77.养精胶囊治疗DAZ基因缺失所致无精子症的临床价值.doc

养精胶囊治疗DAZ基因缺失所致无精子症的临床价值 金保方1,2,3，张华俊1，杨晓玉3，张新东1,2，周玉春1,2， 刘建国1，薛宇阳1，叶 佳1 （1.南京中医药大学男科学研究所，江苏南京　210046；2.南京中医药大学第三附属医院男科，江苏南京　210001；3.江苏省人民医院临床生殖中心，江苏南京　210029） 【摘要】目的探讨方法1.将48例患者随机分为治疗组28例，对照组20例。治疗组给予养精胶囊，每次5粒，每日3次；对照组给予十一酸睾酮胶丸（安特尔），每次40mg，每日2次。观察指标：治疗后6个月疗效，随访ICSI结果，治疗前后3个月精液量、精浆α-糖苷酶（α-Glu）、精浆前列腺酸性磷酸酶（ACP）、精浆果糖（Fru），血清性激素指标（FSH、LH、T、E2、PRL）结果1.治疗组有效10例，无效18例，有效率35.7%；对照组有效2例，无效18例，有效率10.0%（P0.05）；ICSI/PGD后，治疗组正常受精数34，受精率44.7％，生化妊娠5例，生化妊娠率41.7%，临床妊娠3例，临床妊娠率33.3％，活产2例。对照组正常受精数5，受精率35.7％，生化妊娠1例，生化妊娠率50.0%，无临床妊娠。2.治疗组中有效患者和无效患者的平均年龄，双侧睾丸容积和血清FSH之间均存在显著性差异（P0.05）。3. 养精胶囊能升高血清FSH、LH及T水平，对E2及PRL无显著影响；十一酸睾酮能通过升高T水平，进而负反馈抑制LH的分泌。4. 养精胶囊能增加精液量，促进附属性腺的分泌，升高精浆α-Glu、Fru及ACP水平。结论Clinical Observation on Treatment of azoospermia due to DAZ gene deletion with Yangjing Capsule JIN Bao-fang1,2.3, ZHANG Hua-jun1, YANG Xiao-yu3, ZHANG Xin-dong1,2, ZHOU Yu-cun1,2, LIU Jian-guo1, XUE Yu-yang1, YE-Jia1 1. Andrology Institute of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210046; 2. The Third Affiliated Hospital of NJUTCM, Jiangsu Nanjing 210001; 3.Jiangsu Province Hospital Center of Clinical Reproductive Medicine, Jiangsu Nanjing 210029; 【Abstract】Objective: To observe the effects of Yangjing Capsule treatment on azoospermia due to DAZ gene deletion, and discuss the mechanisms. Methods: Forty-eight patients of azoospermia with DAZ gene deletion, were randomly divided into a treatment group(n=28) and a control(n=20). The former treated by Yangjing Capsule(5 pills, tid) and the latter with testosterone undecanoate (40mg, bid). The efficacy was observed after treatment for six months and the inedxes such as semen volume, seminal α-glucosidase enzyme(α-Glu), prostatic acid phosphatase(ACP), fructose in seminal plasma(Fru), gonadal hormone(FSH, LH, T, E2, PRL) were analyzed at 3 months before and after treatment. Results: 1. The totaleffective rate was 35.7% (10/28) in the treated group, which was significantly higher than that in the controlgroup, 10.0% (2/20, P0.05). Afte