Evaluation of sperm mitochondrial function using rh123/PI dual fluorescent staining in asthenospermia and oligoasthenozoospermia

Objective：The recent advent of flow cytometry（FCM）,coupled with fluorescent dyes,has been successfully applied to assess mitochondrial function.The aim of this study was to investigate the feasibility and clinical significance of detecting sperm mitochondrial function and to evaluate sperm mitochondrial function by using Rhodamine 123/propidium（Rh123/PI）dual fluorescent staining and FCM in asthenospermia and oligoasthenozoospermia.Methods：Twenty-five fertile men（with normal sperm parameters）and 230 infertile patients were examined.Fifty-five patients of the above 230 patients were selected for idiopathic infertility samples and were divided into two groups：asthenospermia（n=30）and oligoasthenozoospermia（n=25）.Rh123/PI dual fluorescent staining and FCM were carried out to examine sperm mitochondrial function.Results：Significant differences were found between the normal and abnormal semen samples（P0.05）when Rh123＋/PI-,Rh123-/PI＋and Rh123-/PI-sperm were examined by FCM,but there was no significant difference between the asthenospermia（P=0.469） and oligoasthenozoospermia group（P=0.950）when Rh123＋/PI-and Rh123-/PI＋sperm were then examined;however,a significant difference was found between the 2 groups（P=0.003）when Rh123-/PI-sperm were examined.There was no correlation between Rh123-/PI-sperm and semen parameters in the normal group,but there was a significant negative correlation between the sperm concentration and Rh123-/PI-sperm in asthenospermia and oligoasthenozoospermia patients（r=-0.509,-0.660;P=0.018,0.038）.Conclusion：Rh123/PI dual fluorescent staining and FCM can provide reliable information to assess the quality of sperm and reveal differences in mitochondrial membrane potential in asthenospermia and oligoasthenozoospermia.

Differential analysis of two-dimensional gel electrophoresis profiles of spermatozoa protein in human normal motility sperm and idiopathic asthenospermia

Objective: To evaluate the application of two-dimensional electrophoresis in the research of differentially expressed proteins in the human asthenospermia. Methods: Two-dimensional gel electrophoresis was performed on 4 normal sperm samples from healthy men and 4 sperm samples from 4 asthenospermia patients. After silver staining, the differential expression proteins were analyzed by PDQuest 2D analysis software. Results: Six differential protein spots were identified. Four spots showed increased expression in the control gels compared with the patient gels. Conclusion: The protein profiles of differential expression between the normal spermatozoa and idiopathic asthenospermia were established and some differential proteins were found. The data of this study would establish the better fundament for further isolation and identification of differentially expressed proteins in human asthenospermia sperm.

Network pharmacology research of kidney-invigorating and spleen-strengthening core drugs in treatment of oligospermia and asthenospermia

Objective:Exploring the material basis and mechanism of Kidney-invigorating and Spleenstrengthening method for treating oligospermia based on network pharmacology.Method:Select the effective elements and targets of Yishen Jianpi core drug pairs by searching the Chinese Medicine System Pharmacology Platform(TCMSP);select the disease targets of oligozoospermia by searching the human genetic information database;use R language software to select drugs and Disease common target,use Cytoscape software to build a drugdisease-target interaction network;build a common target protein interaction network(PPI)through the STRING platform;apply R language to the core drugs of Yishen Jianpi and oligospermia Enrichment analysis of GO and KEGG was performed on the common target.Result:A total of 97 effective active ingredients were obtained from Yishen Jianpi traditional Chinese medicine,and 46 possible targets for Yishen Jianpi traditional Chinese medicine to treat oligospermia were obtained.Combined with the results of KEGG enrichment analysis,it can be speculated that Yishen Jianpi traditional Chinese medicine improved male oligospermia The whole mechanism of action may be related to the regulation of human endogenous hormones.Conclusion:Through the research method of network pharmacology,the possible effect targets and pathways of Yishen Jianpi traditional Chinese medicine in the treatment of male oligospermia are predicted.

Discussion on Treatment of Asthenospermia from the Perspective of Psychosomatic Medicine of Traditional Chinese Medicine

The views of the unities between heaven and man and between form and spirit in The Yellow Emperor’s Classic of Internal Medicine essentially reflect the mutual influence of physical and psychological factors.In today’s social environment,psychological and social factors have become important factors that affect the incidence of male asthenospermia.Therefore,the treatment of asthenospermia focuses more on the principle of simultaneous treatment of mind and body.With the development of modern biological-psychological-social medicine,the characteristics and advantages of psychosomatic medicine of traditional Chinese medicine are more prominent,which may provide new ideas for the diagnosis and treatment of asthenospermia.

精浆肉碱测定在男性生育力评估和弱精子症疗效监测中的应用

目的比较正常男性与弱精子症男性精浆中肉碱含量,评估精浆肉碱水平与前向运动精子百分率(PR)之间的一致性,并外源性补充肉碱对弱精子症患者的影响。方法收集511例正常可育男性及弱精子症患者精液样本,采用精浆肉碱检测试剂盒(固定时间法)测定精浆肉碱,比较两组水平差异及与PR的一致性。另选77例弱精子症患者给予左卡尼汀(1 g/次,3次/日,30日/疗程)治疗,监测服药前后精浆肉碱及PR变化。结果弱精子症患者组精浆肉碱含量[(194.34±65.41)μmol/L]显著低于正常可育男性组[(405.43±72.12)μmol/L](P<0.01);以精浆肉碱≥325μmol/L为阈值,Kappa值为0.81,诊断符合率达93.74%;给予左卡尼汀治疗后,弱精子症组精浆肉碱浓度[(356.03±84.87)μmol/L]较之前[(183.61±79.54)μmol/L]明显上升,PR[(32.69±8.35)%]较之前[(16.56±7.74)%]显著升高(P均<0.01)。结论精浆肉碱检测试剂盒能准确高效检测大量临床样本,可用于弱精子症诊断及疗效评估。外源性补充肉碱可提高弱精子症患者精浆肉碱水平和精子活力,有助于改善其生育能力。

补肾增液汤加减联合左卡尼汀对弱精子症患者精液参数及IVF-ET相关指标的影响

目的:探究补肾增液汤辩证加减联合左卡尼汀对弱精子症患者精液参数、体外受精-胚胎移植(IVF-ET)指标的影响。方法:收集2020年1月-2022年1月在本院中心行IVF周期治疗弱精子症94例临床资料,按治疗方式分为对照组(n=41例,左卡尼汀治疗)与联合组(n=53例,补肾增液汤辩证加减联合左卡尼汀治疗),疗程12周,比较两组治疗效果、治疗前后精液质量分析、性功能及IVF周期相关指标。结果:治疗后,联合组精液量(3.71±0.75ml)、精子浓度(30.05±5.75)10^(6)个/ml、精子存活率(58.63±10.14)%、a+b级精子率(66.65±10.45)%均高于对照组[(3.08±0.89ml)、(27.63±5.07)10^(6)个/ml、(53.17±8.45)%、(60.74±8.71)%];勃起信心(3.65±0.46分)、勃起时间(3.89±0.35分)、勃起维持时间(3.63±0.45分)、性交困难(4.35±0.25分)、性满足(4.05±0.21分)及总分(19.57±1.72分)均高于对照组(3.37±0.31分、3.41±0.29分、3.23±0.23分、4.11±0.16分、3.33±0.15分、17.45±1.14分);受精率(82.8±5.1)%、优质胚胎率(56.9±10.3)%、可移植胚胎数目(2.4±0.5个)及临床妊娠率(60.0%)均高于对照组[(81.0±3.7)%、(48.5±8.0)%、1.5±0.5个、37.5%];治疗总有效率(90.6%)高于对照组(73.2%)(均P<0.05)。结论:补肾增液汤辩证加减联合左卡尼汀可提高弱精子症患者精液质量,改善患者性功能,有利于改善IVF-ET周期指标,提高IVF-ET成功率。

精浆miR-122-3p和miR-141-Sp的稳定性及对于特发性弱精症的诊断价值SeminalplasmamiR-122·-3pandmiR-141·。5pstabilityanditsdiagnosisvalueforidiopathicasthenospermia

目的探讨精浆游离miR-122—3p和miR-141—5p的稳定性及其对特发性弱精症的诊断价值。方法分析不同的室温孵育时间、反复冻融次数、4℃放置时间下精浆游离miR-122-3p和miR-141—5p的稳定性。应用实时荧光定量聚合酶链反应（real-time fluorescence guantitative-polymerase chain reaction，RT—PCR）检测实验组和对照组精浆miR-122—3p和miR-141—5p的含量，以U6snRNA作为内参。相对定量采用2^-ΔΔCt帕法。将特发性弱精症组按精子前向运动百分比分为a组（0～20％）和b组（21％～32％），比较两组精浆miR-122—3p和miR-141—5p的含量差异。结果在不同的室温孵育时间、4℃放置时间下，精浆miR-122—3p和miR-141-5p含量无明显变化。在反复冻融的条件下，精浆miR-122-3p和miR-141—5p随着冻融次数的增加而减少。RT-PCR结果表明，特发性弱精症组的精浆游离miR-122-3p含量低于对照组，差异有统计学意义（P〈0．05），miR-141-5p含量高于对照组，差异有统计学意义（P〈0．05）。精浆游离miR-122—3p和miR-141—5p含量在特发性弱精症a组和b组之间均有显著性差异（P〈O．05）。ROC曲线结果显示，miRq22—3p曲线下面积为0．88，当以1．02为最佳截断值时，敏感度为83％，特异度为84％。miR-141—5p的曲线下面积为0．88，当以2．95为最佳截断值时，敏感度为84％，特异度为70％。结论精浆中游离miR-122-3p和miR-141—5p可稳定存在，其在特发性弱精症中的差异表达对特发性弱精症的诊断有一定的应用价值。

罗补甫克比日丸治疗弱精子症的药物经济学评价

目的:评价罗补甫克比日丸治疗弱精子症的经济性。方法:基于已发表的罗补甫克比日丸治疗弱精子症的随机对照试验研究,对罗补甫克比日丸治疗弱精子症进行成本-效果分析。结果:患者用药后,罗补甫克比日丸治疗方案在改善精子前向运动百分率和总有效率方面高于维生素E软胶囊治疗方案。以维生素E软胶囊为参照,针对治疗前后精子前向运动百分率差值,计算罗补甫克比日丸的增量成本-效果比(ICER)为11 452.30,同时达到临床意义界值需多花费3 664.74元,约为2021年我国人均可支配收入(PCDI,35 128.00元)的10.43%;针对治疗后总有效率,计算罗补甫克比日丸的ICER为4 094.10,约为2021年我国PCDI的11.65%。结论:本研究认为,基于2021年我国PCDI作为患者支付意愿阈值的假设,在改善弱精子症患者治疗前后精子前向运动百分率差值、提升临床总有效率方面,使用罗补甫克比日丸比使用维生素E软胶囊更具有经济性。开展罗补甫克比日丸治疗弱精子症的经济学评价,有助于提高医药资源配置的总体效率。

龟龄集联合左卡尼汀治疗男性肾阳虚不育症效果及对患者精子质量及性激素影响

目的:探讨中成药“龟龄集”联合左卡尼汀治疗男性肾阳虚不育症效果。方法:选择2022年1月—2023年12月本院就诊的少弱精子症男性患者205例,随机分为西药组102例、中西药组103例,两组均予以基础对症治疗及左卡尼汀治疗,中西药组联合龟龄集治疗,均连用12周。统计疗效、中医证候积分、精子质量、性激素促黄体生成素,氧化应激指标精浆丙二醛(MDA)、活性氧(ROS)、超氧化物歧化酶(SOD)。结果:研究期间,西药组自行退出1例、记录不全2例,纳入99例;中西药组失访1例,个人因素退出1例,纳入101例。治疗后中西药组主症(8.51±2.53分)、次症及舌脉(3.34±1.02分)、中医证候积分总分(11.85±3.45分)均低于西药组(12.15±3.20分、5.02±1.24分、17.17±3.83分),总有效率(82.2%)高于西药组(67.7%),精子浓度(30.15±5.45)×10^(6)/ml、前向运动A级精子百分率(27.26±4.33)%、A级+B级精子百分率(54.46±6.58)%均高于西药组[(22.04±4.62)×10^(6)/ml、(24.36±4.18)%、(48.52±5.16)%],血清促黄体生成素(3.87±1.01U/L)、卵泡刺激素(5.24±1.78U/L)均低于西药组(4.21±1.23 U/L、6.32±2.26U/L),睾酮(15.54±1.96nmol/L)高于西药组(13.68±2.02nmol/L),精浆ROS(425.26±86.18U/ml)、MDA(6.25±1.73nmol/L)均低于西药组(463.73±82.67U/ml、7.12±1.64nmol/L),精浆SOD(102.54±18.02U/ml)高于西药组(95.10±15.25U/ml)(均P<0.05)。结论:龟龄集联合左卡尼汀治疗男性不育症可明显缓解患者临床症状,提高治疗效果,可能与其可改善精子质量,调节性激素表达,降低氧化应激损伤有关。

衍精助育汤治疗弱精子症肾精亏虚型临床观察

目的:观察衍精助育汤治疗男性弱精子症肾精亏虚型的效果。方法:122例随机分为两组各61例,对照组用维参锌胶囊治疗,研究组用衍精助育汤治疗。结果:总有效率研究组高于对照组(P<0.05)。治疗后两组中医主症、次症及总分低于治疗前且研究组低于对照组(P<0.05)。治疗后两组PR、PR+NP高于治疗前且研究组高于对照组(P<0.05)。治疗后两组睾酮水平高于治疗前,促卵泡激素、促黄体生成素水平低于治疗前且研究组睾酮水平高于对照组,促卵泡激素、促黄体生成素水平低于对照组(P<0.05)。结论:衍精助育汤治疗男性弱精子症肾精亏虚型疗效较好。

1920例遗传咨询者的细胞遗传学研究和分析

目的探讨遗传咨询者外周血染色体核型分析异常的类型、发生率与不良孕产史、不孕症、不育症、无精症、少精弱精症等临床疾病的关系。方法选取2019年9月至2022年5月在西北妇女儿童医院进行遗传咨询者1920例,抽取外周静脉血并对外周血淋巴细胞进行培养,采用染色体核型分析技术进行遗传学分析。结果1920例患者中检出染色体异常325例,异常检出率16.93%,其中染色体多态性变异250例(13.02%),染色体数目异常38例(1.98%),染色体结构异常37例(1.93%)。结论染色体异常在优生遗传咨询者中比例较高,外周血染色体核型分析技术有助于为不良孕产史、不孕症、不育症、无精症、少精弱精症等患者明确病因,为优生遗传咨询提供一定的科学依据,临床上应推荐此类人群接受遗传学核型分析检测。

弱精子症合并超重人群精液PRDX2的表达变化与运动能力的相关性分析

目的:初步探究PRDX2在弱精子症合并超重人群患者精子的表达情况及其与运动能力的相关性。方法:收集大理大学第一附属医院生殖科精液常规检查的101份精液标本,将其进行分组,符合正常体质量及正常活力精子的精液标本纳入正常组(60份),符合体质量超重及弱精子症的精液标本纳入弱精超重组(41份);经精子自动分析仪检测精液常规参数,间接免疫荧光法检测PRDX2在2组精子中的定位与表达量变化,并运用相关软件分析PRDX2的变化与精液参数的相关性。结果:间接免疫荧光结果显示,PRDX2主要定位在人精子中段线粒体处,弱精超重组人精子中PRDX2的荧光表达量显著低于正常组,且PRDX2荧光表达量与体重指数呈负相关(r=-0.857,P=0.002),与前向运动精子百分数呈正相关(r=0.827,P=0.003)。结论:弱精子症合并体质量超重人群精子的PRDX2表达下降,且其表达与精子活力正相关。

基于网络药理学和分子对接技术探讨育嗣升精方治疗弱精子症的作用机制

目的探讨育嗣升精方治疗弱精子症的作用机制。方法采用网络药理学研究方法,运用中药系统药理数据库和分析平台(TCMSP)筛选育嗣升精方核心药物(白术、巴戟天、枸杞子、熟地、太子参)的有效成分及其作用靶点,通过检索文献并在Swiss Target Prediction获取鹿角胶对应活性成分及药物靶点。通过Genecards、OMIM数据库获取弱精子症的疾病靶点,使用STRING平台对二者交集的靶点蛋白构建蛋白相互作用网络,并筛选关键靶点。使用R软件进行基于KEGG和GO数据库的富集分析,寻找关键基因共同的功能及相关通路。对关键基因进行蛋白质相互作用(PPI)网络构建。对5个Hub基因与其靶向OB值最高的一种活性成分运用AutoDock进行分子对接。结果共筛选出育嗣升精方核心药物有效成分73个及其对应的218个药物靶点,获得鹿角胶311个药物靶点,获得3205个弱精子症相关靶点,二者交集获得关键靶点230个,功能富集分析结果显示关键靶点基因与对营养水平的反应、对氧气水平的反应、活性氧代谢过程的调控等显著相关。另外,关键靶点基因还参与了细胞凋亡、缺氧诱导因子-1(HIF-1)信号通路、白介素-17(IL-17)信号通路等通路。分子对接结果显示活性成分与靶点对接良好。结论育嗣升精方可能通过槲皮素等活性成分作用于关键靶点,进而参与调控弱精子症的HIF-1信号通路、IL-17信号通路等,增加对活性氧代谢过程的调控、细胞对氧化应激反应调控等,发挥治疗弱精子症的作用。

DJ-1/Nrf2在精索静脉曲张相关性弱精症生精细胞氧化应激中的表达及意义

目的:考察蛋白DJ-1(DJ-1)/稳定核转录因子红系2相关因子2(Nrf2)在精索静脉曲张相关性弱精症患者生精细胞氧化应激中的表达及意义。方法:收集本院2021年12月-2023年12月收治的120例确诊为精索静脉曲张相关性弱精症的男性患者临床资料,60例为新诊断患者纳入新诊断病例组,60例为接受维生素C联合维生素E治疗3个月的患者纳入病例治疗组;同期婚前健康检查健康男性40例为对照组。检测3组精液生精细胞形态、精液生精细胞的DJ-1、Nrf2蛋白及mRNA,外周血氧化应激[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱苷肽过氧化物酶(GSH-Px)]、DJ-1、Nrf2。结果:3组年龄、体质指数、精液体积及精子尾部畸形率均无差异(P>0.05);对照组、病例治疗组、新诊断病例组精子正常形态依次降低,精子头畸形率、体畸形率、头体环合畸形率依次增高,生精细胞DJ-1(0.35±0.11、0.71±0.16、0.89±0.12)、Nrf2蛋白(0.31±0.09、0.62±0.14、0.78±0.13)及mRNA均依次增高,血清MDA、DJ-1、Nrf2依次增高,SOD、GSH-Px依次降低(均P<0.05)。结论:激活DJ-1/Nrf2通路有助于增强精索静脉曲张相关性弱精症生精细胞的抗氧化能力,保护细胞免受由氧化应激引起的损伤,DJ-1/Nrf2通路或是精索静脉曲张相关性弱精症的治疗的潜在分子靶点。

基于精室理论研制的生精方治疗特发性弱精子症的临床疗效评价

目的:评价生精方治疗特发性弱精子症的临床疗效。方法:参照随机数字表法将125例特发性弱精子症(脾肾亏虚型)患者分为治疗组和对照组,其中治疗组煎服生精方,对照组口服左卡尼汀,两组均连续治疗12周。分别记录两组患者治疗前后的精子浓度、前向运动精子比例、精子DNA碎片率及中医证候评分,进行临床疗效评价。结果:治疗组59例、对照组55例最终纳入研究统计。治疗组总有效率为84.75%(50/59),对照组总有效率为67.27%(37/55)。治疗组精子浓度治疗前为(25.8±3.7)×10^(6)/mL,治疗后为(43.2±5.4)×10^(6)/mL;对照组治疗前为(25.2±3.3)×10^(6)/mL,治疗后为(31.3±4.6)×10^(6)/mL。治疗组前向运动精子的比例治疗前为(16.3±6.1)%,治疗后为(40.6±8.3)%;对照组治疗前为(15.9±5.8)%,治疗后为(21.5±5.5)%。治疗组精子DNA碎片率治疗前为(28.2±5.3)%,治疗后为(12.7±3.8)%;对照组治疗前为(27.8±5.7)%,治疗后为(23.8±4.4)%。治疗组治疗期间临床妊娠率为8.47%(5/59),对照组为1.82%(1/55)。两组患者的精液质量(精子的浓度、前向运动精子的比例、精子DNA碎片率等)与治疗前相比均有不同程度改善,其中治疗组要显著优于对照组。治疗组临床妊娠率亦显著优于对照组。结论:生精方能较好地改善脾肾亏虚型特发性弱精子症患者的精子质量、提高妊娠率,对于患者的临床症状亦有一定的改善作用,具有一定的推广应用价值。

腹腔镜精索静脉结扎联合中药治疗精索静脉曲张伴少、弱精子症的临床研究

目的研究腹腔镜精索静脉结扎联合中药治疗精索静脉曲张伴少、弱精子症的临床疗效。方法收集本院就诊并手术治疗的双侧精索静脉曲张伴少、弱精子症的患者72例,随机分为观察组(36例)和对照组(36例)。两组均行腹腔镜精索静脉高位结扎手术,观察组术后口服中药。两组术后8周、12周、24周复查精液常规检查。结果两组患者术后无复发。观察组与对照组术后第8周、第12周、第24周的精子浓度、向前运动精子率(PR)、非向前运动精子率(NR)+PR较术前均有所改善(P<0.05)。在精子浓度及PR方面,观察组术后第8周、第12周、第24周均优于同时期对照组,差异有统计学意义(P<0.05);在精子总活力(PR+NR)方面,两组在第8周时差异无统计学意义(P>0.05),在第12周、第24周时,观察组优于对照组,差异有统计学意义(P<0.05)。结论腹腔镜精索静脉高位结扎术联合中药治疗精索静脉曲张伴少、弱精子症的临床疗效显著,优于单纯手术治疗,值得临床推广。

补肾衍精汤辅治弱精子症肾阳亏虚型临床观察

目的:观察补肾衍精汤辅治弱精子症肾阳亏虚型的疗效。方法:90例随机分为观察组46例和对照组44例。两组均给予常规治疗,观察组加用补肾衍精汤治疗。结果:观察组总有效率高于对照组(P<0.05),治疗后观察组中医证候积分低于对照组(P<0.05),治疗后观察组精液水平高于对照组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:补肾衍精汤辅治弱精子症肾阳亏虚型有良好疗效,且安全。

Effectiveness of Testosterone Undecanoate Treatment in Men with Asthenospermia

Objective To assess the effectiveness of testosterone undecanoate on sperm motility and pregnancy incidence in men with asthenospermia. Methods A clinical trial was performed. Fifty men with asthenospermia were included to receive placebo （control group, n=9） or T undecanoate 80 mg/d （study group, n=41）. Pregnancy incidence and sperm characteristics after 1, 2 and 3 months of medication and 3 months after the end of the trial were measured. Results Compared with the placebo, T undecanoate treatment produced a satisfactory improvement of seminal motility （F=55.904, P=0.000）. In study group, the incidence of pregnancy was 28.2% while the incidence of pregnancy in control group was 11.1%. In study group, 26patients took T undecanoate for more than 3 months. In the 3 months, semen volume showed no statistical difference （F=1.206, P=0.312） before and after treatment, sperm concentration （F=0.023, P=0.000） and motility a, b, a ＋b （P=0.000） showed statistical differences. Motility grade a showed significantly higher increment in 2 and 3 months after treatment than 1 month and there was no statistical difference between 2 and 3 months. So did grade b. Conclusion The results indicate that T undecanoate increases semjnal motility, leading to a higher incidence of pregnancy in couples with infertility related to asthenoaspermia.

Clinical Observations on Therapeutic Effects of the Modified Shengjing Zhongzi Tang(生精种子汤) in Patients with Asthenospermia and Oligozoospermia

Objective:To compare the therapeutic effects of Shengjing Zhongzi Tang(生精种子汤Decoction for Generating Sperms) and Wuzi Yanzong Wan(五子衍宗丸Pills for Reproduction) for asthenospermia and oligozoospermia.Methods:Seventy patients with asthenospermia and oligozoospermia were divided into a treatment group of 35 cases treated with Shengjing Zhongzi Tang and a control group of 35 cases treated with Wuzi Yanzong Wan for 3 months respectively.The therapeutic effects were evaluated,the semen parameters were analyzed and the spermatic morphology was judged before and after treatment.Results:In the treatment group,the total effective rate was 91.4% with a pregnant rate of 8.6% spouses,and the markedly effective rate was 65.7%.In the control group,the total effective rate was 85.7% with a pregnant rate of 5.7% spouses,and the markedly effective rate was 54.3%.Both the total effective rate and the markedly effective rate were higher in the treatment group than those in the control group,but with no significant statistical difference(P>0.05).The spermatic density,spermatic motility and the percentage of normal spermatic morphology were obviously enhanced in the two groups with the indexes in the treatment group superior to those in the control group(P<0.05 or P<0.01).Conclusion:Shengjing Zhongzi Tang with obvious therapeutic effects for asthenospermia and oligozoospermia can significantly enhance the spermatic density and motility,and raise the pregnant rate in spouses.

金龟毓麟方治疗特发性弱精子症(肾虚肝郁型)临床观察

目的评价金龟毓麟方治疗特发性弱精子症(肾虚肝郁型)的有效性与安全性。方法收集2019年12月至2020年12月就诊于中国中医科学院西苑医院男科门诊的特发性弱精子症(肾虚肝郁型)患者为研究对象,共纳入患者124例。采用随机、对照试验,按1∶1随机分为研究组(62例)和对照组(62例),研究组给予金龟毓麟方治疗,对照组给予左卡尼汀口服液治疗,两组均用药12周,随访4周。主要疗效指标包括前向运动精子(PR)、精子总活力[PR+非前向运动精子(NP)];次要疗效指标包括中医证候评分、精子浓度、精液量、配偶受孕率;安全性指标包括血常规、尿常规、肝肾功能、心电图。结果本研究共入组患者124例,脱落11例(研究组脱落4例,对照组脱落7例),研究组58例和对照组55例纳入最终分析。(1)组内比较,对照组治疗8周、12周后PR及PR+NP精子比例显著提高(P<0.05);研究组在治疗4周、8周、12周后PR及PR+NP精子比例显著提高(P<0.05)。(2)组间比较,研究组治疗8周、12周后,在提高PR及PR+NP精子比例方面均显著优于对照组(P<0.05);研究组治疗4周、8周、12周后在降低中医证候评分方面均显著优于对照组(P<0.05)。在治疗4周、8周、12周后两组间精子浓度、精液量、配偶受孕率比较均无统计学差异(P>0.05)。结论金龟毓麟方在提高特发性弱精子症PR和PR+NP精子比例及降低中医证候评分方面均优于左卡尼汀口服液,且未见明显不良反应,表明金龟毓麟方在治疗肾虚肝郁型特发性弱精子症方面安全有效。