| Objective:To understand the change of sex life after methadone maintenance treatment (Methadone maintenance treatment, MMT) in the drug abuse crowd, and investigate whether Methadone can increase the potential toxicological hazards to the drug users'reproductive system, and to explore its interrelated toxicity mechanism initially.Methods:To Take epidemiological investigation and combined with animal research methods (1) epidemiological study:use self-designed questionnaire, andthe international index of erectile function questionnaire-5 (IIEF-5) to investigate the crowd who use drug previously but is take methadone maintenance treatment (A group), and who are still taking drugs (B group), and who never taking any drugs and methadone (C group).The content of the investigation questionnaire includes crowd common state (such as age,occupation,marital status), drug use information(drug type,quantity,frequency, and drug taking methods etc.),past Medical history; sexual life; and the subjective perception after take part in methadone maintenance treatment. To grade the erectile function of the three group by IIEF-5 scale, To investigate the differences in three groups.(2) animal toxicology experiments:created the morphine dependence mice models by the 5th gradually increasing doses way (A, B, C groups). After the model success, A group change to Methadone replacement therapy group, B group turn to morphine natural withdrawal, C group continued to use morphine, at the same time set group D which used methadone to intragastric administration, group E just use physiological saline.The whole time of experiment is 13 days,the mice were sacrificed at the 14th day. Took the bilateral Testis and epididymis, then survey and evaluate the testis organ coefficient, motility of sperm, sperm count, rate of sperm deformity, testing the oxidative damage index of testis tissue,and observe the pathological section. Statisticed all data types by software SPSS 13.0.Results:1. Epidemiological survey among methadone maintenance treatment:the difference of the commom conditions, ast prevalence of major projects in the A, B, C three groups were not significant (P>0.05). the difference of previous drug taking between A,B two groups was not significant (P>0.05). the difference of the functions of sex and erection in the A, B, C three groups were significant (P<0.05).It show that the function of A, Btwo groups is below the C group (the control group), and the erectile dysfunction is higher than the C group. In A group,about the subjective feeling of sexual function before and after the response of participating in MMT, there were 68 people feel sexual function no differences after the maintenance treatment, the proportion is 49.64%;57 people feel sexual function worse after the maintenance treatment, the proportion is 41.60%; 12 people feel sexual function better after the maintenance treatment, the proportion is 8.76%.2. Methadone effects on the reproductive system in mice Study:model evaluation of A, B, C, D four groups, use naloxone to wake-withdrawal, the number of withdrawal symptoms compared to E group was significantly (P<0.05). Compare the testis organ coefficient of each group, the discrepancy of A, C, D and E group were significantly (P<0.05). The testicular organ coefficient of the E group (the physiological saline group) was significantly higher than other groups,but the discrepancy of B and E group was not significantly.The sperm motility of A,B,C,D group compared with the E group,the difference was significantly (P<0.05), C group sperm motility is lowest, the proportion is 44.71%, followed by is A Group, the proportion is 52.88%, sperm motility sorting:saline group> natural morphine withdrawal group> methadone maintenance group> methadone substitution group> morphine sustained group. Compared A, C, D and E group,the sperm count difference was statistically significant (P<0.05),the value of a quantity were lower than the E group. The rate of sperm deformity of C, D group was significantly highter than E group. (P<0.05). Detected from the testicular oxidative index, the SOD activity of A, C groups were lower than E group,the value of malondialdehyde (MDA) of C, D groups were higher than the E group,,and the differences was significant (P<0.05); The testicular histopathology inspection find that the testis structure of A, B, C, D four group were abnormal. The spermatogenic cells of Testicular seminiferous tubules array sparse, level disorder, part of the wall of seminiferous tubules atrophy, seminiferous tubules interstitium widened than the normal group.CONCLUSION:1. The man who participate in methadone maintenance treatment and continuing drug abuse,the sexual function has declined; 2. methadone is damage to testis and sperm of male mice; 3. The damage to the reproductive system of male mice may be related to the oxidative damage. |
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