维生素E联合他莫昔芬治疗特发性少弱精症患者的前瞻性随机对照研究.docVIP

维生素E联合他莫昔芬治疗特发性少弱精症患者的前瞻性随机对照研究 　　【摘要】目的：评估维生素E作为抗氧化剂和他莫昔芬作为抗雌激素组合治疗对精子浓度和活力的可能效果，并与只用一种药物的特发性少弱精子症患者进行对比。方法：90例特发性少弱精子症患者随机平均分为三组，A组：服用维生素E（300mg/d）6个月；B组：服用他莫昔芬（20mg/d）6个月；C组：服用相同剂量的两种药物组合6个月。所有患者均接受了以下内容：询问病史、全身和生殖器检查、精液分析、血清促卵泡激素、总睾酮、阴囊超声。精液检查在治疗开始时、治疗结束后3个月和结束后6个月分别进行。结果：与治疗前相比，服用维生素E的小组，6个月的治疗后平均精子浓度没有显著增加。另一方面，在6个月的治疗后，其他两个小组的平均精子浓度显著改善，且联合治疗组更明显（P0.01）。在前向运动精子比例方面，所有患者群体中都有所改善，且在联合治疗组更明显。对于服用维生素E组，这一数字是（28.07±9.65）%（P0.01）。对于服用他莫昔芬组，这一数字为（33.33±14.10）%（P0.01），在联合治疗组，是（40.50±17.54）%（P0.01）。结论：结合抗氧化和抗雌激素疗法对于我们选定的患有不明原因的少弱精子症患者治疗有效。 　　【关键词】 少弱精子症；维生素E；他莫昔芬；随机对照研究 　　【Abstract】Objectives： To evaluate any possible effects of combining vitamin E as antioxidant and tamoxifen citrate as antiestrogen on spermatozoa concentration and motility in comparison to give either of medications alone in patients with idiopathic oligoasthenozoospermia. Methods： Ninety patients with idiopathic oligoasthenozoospermia were randomized into equally three groups： Group A received vitamin E（ 300 mg/ day ） for 6 months； Group B received tamoxifen citrate （25 mg / day） for 6 months； Group C received combination of both drugs in the same doses for 6 months. All patients were subjected to the following： history taking， general and genital examination， semen analysis， serum FSH， total testosterone， and scrotal ultrasound. Semen examination was performed at the start of treatment and was repeated after 3 months and after 6 months of treatment. Results： Compared with before treatment， vitamin E group was insignificantly increased in mean sperm concentration after 6 months of treatment. On the other hand， there was a significant improve in mean sperm concentration in the other two groups after 6 months of treatment， with more significance in combination therapy group （P 0.01）. In the aspect of percentage of progressively motile sperm， the percentage of progressively motile sperm improved in all patients groups， with more significance in combination therapy group. In vitamin E group， it