month after treatment,the sperm density and particularly the motility decreased significantly.After 2 months,the motility dropped to 12±9%(all non-progressvie,therefore not fertile)and the density to 25±19 mill/ml.One months after withdrawal of GTW,both the sperm density and motility increased significantly and reached fertile standards,and one more month later they were restored to pretreatment levels.The semen carnitine decreased significantly during treatment and was recovered after GTW removal.No significant side effects were seen and potency and libido were normal.All other parameters observed were not significantly different from the pretreatment levels.Results indicate that GTW can cause reversible infertility in men and that an important site of action is the epididymis.