复方氨基酸胶囊联合克罗米芬治疗男性重度少精子症的疗效

Compound Amino Acid Capsules combined with clomiphene for severe oligospermia

目的:探究复方氨基酸胶囊联合克罗米芬治疗重度少精子症的疗效。方法:2018年1~9月就诊的104例重度少精子症患者纳入研究,随机分为试验组与对照组,试验组60例,对照组为44例。试验组口服复方氨基酸胶囊(0.70 g/次,2次/d)联合克罗米芬(50 mg/次,1次/d)12周,对照组口服克罗米芬(50 mg/次,1次/d)12周,对比及观察两组治疗前及用药后第4、8、12周精子浓度,前向运动(PR)精子百分率,精子总活率[PR+非前向运动(NP)精子百分率],以及用药期间的妊娠率。结果:试验组治疗前及治疗后第4、8、12周的精子浓度分别为(3.13±1.29)、(12.06±2.24)、(22.10±2.65)、(28.13±3.59)×10~6/ml;PR分别为(14.03±2.49)%、(21.05±3.14)%、(29.08±4.70)%、(35.08±3.70)%;PR+NP分别为(20.10±4.05)%、(27.10±4.87)%、(36.09±5.64)%、(45.04±6.69)%;对照组治疗前及治疗后第4,8,12周的精子浓度分别为(3.27±1.46)、(10.21±2.35)、(19.89±2.74)、(25.23±3.69)×10~6/ml,PR分别为(13.32±3.12)%、(17.02±3.26)%、(22.13±3.70)%、(27.18±2.54)%、PR+NP分别为(21.30±4.87)%、(24.22±5.07)%、(30.03±5.33)%、(35.05±5.69)%。与治疗前相比两组治疗后第4、8、12周精液参数有明显改善(P<0.01),试验组同时段的精液参数均显著高于对照组(P<0.01)。试验组和对照组用药后第4、8、12周配偶临床妊娠分别为1.72%vs 0.53%、4.21%vs 2.87%、8.32%vs 6.32%,均有显著差异(P<0.01)。两组患者治疗期间均未见明显的不良反应。结论:复方氨基酸胶囊联合克罗米芬可明显改善重度少精子症患者精液参数,并有较好的安全性。

Objective:To study the effect of Compound Amino Acid Capsules(CAAC)combined with clomiphene in the treatment of severe oligospermia.Methods:A total of 104 patients with severe oligospermia admitted to our Center of Reproductive Medicine from January to September 2018 were randomly assigned to a trial(n=60)and a control group(n=44),the former treated by oral administration of CAAC combined with clomiphene and the latter with clomiphene only,both for 12 weeks.Comparisons were made between the two groups of patients in the sperm concentration,and the percentages of progressively motile sperm(PMS)and total motile sperm(TMS)before and after 4,8 and 12 weeks of medication as well as the pregnancy rate during the treatment.Results:Compared with the baseline,the trial group showed significant elevation at 4,8 and 12 weeks in sperm concentration([3.13±1.29]vs[12.06±2.24],[22.10±2.65]and[28.13±3.59]×10~6/ml,P<0.01),PMS([14.03±2.49]%vs[21.05±3.14]%,[29.08±4.70]%and[35.08±3.70]%,P<0.01)and TMS([20.10±4.05]%vs[27.10+4.87]%,[36.09±5.64]%and[45.04±6.69]%,P<0.01),and so did the control group in sperm concentration([3.27±1.46]vs[10.21±2.35],[19.89±2.74]and[25.23±3.69]×10~6/ml,P<0.01),PMS([13.32±3.12]%vs[17.02±3.26]%,[22.13±3.70]%and[27.18±2.54]%,P<0.01)and TMS([21.30±4.87]%vs[24.22±5.07]%,[30.03±5.33]%and[35.05±5.69]%,P<0.01),even more significant in the trial than in the control group at the three time points after medication(P<0.01).The pregnancy rate was markedly higher in the former than in the latter group at 4(1.72%vs 0.53%,P<0.01),8(4.21%vs 2.87%,P<0.01)and 12 weeks(8.32%vs 6.32%,P<0.01).No adverse reactions were observed in neither of the two groups during the treatment.Conclusion:CAAC combined with clomiphene can significantly improve the semen parameters of the patients with severe oligospermia,with no obvious adverse events.