Phenobarbital On The Clinical Impact And Mechanisms Of Male Reproductive Function With Epilepsy

This study for Phenobarbital treating generalized tonic-clonic seizure(GTCS) patients were from basis to clinical. Firstly, the 268 GTCS cases which treated with Phenobarbital were followed up in five years,to investigate the treatment and management for epilepsy in Yangzhou rural areas of Jiangsu Province,and explore the curative effects of Phenobarbital for GTCS patients in long term,building the treatment and management network for epilepsy,which as Phenobarbital for mainly means. Then to explore the effects of Phenobarbital on sex hormones,sexual functions and sperm for GTCS patients. Further through the empirical study,which evaluating the effects of epileptic seizure in male Wistar rats'reproduction, to explore the inherent mechanism of possibility.Part I The evaluation of treatment and management for epilepsy in Yangzhou rural areas of Jiangsu Province ObjectiveTo investigate the treatment and management for epilepsy in Yangzhou rural areas of Jiangsu Province,and explore the curative effects of Phenobarbital for generalized tonic-clonic seizure(GTCS) patients in long term,in order to provide evidence for the treatment and management for epilepsy in rural areas.MethodsEpidemiological Survey was carried out in Hangjiang rural areas of Yangzhou,the GTCS cases were screened out by physicians from township hospitals,who were received short-term training,and then rechecked and confirmed by neurologists. The patients were underwent treatment with Phenobarbital and regular managed regularly, following up after five years.Results268 GTCS cases were treated with Phenobarbital in group, and 232 cases were followed up five years later,follow-up rate was 86.57%. 160 cases were treated with anti-epileptic medicine( AEDs ) regularly, account for 68.97%, the efficient rate of the patients treated with AEDs was 91.88%, and the significant efficient rate was 25.00%.The efficient rate of 132 cases treated with Phenobarbital was 91.12%, and the significant efficient rate was 26.47%, the dose was centered between 60 to 120 milligrams one day,account for 69.85%. As the time prolong, the side-effect become lessen.ConclusionsThe treatment and management for epilepsy have achieved greatly in Yangzhou rural areas of Jiangsu Province,the treatment effectiveness of Phenobarbital for epilepsy in long time is notable,it had built the treatment and management network for epilepsy,which as Phenobarbital for mainly means.Part II The effects of phenobarbital monotherapy on sex hormones and sperm in male GTCS patientsObjectiveThe effects of phenobarbital monotherapy on sex hormones and sexual functions were evaluated,and further to explore the effects on the motility, appearance and ultrastructure of sperm, so as to guide the clinical medication in male epileptic patients at period of duration.MethodsIIEF-5 investigating was used to estimate the sexual function in male patients with epilepsy who were treated with phenobarbital and radioimmunoassay was used to measure the serum concentration of sex hormone(TT,fT,FSH,LH,PRL,E2). CASAS-QH-HI was used to determine the motility and appearance of sperm in male patients with epilepsy at period of duration, and JEM21200EX transmission electron microscope was used to observe spermatozoa ultrastructure.Results Serum fT level was lower than that in the normal matched group(p<0.05); no differences in serum TT, FSH, PRL, LH and E2 between PB monotherapy GTCSgroup and normal matched group(p>0.05),the scores of IIEF-5 were significantly lower than those in normal matched group(p<0.01). Motility rate of sperm was lower than that in the normal matched group(p<0.05),(A+B) degree motility of sperm was lower than that in the normal matched group(p<0.05),abnormity of the spermatozoa ultrastructure at head ,neck and empennage,observe by dtransmission electron microscope ,was more than in the normal matched group,the apoptosis sperm was increased. ConclusionsThe male patients with epilepsy which taken phenobarbital have an effect on the sexual function and serum level of sex hormones,and it also have an effect on the spermatozoa motility,appearance and ultrastructure in some patients with epilepsy.Part III The effects of epileptic seizure in male Wistar rats'reproduction Objective To investigate the impact of epileptic seizure in Wistar rats'reproduction and their inherent mechanism of possibility.MethodsEstablishing the male LI-PILO epileptic model Wistar rats at period of duration, and radioimmunoassay was used to measure the serum concentration of sex hormone. Weighting testicle of the rats,and their pathological sections were dyed by hematoxylin eosin staining, so as to understand their pathological structures.ResultsThe weigh of male Wistar rats, which made epileptic model succeed, were significantly lower than the epileptic model not succeed and normal matched group(p<0.01),but no differences in organ coefficient (testicle/ body weight); the pregnendione of epileptic model succeed Wistar rats were lower than normal matched group(p<0.01), and total testosterone were significantly lower than the epileptic model not succeed and normal matched group (p<0.01), prolactin were significantly more than the epileptic model not succeed and normal matched group (p<0.01); sperm number in epididymal duct were obviously decreased in pathological structures, necrosis and loss cells were visible, sperm number in testicle convoluted tubule were decreased, and spermatogenic epithelium slightly thin.ConclusionsEpileptic seizure made the weigh of male epileptic model succeed Wistar rats decreased, and had an effect in the serum concentration of sex hormone, it damaged their pathological structures of testicle and epididymis.