他莫昔芬治疗特发性少弱精子症的有效机理分析

Effective mechanism of tamoxifen in the treatment of idiopathic oligoasthenospermia

目的评价他莫昔芬治疗特发性少弱精子症的有效机理。方法196例男性不育患者,使用枸橼酸他莫昔芬片进行治疗,经过3个月治疗,根据治疗前后的精子质量改变状况分成A组(有效)和B组(无效)。分析治疗效果,比较两组患者治疗前后激素及其增值水平。结果经过3个月治疗,患者治疗有效117例(A组),无效79例(B组),有效率为59.69%。其中A组中精子密度提高78例,前向运动精子百分率提高68例,精子密度和前向运动精子百分率同时提高29例。两组雌激素治疗前后及其增值比较,差异均无统计学意义(P>0.05),且两组患者治疗前雄激素比较,差异无统计学意义(P>0.05)。治疗后,A组雄激素(21.11±6.31)pg/ml、雄激素增值(4.61±7.61)pg/ml均高于B组的(19.33±5.76)、(1.38±8.52)pg/ml,差异均具有统计学意义(P<0.05)。结论他莫昔芬治疗特发性少弱精子症使患者体内雄激素的水平增高,促进精子质量的提高。

Objective To evaluate the effective mechanism of tamoxifen in the treatment of idiopathic oligoasthenospermia.Methods 196 male infertility patients were treated with tamoxifen citrate tablets.After 3 months of treatment,they were divided into group A(effective)and group B(ineffective)according to the changes in sperm quality before and after treatment.The treatment effect of all patients was analyzed,and the hormone levels and its increment of the two groups before and after treatment were compared.Results After 3 months of treatment,117 patients were effective(group A)and 79 patients were ineffective(group B),with an effectiveness rate of 59.69%.In group A,the sperm density increased in 78 cases,the percentage of progressively motile sperm rate increased in 68 cases,and both the sperm density and the percentage of progressively motile sperm rate increased in 29 cases.There was no statistically significant difference between the two groups of estrogen before and after treatment and its increment(P>0.05),and the difference between the two groups of androgens before treatment was not statistically significant(P>0.05).After treatment,the androgen(21.11±6.31)pg/ml and its increment(4.61±7.61)pg/ml of group A were higher than(19.33±5.76)and(1.38±8.52)pg/ml of group B,and the difference was statistically significant(P<0.05).Conclusion Tamoxifen in the treatment of idiopathic oligoasthenospermia may increase the level of androgen and promote the quality of sperm.