中药转阴丹联合激素治疗男性不育患者精浆抗精子抗体阳性的临床观察

目的探讨自拟中药转阴丹联合激素治疗抗精子抗体阳性不育患者的临床疗效以及一氧化氮(NO)含量的变化。方法选择精浆抗精子抗体阳性的男性不育患者82例，按数字表法随机分为西药组(20例，用强的松)、中药组(28例，用转阴丹)、中西药组(34例，用强的松和转阴丹)，并观察其临床疗效、治疗前后抗精子抗体的转阴率、精浆NO的含量变化及精子各项运动参数。结果总有效率中西药组为88．2％，中药组为75．0％，西药组为65．0％。中西药组和中药组精浆NO含量、精子运动参数中直线运动速度、直线性、前向性、鞭打频率、精子活力、平均移动角度，精液质量治疗前后比较差异均有显著性(P<0．05或P<0．01)。西药组NO含量、前向性、鞭打频率、平均移动角度，精液质量中精子活力和活率治疗前后比较差异有显著性(P<0．05)。结论转阴丹联合激素可降低精浆NO的含量、改善精子质量。

Clinical Observation on Effect of Combination of Zhuanyindan and Hormone in Treating Male Infertility with Positive Antisperm Antibody

To explore the therapeutic effect of combination of Zhuanyindan (ZYD, a self-made Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. Methods Eighty-two patients were randomly divided (according to the digital list) into the WM group ( n =20, treated with prednisone) , the TCM group (n=28, treated with ZYD) and the ICWM group (n =34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of anti-sperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. Results The total effective rate in the ICWM group was 88.2% , that in the TCM group 75.0% and in the WM group 65.0% . Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P< 0.05 or P< 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P<0.01). Conclusion Combination of Chinese herbs and hormone could lower the NO level in semen and improve the quality of sperm.