首页|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

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

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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.
Effect of chinese patent drug Guilingji combined with levocarnitine for treating male patients with infertility because of kidney-yang deficiency and its influence on the sperm quality and sex hormones levels
Objective:To investigate the effect of chinese patent drug Guilingji combined with levocarnitine for treating male patients with infertility because of kidney-yang deficiency.Methods:205 male patients with oligospermia and as-thenospermia were selected and were randomly divided into group A(102 cases)and group B(103 cases)from January 2022 to December 2023.The patients in both groups were given basic symptomatic treatment and asthenospermia,and the patients in group B was given Guilingji additionally.The patients in both groups were treated for 12 weeks continu-ally.The therapeutic effect,the TCM syndrome score,the sperm quality,the levels of sex hormones,such as luteini-zing hormone(LH),testosterone(T)and follicle stimulating hormone(FSH),and the levels of oxidative stress,such as seminal plasma malondialdehyde(MDA),reactive oxygen species(ROS)and superoxide dismutase(SOD)of the pa-tients in the two groups were counted.Results:In group A,there were 99 patients were included,with 1 case withdrawing by himself and 2 cases without complete the study records.In group B,there were 101 patients were in-cluded,with 1 case lost to follow-up and 1 case withdrew due to personal factors.The scores of primary symptom(8.51±2.53 points),the second symptom and tongue symptom(3.34±1.02 points)and the total TCM syndrome(11.85±3.45 points)of the patients in group B after treatment were significantly lower than those(12.15±3.20 points,5.02±1.24 points and 17.17±3.83 points)of the patients in group A.The total effective rate(82.2%)of the patients in group B after treatment was significantly higher than that(67.7%)of the patients in group A.The sperm concentration(30.15±5.45 ×10 6/ml),the percentages of grade A(27.26±4.33%)and grade A+B(54.46±6.58%)of sperm forward movement of the patients in group B were significantly higher than those(22.04±4.62 × 10 6/ml,(24.36±4.18%and 48.52±5.16%)of the patients in group A.The levels of the serum luteinizing hormone(3.87±1.01 U/L)and follicle-stimulating hormone(5.24±1.78 U/L),and the levels of seminal plasma ROS(425.26±86.18U/ml)and MDA(6.25±1.73nmol/L)of the patients in group B were significantly lower than those(4.21±1.23 U/L,6.32±2.26U/L,463.73±82.67U/ml and 7.12±1.64nmol/L)of the patients in group A.The levels of serum testosterone(15.54±1.96nmol/L)and seminal plasma SOD(102.54±18.02U/ml)of the patients in group B were significantly higher than those(13.68±2.02nmol/L and 95.10±15.25U/ml)of the patients in group A(all P<0.05).Conclusion:Guilingji combined with levocarnitine for treating the male infertility patients can significantly alleviate their clinical symptoms and improve the therapeutic effect,which may be related to the improvement of the sperm quality,to the regulation of sex hormones expressions and to the reduction of oxidative stress injury of the patients.

Male infertilityOligospermia and asthenospermiaChinese patent drug"Guilingji"LevocarnitineSperm qualitySex hormoneOxidative stress

苏军、王锦、王久源

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四川大学华西第二医院成华妇女儿童医院,成都市成华区妇幼保健院(610000)

四川泌尿外科医院

成都中医药大学附属医院

男性不育症 少弱精子症 中成药"龟龄集" 左卡尼汀 精子质量 性激素 氧化应激

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(8)