3种不同方案治疗肾精亏虚证少精子症患者临床观察

目的比较3种不同方案治疗肾精亏虚证少精子症的临床疗效。方法 450例患者随机分为治疗组、对照1组及对照2组，每组150例。治疗组口服补肾益精汤和枸橼酸他莫昔芬片、甘草锌胶囊及维生素E胶丸治疗；对照1组口服补肾益精汤、甘草锌胶囊和维生素E胶丸治疗；对照2组口服枸橼酸他莫昔芬片、甘草锌胶囊和维生素E胶丸治疗。3组均治疗3个月。比较3组配偶受孕率、治疗前后精液参数［精子密度、a级精子比例、（a+b）级精子比例、（a+b+c）级精子比例、精子正常形态率］及中医单项症状临床疗效。结果至治疗结束后3个月，治疗组共受孕61例，对照1组36例，对照2组30例。治疗组精子密度、a级精子比例、（a+b）级精子比例和（a+b+c）级精子比例治疗前后差值均明显高于对照1组和对照2组（P<0.01）；治疗组和对照1组精子正常形态率治疗前后差值均明显高于对照2组（P<0.01）。治疗组和对照1组在改善性欲淡漠、腰膝酸软、阳痿、早泄、遗精、头晕、耳鸣、健忘、脱发方面明显优于对照2组 （P<0.01，P<0.05）。治疗组与对照1组上述中医症状总有效率比较，差异均无统计学意义（P>0.05）。结论补肾益精汤联合枸橼酸他莫昔芬片、甘草锌胶囊及维生素E胶丸治疗，可显著提高肾精亏虚证少精子症患者的精子质量，改善中医症状。

英文摘要:

Objective To compare the clinical efficacy of 3 different treatment programs for oligospermia patients of Shen essence deficiency syndrome （SEDS）. Methods Totally 450 male patients were randomly assigned to 3 groups， i.e.， the treatment group， the control group 1， and the control group 2， 150 in each group. Patients in the treatment group were treated by Bushen Yijing Decoction （BYD）， tamoxifen tablet （TT）， Licorzine Capsule （LC）， and Vitamin E Soft Capsule （VESC）. Those in the control group 1 were treated by BYD， LC， and VESC. Those in the control group 2 were treated by TT， LC， and VESC. All patients were treated for 3 months. Their pregnant rates were compared. Clinical efficacies of each Chinese medical symptom and sperm parameters ［sperm density， grade a sperm motility rate， grade （a+b） sperm motility rate， grade （a+b+c） sperm motility rate， and normal sperm morphology rate］ were compared before and after treatment. Results At 3 months after treatment 61 patients were pregnant in the treatment group， 36 patients were pregnant in the control group 1， and 30 patients were pregnant in the control group 2. The differences in the sperm density， grade a sperm motility rate， and grade （a+b） sperm motility rate， and grade （a+b+c） sperm motility rate between before and after treatment were significantly higher in the treatment group than in the control group 1 and the control group 2 （P<0.01）. The difference in the normal sperm morphology rate between before and after treatment was obviously higher in the treatment group and the control group 1 than in the control group 2 （P<0.01）. Better results were obtained in the treatment group and the control group 1 in improving the sexual apathy， soreness and weakness of waist and knees， impotence， premature ejaculation， seminal emission， dizziness， tinnitus， forgetfulness， alopecia， when compared with the control group 2 （P<0.01， P<0.05）. There was no statistical difference in the total effective rate of improving Chinese medical symptoms between the treatment group and the control group 1 （P>0.05）. Conclusion BYD combined with TT， LC， and VESC could significantly improve sperm qualities and clinical Chinese medical symptoms of oligospermia patients of SEDS.

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