中药转阴丹联合激素治疗男性不育患者精浆抗精子抗体阳性的临床观察

目的 探讨自拟中药转阴丹联合激素治疗抗精子抗体阳性不育患者的临床疗效以及一氧化氮(NO)含量的变化。方法 选择精浆抗精子抗体阳性的男性不育患者82例,按数字表法随机分为西药组(20例,用强的松)、中药组(28例,用转阴丹)、中西药组(34例,用强的松和转阴丹),并观察其临床疗效、治疗前后抗精子抗体的转阴率、精浆NO的含量变化及精子各项运动参数。结果 总有效率中西药组为88.2％,中药组为75.0％,西药组为65.0％。中西药组和中药组精浆MO含量、精子运动参数中直线运动速度、直线性、前向性、鞭打频率、精子活力、平均移动角度,精液质量治疗前后比较差异均有显著性(P<0.05或P<0.01)。西药组NO含量、前向性、鞭打频率、平均移动角度,精液质量中精子活力和活率治疗前后比较差异有显著性(P<0.05)。结论 转阴丹联合激素可降低精浆NO的含量、改善精子质量。

生殖系多种病原体感染与男性不育的关系

目的 探讨男性不育患者弓形体、解脲支原体、沙眼衣原体感染情况和抗精子抗体在男性不育中的作用。 方法 应用多聚酶链反应 (PCR)技术分别对 112例男性不育病人和 6 2例正常生育者的精液进行精浆弓形体 DNA、解脲支原体和沙眼衣原体 DNA的检测 ,用金标免疫斑点试验检测精浆抗精子抗体 (As Ab)。 结果 男性不育组弓形体阳性 2 0例 (17.86 % ) ,解脲支原体阳性 35例 (31.2 5 % ) ,沙眼衣原体阳性 18例 (16 .0 7% ) ,抗精子抗体阳性 33例 (2 9.4 6 % )。3种病原体感染率与抗精子抗体的阳性率均明显高于正常对照组 (P<0 .0 1) ,且多种病原体感染患者抗精子抗体的阳性率明显高于单项感染者。 结论 男性不育患者多种病原体感染后 ,导致抗精子抗体的产生是男性不育的重要免疫因素。

生精液化胶囊治疗男性不育症38例疗效观察及对患者精液运动参数、NO和细胞因子水平的影响

目的:观察生精液化胶囊治疗男性不育症的疗效及对患者精液质量、运动参数、精液NO和细胞因子水平的影响。方法:用生精液化胶囊(处方:生山药、茯苓、泽泻、熟地黄、山茱萸、穿山甲、牡丹皮)治疗男性不育患者38例,观察治疗前后精子的各项运动参数和精子运动速度及测定精液一氧化氮(NO)的含量、肿瘤坏死因子(TNF)、白细胞介素-1(IL-1)、白细胞介素-10(IL-10)的水平变化。结果:治疗后精子液化时间、精子密度、精子活率与治疗前比较,差异均有显著性意义(P<0.05)。精子活力与治疗前比较,差异有非常显著性意义(P<0.01);NO和TNF的含量均明显下降,与治疗前比较,差异有非常显著性意义(P<0.01);IL-10升高,与治疗前比较,差异有显著性意义(P<0.05)。IL-1有下降趋势,但无统计学意义。结论:生精液化胶囊通过改变精浆内细胞因子和NO的水平,起到治疗男性不育的作用。

过期妊娠126例临床分析

过期妊娠能增加围产期发病率和新生儿发病率.对我院805例分娩中126例过期妊娠结合B型超声波测定胎儿双顶径及胎盘成熟度(分级)进行分析如下:

Clinical Observation on Effect of Combination of Zhuanyindan (转阴丹) and Hormone in Treating MaleInfertility with Positive Antisperm Antibody

Objective:To explore the therapeutic effect of combination of Zhuanyindan (ZYD, 转阴丹, a self-made Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. Methods:Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n=28, treated with ZYD) and the ICWM group (n=34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. Results: The total effective rate in the ICWM group was 88.2%, that in theTCM group 75. 0% and in the WM group 65. 0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen ( P < 0. 05 or P < 0. 01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P<0. 01). Conclusion: Combination of Chinese herbs and hormone could lower the NO level in semen and improve the quality of sperm.Original article on CJITWM (Chin) 2004 ;23 (3): 223