天然维生素E辅助治疗特发性少弱精子症多中心前瞻性随机对照研究(附106例报告)  

Efficacy of natural vitamin E on oligospermia and athenospermia:A prospective multi-centered randomized controlled study of 106 cases

作　　者：陈向锋[1] 李铮[1] 平萍[1] 戴继灿[1] 张峰彬[2] 商学军[3] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿科,上海200001 [2]浙江大学医学院附属妇产科医院男科,浙江杭州310006 [3]南京军区南京总医院男科,江苏南京210001

出　　处：《中华男科学杂志》2012年第5期428-431,共4页National Journal of Andrology

摘　　要：目的:观察天然维生素E(VitE)作为少弱精子症辅助用药的临床疗效,评估其治疗男性不育症的安全性与有效性。方法:采用多中心、前瞻性、随机对照、观察性研究,2011年1～4月共计入组病例106例,其中少精子症64例(对照组31例,他莫昔芬10 mg/bid;研究组33例,他莫昔芬10 mg/bid+VitE 100 mg/tid),弱精子症42例(对照组20例,左卡尼汀口服液1支/bid;研究组22例,左卡尼汀口服液1支/bid+VitE 100 mg/tid),对其用药前和用药3个月后精液分析中的精子浓度、前向运动精子比例,以及配偶自然受孕情况进行观察分析,同时记录观察研究中出现的不良反应。结果:少精子症患者中,对照组和研究组用药前的精子浓度均值为8.00×106/ml和10.66×106/ml,两组比较无统计学差异(P>0.05);用药治疗结束后,对照组和研究组精子浓度改善不明显的分别为10例和9例,两组比较无统计学差异(P>0.05);轻度改善的分别为16例和14例,两组比较无统计学差异(P>0.05);中度改善的分别为5例和4例,两组比较无统计学差异(P>0.05);明显改善的分别为0例和0例,两组比较无统计学差异(P>0.05);女方自然受孕的分别为0例和6例,两组比较有显著差异(P<0.01)。弱精子症患者中,对照组和研究组用药前的前向运动精子比例均值为17.00%和18.10%,两组比较无统计学差异(P>0.05);用药治疗结束后,对照组和研究组前向运动精子比例改善不明显的分别为7例和2例,两组比较有显著差异(P<0.01);轻度改善的分别为4例和8例,两组比较有显著差异(P<0.01);中度改善的分别为3例和2例,两组比较无统计学差异(P>0.05);明显改善的各1例,两组比较无统计学差异(P>0.05);女方自然受孕的分别为5例和9例,两组比较有显著差异(P<0.01)。观察研究中没有出现不良反应。结论:天然VitE作为特发性少弱精子症辅助用药安全有效,能够改善精子浓度和前向运动精子比例,有助于提高女方自然受孕�Objective： To explore the therapeutic effect of natural vitamin E（VitE） on oligospermia and athenospermia in infertile men.Methods： We conducted a prospective multi-centered randomized controlled study on 64 infertile men with oligospermia（31 as controls treated with Tamoxifen 10 mg bid and 33 as experimental cases treated with Tamoxifen 10 mg bid ＋ VitE 100 mg tid） and 42 cases of athenospermia（20 as controls treated with Levocarnitine oral solution 1 bottle bid and 22 as experimental cases treated with Levocarnitine oral solution 1 bottle bid ＋ VitE 100 mg tid）.We compared the control and experimental groups in sperm concentration and percentage of progressively motile sperm before and 3 months after medication,as well as the rate of clinical pregnancy and adverse events.Results： Among the oligospermia patients,the average sperm concentrations in the control and experimental groups were 8.00 × 106/ml and 10.66 × 106/ml before medication（P0.05）.After medication,the numbers of cases evaluated as with no,slight,moderate and marked improvement in sperm concentration were 10 and 9（P0.05）,16 and 14（P0.05）,5 and 4（P0.05） and 0 and 0（P0.05）;and the numbers of natural pregnancies were 0 and 6 in the control and experimental groups（P0.01）.Among the athenospermia patients,the average rates of progressively motile sperm were 17.00% and 18.10% in the control and experimental groups before medication（P0.05）.After medication,the numbers of cases evaluated as with no,slight,moderate and marked improvement in the percentage of progressively motile sperm were 7 and 2（P0.01）,4 and 8（P0.01）,3 and 2（P0.05） and 1 and 1（P0.05）,and the numbers of natural pregnancies were 5 and 9 in the two groups（P0.01）,but no adverse events were observed.Conclusion： As a safe and effective adjuvant agent for the treatment of oligospermia and athenospermia,vitamin E can improve sperm concentration,the percentage of progressively motile sperm,and finally the rate of natural pregn

关 键 词：少精子症 弱精子症 天然维生素E 随机对照研究 

分 类 号：R698.2[医药卫生—泌尿科学]