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目的:观察α-硫辛酸胶囊联合枸橼酸他莫昔芬片对少弱精子症患者的疗效。方法:选择2016年6~11月就诊的60例少弱精子症患者,将其随机分为2组,每组30例。治疗组给予α-硫辛酸胶囊(0.6 g,1次/d)联合枸橼酸他莫昔芬片(20 mg,1次/d)口服治疗,对照组给予左卡尼汀口服液(1 g,2次/d)联合枸橼酸他莫昔芬片(20 mg,1次/d)口服治疗,治疗前及治疗后3个月检测所有病例精液参数及精液氧化应激生物标志物,包括丙二醛(MDA),总抗氧能力(TAC)水平,同时了解配偶妊娠率及不良反应发生情况。结果:57例患者完成了全部治疗,包括治疗组28例,对照组29例。治疗组治疗前、后精液量分别为(2.50±0.71)ml、(3.37±0.70)ml,精子浓度(12.00±1.65)×10~6/ml、(19.34±2.04)×10~6/ml,前向运动精子百分率(18.01±3.01)%、(35.41±6.49)%,精浆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;对照组治疗前、后精液量分别为(2.76±0.67)ml、(3.36±0.93)ml,精子浓度(11.47±1.10)×10~6/ml、(17.77±3.56)×10~6/ml,前向运动精子百分率(19.22±1.41)%、(36.01±5.22)%、精浆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,上述各指标两组治疗后均较治疗前有显著改善(P<0.05),精浆TAC改善方面治疗组优于对照组(P<0.05),其余指标两组之间差异无统计学意义(P>0.05),两组正常形态精子百分率治疗前后无统计学差异(P>0.05)。治疗3个月后配偶妊娠,治疗组3例(10.7%),对照组1例(3.45%),两组比较差异无统计学意义(P>0.05),治疗期间所有患者均未见明显不良反应。结论:α-硫辛酸胶囊联合枸橼酸他莫昔芬片可明显改善精浆氧化应激损伤,进而改善少弱精子症患者的精液质量。
Objective: To observe the effect of α-lipoic acid capsules combined with tamoxifen citrate tablets in patients with oligospermia. Methods: Sixty oligo asthenospermia patients were selected from June to November in 2016, and were randomly divided into two groups (n = 30 in each group). Patients in the treatment group were treated with α-lipoic acid capsule (0.6 g once daily) and tamoxifen citrate tablets (20 mg once daily), while those in the control group were given L-carnitine oral solution (1 g , 2 times / d) combined with tamoxifen citrate tablets (20 mg once daily) before treatment and 3 months after treatment to detect all cases of semen parameters and sperm oxidative stress biomarkers, including Malondialdehyde (MDA), total antioxidant capacity (TAC), and to understand the incidence of pregnancy and adverse reactions. Results: All 57 patients completed the treatment, including 28 in the treatment group and 29 in the control group. The amount of semen in the treatment group before and after treatment were (2.50 ± 0.71) ml, (3.37 ± 0.70) ml and sperm concentration (12.00 ± 1.65) × 10 ~ 6 / ml and (19.34 ± 2.04) × 10 ~ The percentage of forward motile spermatozoa (18.01 ± 3.01)%, (35.41 ± 6.49)%, seminal plasma TAC (9.83 ± 1.02) U / ml and (12.25 ± 1.11) U / ml MDA and 14.96 ± 2.76 nmol / (10.04 ± 1.04) nmol / ml respectively. The amount of semen in the control group before and after treatment were (2.76 ± 0.67) ml, (3.36 ± 0.93) ml and sperm concentration (11.47 ± 1.10) × 10-6 / ml 3.56) × 10 ~ 6 / ml, the percentage of forward motile sperm was (19.22 ± 1.41)%, (36.01 ± 5.22)%, seminal plasma TAC was 9.84 ± 0.90 U / ml, (11.14 ± 0.84) U / (14.66 ± 2.75) nmol / ml and (10.14 ± 1.01) nmol / ml, respectively. The above indexes were significantly improved in both groups after treatment (P <0.05) There was no significant difference between the two groups (P> 0.05). There was no significant difference between the two groups (P> 0.05) before and after the treatment of normal sperm percentage. Three months after treatment, 3 cases (10.7%) in the treatment group and 1 case (3.45%) in the control group showed no significant difference (P> 0.05), and no adverse reactions were found in all the patients during the treatment . CONCLUSION: Alpha-lipoic acid capsule combined with tamoxifen citrate tablets can significantly improve the oxidative stress injury in seminal plasma and further improve the semen quality of asthenospermia patients.