十子二仙汤对肾阳虚型弱精子症患者的精子顶体完整率及精子DNA完整率影响研究

Effect of Shizi Erxian Decoction on Sperm DNA Integrity and Acrosomal Integrity of Patients with Renal-Yang Asthenia

目的:观察十子二仙汤治疗肾阳虚型弱精子症患者精子DNA完整率和顶体完整率的临床效果。方法:实验前取配偶怀孕后半年内正常精液标本20例测定精子顶体完整率及精子DNA断裂指数(DFI)做预试验,其数值拟做疗效参考指标。肾阳虚型弱精子症300例,随机分为治疗组(十子二仙汤治疗)和对照组(左卡尼汀治疗),每组各150例,进行1个周期(3个月)的观察治疗。治疗1个周期后,对疗效不明显(主要指DFI和顶体完整率),DFI≥15,顶体完整率<90%的患者,停药1周后,互换治疗方案,即原治疗组采用左卡尼汀治疗,原对照组采用十子二仙汤治疗,并作二期治疗1个周期观察。结果:经过1个周期的治疗,治疗组和对照组患者精子密度、精子活力、DFI和顶体完整率较治疗前都有了改善。其中,精子密度,治疗组和对照组改善程度差异不明显(P>0.05)。精子活率、精子活力、DFI和顶体完整率,治疗组改善程度优于对照组(P<0.05)。互换治疗方案后,二期观察显示十子二仙汤在治疗精子DNA完整率和顶体完整率上,效果仍然优于左卡尼汀(P<0.05)。结论:十子二仙汤能有效的改善肾阳虚型弱精子症患者的精子DNA完整率和顶体完整率。

Objective： To investigate effect of Shizi Erxian Decoction on sperm DNA integrity and acmsomal integrity of pa- tients with renal-Yang asthenia. Methods ： The integrity of sperm DNA and acrosomal integrity were determined in 20cases of nor- real sperm samples, and the parameters are treated as references. 300cases with renal-Yang asthenia came from the reproductive of our hospital from April 2008to January 2011. They were randomly divided into treatment group （treated with Shizi Erxian De- coction） and the control group （treated with L-carnifine）. Every group had 150cases and all patients treated 3months continual- ly. After 3months treatment, the patients of DFI I〉 15and acrosomal integrity〈90% were drug withdrawal one week. Then, we exchanged the treatment programs. The patients of original control group were treatment with Shizi Erxian Decoction but the origi- nal treatment group were used L-carnitine. Results ： After one cycle of treatment, the sperm density, motility, DFI and acroso- real integrity of beth groups all were improved. Among of them, the sperm motility, DFI and acrosomal integrity of treatment group were better than the control group （P〈0. 05）, but the sperm density was no significant difference between them （P〉 0.05）. When we exchanged the treatment programs and the treatment duration was also 3months, the effect of s Shizi Erxian Decoction was still better than L-carnitine （P〈0. 05 ）. Conclusion： Shizi Erxian Decoction can reduce sperm DFI of patients with renal-Yang asthenia and can effectively improve acrosomal integrity.