复方玄驹胶囊治疗少弱精子症患者的多中心临床研究

目的:观察复方玄驹胶囊治疗少弱精子症患者的疗效。方法:采用多中心、开放性、自身前后对照的临床研究方法,对120例少弱精子症患者采用口服复方玄驹胶囊(3粒,3次/d)治疗12周。以精子密度和(a+b)级精子为主要疗效指标,以a级精子、精子活动率及精液量为次要疗效指标,评价复方玄驹胶囊治疗效果。结果:有107例患者完成了临床研究,与治疗前相比,除精液量仅在治疗12周后明显增加(P<0.01)外,精子密度、a级精子和(a+b)级精子及精子活动率等精液参数在治疗4、8和12周后具有显著改善(P均<0.01)。此外,与治疗4周后相比,精子密度、a级精子和(a+b)级精子及精子活动率等精液参数在治疗8周和12周后也有显著改善(P<0.05或0.01);同样,与治疗8周后相比,精液参数在治疗12周后也有显著改善(P均<0.01)。治疗12周后,精子密度增加了63.28%,达到正常标准的病例数为73例(68.22%);(a+b)级精子提高了63.17%,达到正常标准的病例数为39例(36.45%);a级精子提高了78.56%,达到正常标准的病例数为34例(31.78%);精子活动率提高了44.36%,达到正常标准的病例人数为77例(71.96%);精液量增加了18.13%。结论:复方玄驹胶囊可明显提高少弱精子症患者精液质量,未见明显不良反应。     

补肾活血法治疗男性少弱精子症研究进展

少弱精子症是男性不育的常见病因，因其发生机制不明，现代医学缺乏针对性的治疗方式。中医学在治疗少弱精子症方面具有明显优势。补肾活血法为辨证论治少弱精子症的法则之一，越来越多的基础及临床研究证实其在改善精子质量方面效果显著。文章就近期相关研究进行综述，旨在为临床上治疗本病提供新的思路。     

五子衍宗口服液联合复方玄驹胶囊治疗少弱精子症的临床观察

目的观察五子衍宗口服液联合复方玄驹胶囊治疗少弱精子症的疗效。方法对30例少弱精子症患者给予五子衍宗口服液和复方玄驹胶囊口服，1个月为1个疗程，共治疗3个疗程。结果30例患者治疗结束后显效10例，有效16例，无效4例，总有效率达86．7％。结论五子衍宗口服液联合复方玄驹胶囊治疗少弱精子症有明显疗效。     

崔云教授治疗少弱精子症学术特色探析

[目的] 探析崔云教授治疗少弱精子症的学术特色。[方法] 通过跟随崔师门诊学习,整理并分析医案,从崔师治疗少弱精子症的“肝肾同源”理论、“女方男用”心得、“风药”运用经验和常用药对等方面,系统总结其治疗少弱精子症的学术特色,并举隅医案加以佐证。[结果] 崔师治疗少弱精子症首分虚实,强调肝肾同治,并从风药“如风之性”出发,重视风药在男科疾病中的运用,且善援用妇科经典方剂,将温清饮、当归芍药散、佛手散等应用在男科疾病治疗领域中。崔师常用药对中,黄芩、大枣清补为用,生麦芽、生谷芽健脾疏肝,女贞子、墨旱莲平补肝肾,防风、蝉衣泻湿土而达木郁,当归、川芎养血活血、祛瘀生新,均体现出其鲜明的学术特色。所附医案,崔师辨为肝肾不足、精血亏损,法当肝肾同治,治疗用三合饮配以风药加减,取得良好效果。[结论] 崔师重视肝肾同治,善以风药增效,多用妇科方剂治疗少弱精子症,学术特色鲜明,为现代中医男科提供了新的治疗思路,其经验值得学习和借鉴。     

基于重振雄阳法探讨天雄散治疗特发性少弱精症并见昼夜节律紊乱

少弱精症有过半原因不能明确,而昼夜节律紊乱可能是其中一大原因。基于中医理论,探讨特发性少弱精子并见昼夜节律紊乱的病机和治法特点。认为其基本病机在于“肾主生殖”的功能失职,阴阳失于调摄,具体为阳不入阴,初阳不生,在精液病机表现为“精气清冷”。从而提出“重振雄阳法”,意在调节肾之阴阳,助阳初生,重振雄风。作为重振雄阳的经典代表方,天雄散有温振肾阳,镇阴潜阳,助阳初生之功,符合特发性少弱精症并见昼夜节律紊乱的治疗要求。结合现代研究进展和方药分析,该方可能会在调节昼夜节律和改善少弱精症等方面具有一定治疗作用。因此,提出天雄散运用于特发性少弱精症并见昼夜节律紊乱的治疗,以期为中医临床治疗提供新思路。     

自拟益精汤治疗少弱精子症的疗效观察

目的:研究益精汤治疗男性少弱精子症的临床疗效。方法:将80例少弱精子症患者随机分为两组,治疗组40例,采用益精汤进行治疗,对照组40例,采用维生素E治疗,12周为1个疗程。分别于治疗前后对患者进行综合疗效评价、精液参数分析及精子正常形态判定。结果:经过12周的治疗,治疗组较对照组患者精液检测各项指标的改善差异有显著性(P<0.01)。治疗组上述指标较治疗前改善,差异有显著性(P<0.01)。结论:益精汤能提高精子的密度、活力及活动率。     

邻苯二甲酸二酯与特发性少弱精子症关系的探讨

目的:通过检测精浆中邻苯二甲酸二酯(DEHP)的含量,探讨DEHP与男性特发性少弱精子症之间的关系。方法:收集潍坊地区3家医院特发性少弱精子症所致不育患者100例,分为A组:常年接触蔬菜大棚塑料薄膜者50例;B组:常年食用塑料包装盒饭者50例;另设立C组(对照):为精液正常之志愿者50例。采用计算机辅助精子分析仪检测精子浓度和活率,采用反相液相高效色谱法测定精浆中DEHP的浓度。结果:1A、B、C3组中DEHP含量分别为(0.72±0.48)、(0.71±0.49)、(0.21±0.18)mg/L,C组与A、B组比较,差异均有统计学意义(P均0.05)。2精浆中DEHP浓度与精子活率呈负相关(A组:r=-0.354,B组r=-0.348,P0.05)。结论:常年接触某些塑料制品的男性不育患者,精浆中DEHP浓度高于正常人群,精浆内DEHP过量蓄积可能是不育的重要因素之一。     

Network Pharmacology‑Based Study of Chinese Herbal Qixiong Formula in Treating Oligoasthenospermia

Objective: The objective isto study the network pharmacology of Qixiong formula (QXF) and explore the mechanism of QXF in the treatment of oligoasthenospermia. Materials and Methods: Using Traditional Chinese Medicine Systems Pharmacology Database andAnalysis Platform (TCMSP), aBioinformaticsAnalysisToolfor Molecular mechANism ofTraditionalChinese Medicine (BATMAN-traditionalChinese medicine), and an encyclopaedia of traditional Chinese medicine (ETCM) databases as well as data from relevant studies, the effective components and targets of QXF were obtained. Genes associated with oligospermia were screened using GeneCards, OMIM, DisGeNet, DrugBank, and GAD databases. The intersection target was obtained by mapping the target to the gene, and the protein interaction network was created using the STRING database to screen the core target of QXF in the treatment of oligospermia. The intersection target was enriched using gene ontology (GO) and the Kyoto Encyclopedia of genes and genomes (KEGG) pathway analysis with the DAVID database. The network of the disease drug target pathway was drawn using Cytoscape software. Results: Overall, 536 active components of QXF and 40 core targets for the treatment of oligoasthenozoospermia were obtained. The analysis of GO and KEGG showed that QXF is mainly involved in oxidative stress, cell motility, nutritional response, and other biological processes. Through the regulation of FOXO, p53, PI3K/Akt, MAPK, mammalian target of rapamycin, Foxo, Wnt, and other signaling pathways, QXF played a role in the treatment of oligoasthenospermia. Conclusion: QXF has multi-component, multi-target, and multi-channel characteristics, providing a new way to study the mechanism of QXF in the treatment of oligoasthenospermia.     

Effects of a micronutrient supplementation combined with a phosphodiesterase type 5 inhibitor on sperm quantitative and qualitative parameters,percentage of mature spermatozoa and sperm capacity to undergo hyperactivation: A randomised controlled trial

The main objective of this study was to evaluate the effects of a micronutrient supplementation (MS) combined with avanafil on sperm function. Oligoasthenospermic men (n = 217) were treated daily for 90 days with either an MS (45 men, Group A), l ‐carnitine (44 men, Group B), MS plus avanafil (43 men, Group C) or avanafil (43 men, Group D); another group of 42 men with oligoasthenospermia (Group E) received no treatment. Sperm parameters were evaluated before and after the end of treatment in each Group A, B, C and D respectively. The same sperm parameters were measured in each participant of Group E before and at the 90‐day experimental period. Within Groups A, C or D, the total percentage of motile spermatozoa, the hypoosmotic swelling test (HOST) result and the percentage of hyperactivated spermatozoa after incubation under conditions known to induce sperm capacitation were significantly greater after MS or MS plus avanafil treatment, or avanafil treatment than before the respective treatment. We suggest that MS or MS plus avanafil combined administration or avanafil alone improves sperm membrane permeability with an overall result improvement in sperm motility, outcome of HOST and increase in the percentage of hyperactivated spermatozoa.