【作者】 王鹏；

【导师】 谢建兴；

【作者基本信息】 广州中医药大学 ， 中医外科学， 2008， 硕士

【摘要】 目的:观察补中益气汤合左卡尼汀治疗精索静脉曲张(varicocele.VC)少弱精症的临床疗效及对精液参数的影响,探讨该病的基本病机,并研究分析本方法提高精子密度、精子活力的可能机制。方法:本研究将符合纳入标准的50例患者,按照随机的原则分成治疗组25例及对照组25例,分别予以观察研究,其中治疗组均采用补中益气汤结合左卡尼汀,对照组仅口服左卡尼汀,疗程3个月。主要观察临床疗效,并在治疗前后分别测定精子密度和精子活力等。对所有受检者精液采用计算机辅助精子质量分析(CASA)。所有资料应用SPSS13.0软件包进行处理,进行T检验、X~2检验及Ridit分析等统计学处理。结果:治疗组的总有效率为90.91%,优于对照组的71.43%,经Ridit分析,治疗组疗效优于对照组治疗组,两组之间具有显著性差异(P＜0.05)。治疗后精子活率比较,经F检验,治疗组与对照组之间有显著性差异(P＜0.05),治疗组也优于对照组。治疗后精子密度、A级及A+B级精子活力比较,经F检验,治疗组与对照组之间有极显著性差异(P＜0.01),治疗组优于对照组。同时,经X~2检验,治疗后两组临床症状改善率相比较,有极显著性差异(P＜0.01),治疗组优于对照组。此外,治疗前后组内比较精子密度、精子活率及精子活力,经T检验,治疗组、对照组都有极显著的差异意义(P＜0.01),说明两组均对改善精液质量有效。结论:补中益气汤联合左卡尼汀治疗精索静脉曲张少弱精症有良好临床疗效,不仅可以改善精索静脉曲张的临床症状,而且更能显著提高精子密度、精子活力等。由此推测精气血的生成与运行障碍是其基本病机;此外,左卡尼汀是非常有潜力的治疗男性少弱精症的药物,较为安全,值得推广。但是其作用及其转运机制等尚未完全阐明,有待进一步深入研究。更多还原

【Abstract】 [Objective]To observe the therapeutic effect of Buzhong Yiqi Decoction combining L-carnitine for varicocele cases associated with oligozoospermia or with asthenospermia.To discuss the pathological mechanism of it and to explore the possible mechanism of improving the sperm density and motility.[Methods]50 cases of varicocele infertility according to the accepted standard were enrolled and divided into two groups randomly:the treatment group(25cases)received Buzhong Yiqi Decoction combining L-carnitine therapy; while the control group with 25 cases received only L-carnitine.After three monthes of therapy,to evaluate the clinical effection and compare the sperm density,sperm vitality and sperm motility.The semen characteristics were carried out by the computer-aided semen analysis(CASA)technique.All the data were analysised by SPASS13.0.[Results]The general effective rate of treatment group was 90.91%,through Ridit analysis,the treatment group was obviously superior to the control group.Compared with the control group in terms of vitality of sperm,through F test,the treatment group was superior(P<0.05).There were significant differences between the treatment group and the control group referring the sperm density and(A,A+B)grade sperm percentage(P<0.01),the treatment group was obviously superior.On the other hand,through X~2 test,the clinical symptom were markedly improved in contrast to before(P<0.01).In terms of density, vitality and movable ratio,through T test,there were differences between post-treatment and pre-therapy of the treatment group and the control group (P<0.01),both of the team were effective on improving the sperm density and motility.[Conclusion]Therapy of Buzhong Yiqi Decoction combining L-carnitine varicocele infertility could not only release varicocele symptom,but also better the quality of semen,and improve the density,vitality and movable ratio of sperm.The pathological mechanism could be disturbance of Qi、Xue and Jing,deducing from the research.L-carnitine was eutherapeutic and safe medicine for male infertility,but the mechanism of action needed further research.更多还原