养精赞育颗粒对弱精子症患者精子DNA完整性的影响

目的探讨养精赞育颗粒治疗弱精子症患者对精子DNA完整性的影响。方法选择弱精子症患者86例,口服养精赞育颗粒3个月。通过吖啶橙试验（AOT）与计算机辅助精液分析（CASA）检测DFI（精子DNA断裂指标）和精液常规参数。再将86例患者按照DFI值（大于10%或小于10%）进行分层研究并使用SPSS11.5软件进行数据分析。结果治疗3个月后,a级精子百分比和（a＋b）精子百分比与治疗前相比差异均有统计学意义（P〈0.01）;所有86例患者DFI绝对值（6.89±4.08）与治疗前（11.31±7.21）相比差异有统计学意义（P〈0.01）;DFI正常组DFI绝对值（4.71±1.87）与治疗前（5.25±2.61）相比差异无统计学意义（P〉0.05）;DFI异常组DFI绝对值（8.61±4.53）与治疗前（16.11±5.94）相比差异有统计学意义（P〈0.01）。结论应用养精赞育颗粒治疗男性不育可显著改善精子的活力和精子DNA的完整性;补脾益肾是提高精子DNA完整性的有效方法。     

L-肉碱对奥硝唑所致弱精子症大鼠的治疗作用

目的:探讨L-肉碱(LC)对奥硝唑(ORN)所致的弱精子症雄性大鼠的治疗作用。方法:性成熟雄性SD大鼠(200～230g)40只,随机均分为5组,连续灌胃20d,1次/d,每次1ml。A组(对照组):0.5%的羧甲基纤维素钠(溶剂);B组:ORN[400mg/(kg.d)];C组:ORN[400mg/(kg.d)]+LC[100mg/(kg.d)];D组:ORN[800mg/(kg.d)];E组:ORN[800mg/(kg.d)]+LC[100mg/(kg.d)]。将各组半数大鼠末次给药24h后,麻醉处死,取附睾,进行精子活力检测,并对附睾尾精子进行计数,剩余大鼠进行交配实验。结果:①与A组相比,B组,D组附睾头和附睾尾精子活力显著降低(P<0.05);精子数目显著减少(P<0.05)。②与B组相比,C组精子活力明显升高(P<0.05),精子数目明显增多(P<0.05),与A组比较无显著差异(P>0.05)。③E组大鼠的精子活力没有显著的提高,精子数目无明显增多,并且与D组相比没有差别(P>0.05)。结论:LC治疗后能提高ORN所致弱精子症大鼠的精子活力,增加精子密度。     

Study of sperm characteristics in persons occupationally exposed to lead.

The sperm characteristics of 38 male workers exposed to lead in a battery factory were studied. Sperm analysis was performed after 4 days of sexual abstinence. Parameters analyzed were: volume, sperm count, motility, and morphology. Exposure levels were estimated by measuring the concentration of lead and delta-aminolevulinic acid in the serum. Based on blood lead levels, the tested individuals were divided in three groups: A (12), B (11), and C (15). Significant levels of asthenospermia and teratospermia were found in exposed workers when compared with unexposed controls. Long-term exposure to lead may lead to changes in sperm characteristics and function.     

Ultrastructural Aspects of Asthenospermia

In fifty cases of proven asthenospermia semen samples were examined for ultrastructural abnormalities. In 32 of the cases the sperm cells appeared either completely normal, or presented only minor abnormalities. In 15 cases severe teratospermia was observed. In the 3 remaining cases, specific and hitherto undescribed tail abnormalities were detected.     

单味中药治疗弱精子症的研究现状

综述了近年来用于治疗弱精子症的常用单味中药的作用机制及其研究进展,为提高弱精子症的治疗水平提供新的思路。     

自拟七子补肾生精汤联合他莫昔芬、维生素E治疗少弱精子症疗效观察

目的观察自拟七子补肾生精汤联合他莫昔芬片、维生素E软胶囊治疗少弱精子症的临床疗效及安全性。方法选择2013年6月至2014年11月在邢台不孕不育专科医院男性不育科就诊的不育症患者184例,按不同用药分为两组:治疗组92例用自拟七子补肾生精汤水煎+口服他莫昔芬、维生素E口服;对照组92例用五子衍宗丸+他莫昔芬、维生素E口服。疗程均为3个月,观察治疗前后两组患者精液参数及疗效。结果经过3个月治疗,治疗组患者精子浓度[(36.81±4.26)m L]、精子活力[PR值(50.63±5.73)%]较治疗前[(8.57±4.51)m L、(24.92±3.76)%]显著提高(P0.05);对照组患者治疗后精子浓度[(18.43±5.12)m L]、精子活力[PR值(36.23±4.04)%]较治疗前[(8.29±4.85)m L、(22.15±4.82)%]也有提高(P0.05),但治疗组临床疗效明显优于对照组(P0.05)。两组治疗中未发生明显不良反应。结论补肾生精汤联合他莫昔芬、维生素E治疗少弱精子症的疗效显著且安全性良好。     

The use of the modified hypo-osmotic swelling test for the selection of immotile testicular spermatozoa in patients treated with ICSI: a randomized controlled study

BACKGROUND: Various methods for the selection of viable sperm from among immotile testicular spermatozoa for use in ICSI have been described in non-randomized studies. We have conducted a randomized controlled study to compare the use of the modified hypo-osmotic swelling (HOS) test (50% culture medium + 50% Milli-Q grade water) with that of sperm selection on the basis of their morphology alone. METHODS: A total of 79 couples with immotile testicular spermatozoa treated with ICSI were randomly assigned into two groups. In the first group, spermatozoa used for injection were selected using the modified HOS test, while in the second group spermatozoa were selected on the basis of their morphology. RESULTS: The fertilization rate was significantly higher in the HOS test group (43.6%) compared with the no-HOS test group (28.2%) [odds ratio (OR) 2.494; 95% confidence interval (CI) 1.606-3.872]. The pregnancy and ongoing pregnancy rates were also higher in the HOS test group (27.3% versus 20.5%) compared with the no-HOS test group (5.7% versus 2.9%) (OR 6.188, 95% CI 1.282-29.860; and OR 8.743, 95% CI 1.050-72.783, respectively). CONCLUSIONS: The use of the modified HOS test for the selection of viable sperm from among immotile testicular spermatozoa for ICSI results in higher fertilization, pregnancy and ongoing pregnancy rates compared with morphological selection.     

七子补肾生精汤联合维生素E治疗弱精子症临床研究

目的:观察自拟七子补肾生精汤联合维生素E软胶囊对弱精子症患者精子浓度和前向运动精子的影响及临床疗效和不良反应。方法:将166例患者随机分为对照组和治疗组,每组83例。治疗组采用七子补肾生精汤治疗,方药组成:菟丝子、枸杞子、覆盆子、五味子、车前子、女贞子、韭菜子、当归、黄芪、山药、山萸肉、茯苓、党参、黄精、淫羊藿、仙茅、肉苁蓉、巴戟天、鹿角霜、红花、丹参、莪术,每日1剂,分2次服。维生素E 100 mg,每日2次;对照组采用硫酸锌口服液10m L,每日2次,维生素E 100 mg,每日2次。两组疗程均为2.5个月,并于治疗前后对两组患者进行精液参数及疗效观察。结果:治疗组治疗后精子浓度和前向运动精子与治疗前比较,差异有统计学意义(P0.05),两组患者治疗后精子浓度和前向运动精子比较,差异有统计学意义(P0.05);治疗组有效率为92.77%,对照组有效率为30.12%,两组比较,差异有统计学意义(P0.05);两组患者在治疗期间均未发生明显不良反应。结论:补肾生精汤联合维生素E胶囊治疗有较好的补肾生精、活精的功效,能提高精子活力和前向运动精子量,临床疗效显著且无明显不良反应。     

人精浆中胎盘生长因子表达与少弱精子症临床相关性分析

目的 探究人精浆中胎盘生长因子(PlGF)的表达水平及其与精子质量的相关性,以及其在少弱精子症和无精子症中的临床意义.方法 选择2014年9月至11月于第二军医大学长海医院生殖医学中心行精液检测的88例患者,根据检测结果分为3组:10例精液正常者、68例少弱精子症患者以及10例无精子症患者.对其中5例精液正常者和5例少弱精子症患者的精浆样本进行细胞因子相关蛋白质芯片检测.利用ELISA法检测精浆中PlGF的含量,运用Pearson相关性分析研究精浆中P1GF含量与精液中精子浓度和活力、患者年龄的相关性.结果 精液正常组患者精浆中P1GF含量高于少弱精子症组和无精子症组(P＜0.05).精浆中PlGF含量与精子的浓度和活力均存在相关性(r=0.362、0.253,P均＜0.05),与患者的年龄无明显相关性.结论 精浆中P1GF含量与精子的浓度存在相关性,临床上可为少弱精子症和无精症的诊断和治疗提供参考.     

复方生精汤治疗少弱精子症男性不育临床研究

目的:探讨复方生精汤治疗少弱精子症男性不育的临床疗效。方法:选择2014年1月至2017年12月收治的男性不育症患者60例,随机分为观察组与对照组各30例。观察组采用复方生精汤治疗,对照组采用六味地黄丸治疗。比较两组患者临床疗效、精子存活率、精子密度、精子活力、性激素水平。结果:观察组治愈及总有效人数多于对照组,差异有统计学意义(P0.05);治疗后两组精子密度、精子存活率、a级活力以及a级+b级活力均显著高于治疗前,差异有统计学意义(P0.05),且观察组精子存活率、a级活力以及a级+b级活力显著高于对照组,差异有统计学意义(P0.05);治疗后两组患者性激素指标较治疗前均有改善(P0.05),但组间比较差异无统计学意义(P 0.05)。结论:复方生精汤可通过提高精子质量、改善激素水平治疗少弱精子症男性不育。