复方玄驹胶囊联合中药复方治疗吸烟致男性不育症的临床研究

Combined therapy of Compound Xuanju Capsules and traditional Chinese medicinal formula for infertility in male smokers

目的:初步探讨复方玄驹胶囊联合中药复方在治疗吸烟男性不育症的临床疗效。方法:将176例男性不育症患者分为非吸烟组和吸烟组,吸烟组再根据每日吸烟支数以及烟龄分为:轻度吸烟组、中度吸烟组以及重度吸烟组。入选患者给予复方玄驹胶囊联合中药复方3个疗程的治疗,于治疗后的4、8、12周对各组患者进行中医证候评分、精液常规参数、精子形态学以及精子DNA完整性进行检测,比较治疗前后变化。结果:吸烟组与非吸烟组比较:治疗前,重度吸烟组患者的中医症候评分显著高于非吸烟组(P<0.05),而轻、中度吸烟组无显著性差异(P>0.05);重度吸烟组患者头部缺陷精子显著高于非吸烟组(P<0.05);中、重度吸烟组患者的DNA完整性(DFI值)偏高,具有显著差异(P<0.05);治疗后,4组不同吸烟组患者中医症候、精液常规质量、精子形态以及精子完整性方面均有一定的改善作用,尤其是在改善精子前向运动活力以及头部缺陷精子方面,重度吸烟组患者治疗前a+b级精子活力为(17.12±2.54)%,正常精子百分率为(15.54±1.98)%,头部缺陷精子百分率为(27.02±2.14)%,治疗后a级精子活力上升至(30.15±3.10)%,正常精子百分率升高至(26.82±3.52)%,头部缺陷精子百分率降至(22.07±1.52)%,差异显著(P<0.05)。结论:与轻度吸烟的患者相比,中重度吸烟会严重影响患者的精子质量,增加患者不育发生的可能性。此外,复方玄驹胶囊联合中药复方可有效改善吸烟男性不育患者的精液质量和精子形态,对精子DNA损伤有一定的改善作用,但仍需要进一步的深入研究。

Objective： To investigate the clinical effects of the combined therapy of Compound Xuanju Capsules （CXJC） and tradi- tional Chinese medicinal formula on infertility in male smokers. Methods ： A total of 176 male infertility patients were divided into a smoking and a non-smoking group and the former further divided into mild, moderate and heavy smokers according to the daily con- sumption of cigarettes and the length of smoking history. The patients were treated with CXJC combined with traditional Chinese medici- nal formula for 3 four-week courses and the therapeutic results were evaluated by comparing the indicators of the traditional Chinese medicine （TCM） syndrome, routine semen parameters, sperm morphology, and sperm DNA fragmentation index （DFI） among differ-ent groups before and after treatment. Results ： The baseline TCM syndrome scores were remarkably higher in the heavy smokers than in the non-smoking group （P 〈 O. 05） but showed no statistically significant differences between the mild and moderate smokers （P 〉 O. 05）. The baseline percentage of sperm head defects and DFI were also markedly higher in the heavy and moderate smokers than in the non-smoking group （P 〈 0.05）. Compared with the baseline, significant improvement was achieved after treatment in the TCM syndrome, routine semen parameters, sperm morphology and sperm DFI, especially in the heavy smokers in the percentages of grade a ＋ b sperm （ [ 17.12 ±2.54] vs [30.15 ± 3.10] %, P 〈 O. 05）, morphologically normal sperm （ [ 15.54 ± 1. 981 vs [26.82± 3.521%, P 〈 0.05）, and head-defective sperm （[27.02 ±2.14] vs [22.07±1.521%, P 〈 0.05）. Conclusion： Sperm quality is significantly decreased while the risk of infertility remarkably increased in moderate and heavy smokers. The combined thera- py of CXJC and traditional Chinese medicinal formula can effectively improve semen quality, sperm morphology and sperm DFI in male smokers with infertility, though more evidence is to be collected from further studies.