【摘要】：目的:觀察α-硫辛酸膠囊聯(lián)合枸櫞酸他莫昔芬片對少弱精子癥患者的療效。方法:選擇2016年6~11月就診的60例少弱精子癥患者,將其隨機(jī)分為2組,每組30例。治療組給予α-硫辛酸膠囊(0.6 g,1次/d)聯(lián)合枸櫞酸他莫昔芬片(20 mg,1次/d)口服治療,對照組給予左卡尼汀口服液(1 g,2次/d)聯(lián)合枸櫞酸他莫昔芬片(20 mg,1次/d)口服治療,治療前及治療后3個(gè)月檢測所有病例精液參數(shù)及精液氧化應(yīng)激生物標(biāo)志物,包括丙二醛(MDA),總抗氧能力(TAC)水平,同時(shí)了解配偶妊娠率及不良反應(yīng)發(fā)生情況。結(jié)果:57例患者完成了全部治療,包括治療組28例,對照組29例。治療組治療前、后精液量分別為(2.50±0.71)ml、(3.37±0.70)ml,精子濃度(12.00±1.65)×10~6/ml、(19.34±2.04)×10~6/ml,前向運(yùn)動(dòng)精子百分率(18.01±3.01)%、(35.41±6.49)%,精漿TAC(9.83±1.02)U/ml、(12.25±1.11)U/ml,MDA(14.96±2.76)nmol/ml、(10.04±1.04)nmol/ml;對照組治療前、后精液量分別為(2.76±0.67)ml、(3.36±0.93)ml,精子濃度(11.47±1.10)×10~6/ml、(17.77±3.56)×10~6/ml,前向運(yùn)動(dòng)精子百分率(19.22±1.41)%、(36.01±5.22)%、精漿TAC(9.84±0.90)U/ml、(11.14±0.84)U/ml,MDA(14.66±2.75)nmol/ml、(10.14±1.01)nmol/ml,上述各指標(biāo)兩組治療后均較治療前有顯著改善(P0.05),精漿TAC改善方面治療組優(yōu)于對照組(P0.05),其余指標(biāo)兩組之間差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組正常形態(tài)精子百分率治療前后無統(tǒng)計(jì)學(xué)差異(P0.05)。治療3個(gè)月后配偶妊娠,治療組3例(10.7%),對照組1例(3.45%),兩組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),治療期間所有患者均未見明顯不良反應(yīng)。結(jié)論:α-硫辛酸膠囊聯(lián)合枸櫞酸他莫昔芬片可明顯改善精漿氧化應(yīng)激損傷,進(jìn)而改善少弱精子癥患者的精液質(zhì)量。
[Abstract]:Objective: to observe the therapeutic effect of 偽-lipoic acid capsule combined with tamoxifen citrate tablets on oligoasthenospermia. Methods: 60 patients with oligozoospermia from June to November 2016 were randomly divided into two groups with 30 cases in each group. The treatment group was treated with 偽-lipoic acid capsule (0.6g, once a day) combined with tamoxifen citrate tablet (20 mg,1 / d), while the control group was treated with levocarnitine oral liquid (1g, 1g). (2 / d) combined with tamoxifen citrate (20 mg,1 / d) oral treatment. Semen parameters and biomarkers of oxidative stress, including malondialdehyde (MDA), were measured before and 3 months after treatment. The level of total antioxidant capacity (TAC), pregnancy rate and adverse reactions were also investigated. Results: 57 patients completed all treatment, including 28 cases in the treatment group and 29 cases in the control group. Before treatment, the sperm volume of the treatment group was (2.50 鹵0.71) ml, (3.37 鹵0.70) ml, sperm concentration (12.00 鹵1.65) 脳 10 ~ (6) mmol / ml, (19.34 鹵2.04) 脳 10 ~ (6) mmol / ml, and the percentage of forward motility sperm was (18.01 鹵3.01)%. (35.41 鹵6.49)%, seminal plasma TAC (9.83 鹵1.02) U / ml, (12.25 鹵1.11) U / ml, (14.96 鹵2.76) nmol/ml, (10.04 鹵1.04) nmol/ml; Before the treatment, the sperm volume of the control group was (2.76 鹵0.67) ml, (3.36 鹵0.93) ml, sperm concentration (11.47 鹵1.10) 脳 10 脳 10 ~ (6) mmol / ml, (17.77 鹵3.56) 脳 10 脳 10 ~ (6) mmol / ml, and the percentage of forward motility sperm was (19.22 鹵1.41)%. (36.01 鹵5.22)%, seminal plasma TAC (9.84 鹵0.90) U / ml, (11.14 鹵0.84) U / ml, (14.66 鹵2.75) nmol/ml, (10.14 鹵1.01) nmol/ml, The above indexes were significantly improved in the two groups after treatment (P0.05), and the improvement of seminal plasma TAC in the treatment group was better than that in the control group (P0.05), while there was no significant difference between the other two groups (P0.05). There was no statistical difference in the percentage of normal morphology sperm between the two groups before and after treatment (P0.05). There were 3 cases (10.7%) in the treatment group and 1 case (3.45%) in the control group after 3 months of treatment. There was no significant difference between the two groups (P0.05). No obvious adverse reaction was observed in all the patients during the treatment. Conclusion: 偽-lipoic acid capsule combined with tamoxifen citrate tablets can significantly improve the damage of seminal plasma oxidative stress, and then improve the semen quality of oligoasthenospermia patients.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院泌尿外科;
【分類號】：R698.2

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