中西药联合治疗男性少精及弱精患者的临床疗效观察

Clinical observation of combination of Chinese and Western medicine in the treatment of male patients with oligospermia and asthenozoospermia

目的观察七子汤加味联合克罗米芬、维生素E治疗男性少精及弱精患者的临床疗效。方法选取医院2014年5月-2016年3月收治的少精及弱精患者86例作为研究对象,随机分为观察组和常规组,每组43例。常规组给予克罗米芬、维生素E口服治疗,观察组在常规组基础上给予中药汤剂七子汤加味治疗,比较2组患者治疗前后精液质量、精子形态、激素水平以及临床疗效。结果治疗后2组精液量明显增加,液化时间明显缩短,精液密度、a级精子和a+b级精子比例及存活率均明显提高,且观察组优于常规组,差异均有统计学意义(P<0.05)。治疗后2组患者精子正常形态率均较治疗前明显增加,精子畸形率和精子头部畸形率明显降低,差异均有统计学意义(P<0.05);且观察组治疗后正常形态率明显高于常规组,畸形率明显低于常规组,差异均有统计学意义(P<0.05);治疗后2组精子头部畸形率比较差异无统计学意义(P>0.05)。治疗后2组血清促黄体生成素(LH)、卵泡刺激素(FSH)和睾酮(T)水平明显提高,且观察组LH、FSH以及T水平均明显高于常规组,差异均有统计学意义(P<0.05)。观察组总有效率为79.1%高于常规组的48.8%,差异有统计学意义(P<0.05)。结论七子汤加味联合克罗米芬、维生素E治疗少精、弱精症能进一步提高治疗效果,改善精子质量,值得临床推广应用。

Objective To study the clinical curative effect of qizi decoction combined with clomiphene and Vitamin E in treatment of male patients with oligospermia and asthenozoospermia. Methods A total of 86 patients with oligospermia and asthenozoospermia were enrolled in the hospital from May 2014 to March 2016. They were randomly divided into observation group and conventional group,each group of 43 cases. Conventional group was given with clomiphene,vitamin E oral therapy,on the basis of conventional group,observation group was given with qizi decoction addition and subtraction treatment. The sperm quality,sperm morphology,hormone levels and clinical efficacy were compared between two groups before and after treatment. Results After treatment,the amount of semen was significantly increased,the liquefaction time was shortened,the semen density,a grade sperm and a ＋ b grade sperm ratio and survival rate were significantly improved,and observation group was superior to conventional group,the difference was statistically significant（ P〈0. 05）. After treatment,the normal morphological rate of spermatozoa in two groups was significantly higher than that before treatment,the sperm deformity rate and sperm head deformity rate were significantly lower,the difference was statistically significant（ P〈0. 05）; And normal morphology of observation group was significantly higher than conventional group,the deformity rate was significantly lower than conventional group,the difference was statistically significant（ P〈0. 05）. There was no significant difference in the deformity rate of the head of two groups after treatment（ P〉0. 05）. The levels of LH,FSH and T were significantly increased in two groups after treatment,and the levels of LH,FSH and T in observation group were significantly higher than those in conventional group,the difference was statistically significant（ P〈0. 05）. The total effective rate was 79. 1% in observation group and 48. 8% higher than that in conventional group,the difference was statistically significant（ P〈0. 05）. Conclusion Qizi decoction plus taste combined with clomiphene,vitamin E treatment of less refined,weak essence can further improve the treatment effect,improve sperm quality,worthy of clinical application.