复方氨基酸胶囊(8-11)联合左旋肉毒碱治疗弱精子症的临床研究  

Compound Amino Acid Capsule(8-11)combined with L-carnitine for the treatment of asthenospermia

作　　者：梁明[1] 杨怀亮[1] 孟凡伟[2] 王雄[3] 史本康[4] LIANG Ming;YANG Huai-liang;MENG Fan-wei;WANG Xiong;SHI Ben-kang(Department of Reproductive Medicine,The Second Affiliated Hospital of Shandong University of Chinese Medicine,Jinan,Shandong 250001,China;Center of Reproductive Medicine,Qilu Hospital of Shandong University,Jinan,Shandong 250012,China;Center of Reproductive Medicine,Yantai Yuhuangding Hospital,Yantai,Shandong 264099,China;Department of Urology,Qilu Hospital of Shandong University,Jinan,Shandong 250012,China)

机构地区：[1]山东中医药大学第二附属医院生殖医学科,山东济南250001 [2]山东大学齐鲁医院,生殖医学中心,山东济南250012 [3]烟台毓璜顶医院生殖医学中心,山东烟台264099 [4]山东大学齐鲁医院,泌尿外科,山东济南250012

出　　处：《中华男科学杂志》2023年第3期233-238,共6页National Journal of Andrology

摘　　要：目的:观察联合应用复方氨基酸胶囊(8-11)和左旋肉毒碱类药物治疗特发性弱精子症的临床效果,并探讨其可能的治疗机理。方法:对多中心符合弱精子症诊断标准的120例特发性弱精子症病例,按照双盲、对照的原则随机分为:复方氨基酸胶囊(8-11)+左卡尼汀口服液作为治疗组;对照组单用左卡尼汀口服液;空白组为给予生活干预者,以上分组治疗疗程均为12周。收集治疗前后各组的精液标本。观察治疗前后精子活动率、中性α-葡糖苷酶含量、精子DNA碎片指数、ROS含量及Nrf2表达量。结果:复方氨基酸胶囊(8-11)与左旋肉毒碱对弱精子症患者精子活力有明显改善作用,治疗后治疗组附睾中性α-葡糖苷酶含量明显增加,ROS含量明显下降,Nrf2表达量明显增加。结论:复方氨基酸胶囊(8-11)联合左旋肉毒碱对弱精子症患者有较好的临床疗效,并未见不良反应。复方氨基酸胶囊(8-11)联合左旋肉毒碱对弱精子症患者的治疗机制可能是:通过调控精子Nrf2通道蛋白的高表达,降低ROS的产生,减轻氧化应激对精子活力的损伤。Objective:To observe the clinical effect of combined application of Compound Amino Acid Capsule(8-11)(CAAC8-11)and L-carnitine(LC)in the treatment of idiopathic asthenospermia(IAS),and to explore its possible therapeutic mechanism.Methods:Based on the principle of double-blind and control,we selected 120 cases of IAS meeting the diagnostic criteria of asthenospermia in the WHO Manual for the Examination and Processing of Human Semen(5th Ed)and randomly divided them into three groups of an equal number:CAAC8-11+LC,LC control and blank control,the former given CAAC8-11 in addition to LC oral liquid,and the latter two given LC oral liquid and life intervention,respectively,all for 12 weeks.We collected semen samples from all the patients before and after treatment,and examined perm motility,the contents of neutralα-glucosidase(NAG)and reactive oxygen species(ROS),sperm DNA fragmentation index(DFI),and the expression of the Nrf2 protein.Results:Compared with the baseline,the total sperm motility was significantly improved in the IAS patients after treated with CAAC8-11+LC([27.50±0.77]%vs[32.50±0.74]%,P<0.05)or LC only([27.60±0.66]%vs[30.90±0.70]%,P<0.05),dramatically higher in the CAAC8-11+LC than in the LC and blank control groups(P<0.01).The content of NAG in the epididymis was remarkably increased after treatment in the CAAC8-11+LC than in the LC and blank control groups([23.90±0.56]vs[21.20±0.49]and[16.80±0.42]mU,P<0.05),so was the expression of Nrf2(P<0.05),while the ROS level was markedly decreased in the former than in the latter two groups([81.60±2.50]vs[88.50±2.50]and[88.70±2.40]μg/ml,P<0.05).Conclusion:CAAC8-11+LC has a good clinical effect on asthenospermia,with no adverse reactions,which may be attributed to its ability to regulate the high expression of Nrf2,decrease the production of ROS and reduce the damage of oxidative stress to sperm motility.

关 键 词：男性不育 特发性弱精子症 ROS Nrf2通道 中性α-葡糖苷酶 精子DNA碎片指数 复方氨基酸胶囊(8-11) 

分 类 号：R698.2[医药卫生—泌尿科学]