CAJ | 학술논문

目的：观察补肾益精汤联合枸橼酸他莫西芬、甘草锌和维生素E对肾精亏虚证少精子症患者精子密度的影响及临床疗效。方法将450例少精子症患者按数字表法随机分为三组，治疗组150例采用补肾益精汤联合枸橼酸他莫西芬、甘草锌、维生素E治疗；对照Ⅰ组150例采用补肾益精汤、甘草锌和维生素E治疗；对照Ⅱ组150例采用枸橼酸他莫西芬、甘草锌和维生素E治疗。三组均治疗3个月，治疗不足3个月其配偶受孕者终止治疗，治疗3个月后其配偶仍未受孕，继续观察3个月统计受孕率，统计分析三组治疗前后精子密度等精液质量其他指标（精液量、pH值、活动力、活动率、正常形态率）的变化。结果治疗组、对照Ⅰ组、对照Ⅱ组总有效率分别为90．21％、85．11％、72．22％，治疗组总有效率高于对照Ⅰ组（χ2＝9．53，P＜0.05）和对照Ⅱ组（χ2＝23．38，P＜0．01）；治疗组、对照Ⅰ组、对照Ⅱ组配偶受孕率分别为42．66％、25．53％、20．83％，治疗组患者配偶受孕率明显优于对照Ⅰ组（χ2＝9．26，P＜0．01）和对照Ⅱ组（χ2＝15．78，P＜0．01）；治疗组治疗后精子密度、活动力、活动率、精子正常形态率明显优于治疗前（ t＝-22．22、-18．07、-33．48、-28．46，均P＜0．01）。结论补肾益精汤联合枸橼酸他莫西芬、甘草锌和维生素E能明显改善肾精亏虚证少精子症患者的精子密度及精液质量，显著提高其配偶受孕率。
목적：관찰보신익정탕연합구연산타막서분、감초자화유생소E대신정우허증소정자증환자정자밀도적영향급림상료효。방법장450례소정자증환자안수자표법수궤분위삼조，치료조150례채용보신익정탕연합구연산타막서분、감초자、유생소E치료；대조Ⅰ조150례채용보신익정탕、감초자화유생소E치료；대조Ⅱ조150례채용구연산타막서분、감초자화유생소E치료。삼조균치료3개월，치료불족3개월기배우수잉자종지치료，치료3개월후기배우잉미수잉，계속관찰3개월통계수잉솔，통계분석삼조치료전후정자밀도등정액질량기타지표（정액량、pH치、활동력、활동솔、정상형태솔）적변화。결과치료조、대조Ⅰ조、대조Ⅱ조총유효솔분별위90．21％、85．11％、72．22％，치료조총유효솔고우대조Ⅰ조（χ2＝9．53，P＜0.05）화대조Ⅱ조（χ2＝23．38，P＜0．01）；치료조、대조Ⅰ조、대조Ⅱ조배우수잉솔분별위42．66％、25．53％、20．83％，치료조환자배우수잉솔명현우우대조Ⅰ조（χ2＝9．26，P＜0．01）화대조Ⅱ조（χ2＝15．78，P＜0．01）；치료조치료후정자밀도、활동력、활동솔、정자정상형태솔명현우우치료전（ t＝-22．22、-18．07、-33．48、-28．46，균P＜0．01）。결론보신익정탕연합구연산타막서분、감초자화유생소E능명현개선신정우허증소정자증환자적정자밀도급정액질량，현저제고기배우수잉솔。
Objective To observe the clinical efficacy and sperm density of Bushen Yijing decoction and tamoxifen,zinc and vitamin E in treating oligospermia with kidney deficiency syndrome .Methods 450 patients with oligospermia were randomly divided into 3 groups.150 patients of the treatment group were treated by Bushen Yijing decoction,tamoxifen,zinc and vitamin E,150 patients of the control group I were treated by Bushen Yijing decoction , zinc and vitamin E,150 patients of the control group II were treated by tamoxifen ,zinc and vitamin E.3 groups were treated for 3 months,pregnancy terminating of treatment and otherwise continued to observe for 3 months after the end of treatment,the sperm density and other sperm parameters (sperm amount,pH,sperm motility,sperm survival rate, sperm normal modality rate ) were evaluated before and after treatment .Results The total effective rates of the treat-ment group,control group I and II were 90.21%,85.11%,72.22%respectively.The total effective rate of the treat-ment group was higher than that of the control group I (χ2 =9.53,P<0.05) and II(χ2 =23.38,P<0.01).The pregnancy rates of the treatment group ,control group I and II were 42.66%,25.53%,20.83%,respectively.The pregnancy rate of treatment group was significantly better than that of the control group I (χ2 =9.26,P<0.01) and II (χ2 =15.78,P<0.01).There were significant differences between before and after treatment on sperm density , sperm motility,sperm survival rate and sperm normal modality rate in the treatment group ( t=-22.22,-18.07,-33.48,-28.46,all P<0.01).Conclusion Bushen Yijing decoction combined with tamoxifen ,zinc and vitamin E can evidently improve the sperm density and other sperm qualities and conception rate of oligospermia with kidney deficiency syndrome .