目的 研究復(fù)方玄駒膠囊聯(lián)合十一酸睪酮膠丸治療少弱精子癥的臨床療效。方法 將2012年12月—2013年11月中國(guó)人民解放軍第306醫(yī)院收治的120例少弱精子癥患者，隨機(jī)分為復(fù)方玄駒膠囊組（40例）、十一酸睪酮膠丸組（32例）和聯(lián)合用藥組（48例）。復(fù)方玄駒膠囊組口服復(fù)方玄駒膠囊，3粒/次，3次/d；十一酸睪酮膠丸組口服十一酸睪酮膠丸，1粒/次，2次/d；聯(lián)合用藥組口服復(fù)方玄駒膠囊和十一酸睪酮膠丸，用法用量同以上兩組。1個(gè)月為1個(gè)療程，共治療4個(gè)療程。對(duì)3組的臨床療效進(jìn)行評(píng)價(jià)，同時(shí)對(duì)精液相關(guān)指標(biāo)進(jìn)行分析。結(jié)果 復(fù)方玄駒膠囊組、十一酸睪酮膠丸組、聯(lián)合用藥組的總有效率分別為75.0%、68.8%、91.7%，聯(lián)合用藥組的有效率顯著高于其他兩組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組患者的精液量明顯增多，精子存活率、a級(jí)精子比、（a+b）級(jí)精子比、精子密度、向前精子活動(dòng)率、直線運(yùn)動(dòng)速度、血清雄激素（T）水平、α-葡萄糖苷、精子頂體酶、果糖、精漿鋅均較治療前明顯提高，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后聯(lián)合用藥組高于其他兩組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組患者的精子液化時(shí)間、畸形精子率、血清FSH、LH、DNA碎片指數(shù)、精漿彈性蛋白酶均較治療前顯著下降，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，聯(lián)合用藥組低于其他兩組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 復(fù)方玄駒膠囊聯(lián)合十一酸睪酮膠丸治療少弱精子癥有較好的臨床療效，可以改善精子相關(guān)指標(biāo)，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of Compound Xuanju Capsule combined with Testosterone Undecanoate Capsule in the treatment of oligoasthenospermia. Methods Patients with oligoasthenospermia (120 cases) in the 306th Hospital of PLA from December 2012 to November 2013 were randomly divided into Compound Xuanju Capsule (40 cases), Testosterone Undecanoate Capsule (32 cases), and combined treatment (48 cases) groups. Patients in the Compound Xuanju Capsule group were po administered with Compound Xuanju Capsule, 3 grains/time, three times daily. Patients in the Testosterone Undecanoate Capsule group were po administered with Testosterone Undecanoate Capsule, 1 grain/time, twice daily. Patients in the combined treatment group were given Compound Xuanju Capsule and Testosterone Undecanoate Capsule, and the usage and dosage were the same with the above two groups. One month was as a period of treatment, and three groups were administered for three courses. The treatment efficacy was evaluated, while the related parameters of semen were analyzed.Results The efficacies on the patients in the Compound Xuanju Capsule, Testosterone Undecanoate Capsule, and combined treatment groups were 75.0%, 68.8%, and 91.7%, and the clinical efficacies in combined treatment group were higher than those in the other two groups with significant difference (P < 0.05). After treatment, semen volume, sperm survival rate, a grade sperm ratio, (a + b) sperm, sperm density, sperm activity rate, linear motion forward speed, the serum level of T, α-glucoside, sperm acrosome enzyme, fructose and seminal plasma zinc in three groups were improved obviously, and the differences were statistically significant before and after treatment in the same group (P < 0.05). The results in the combined treatment group was higher than other two groups, and the difference was statistically significant (P < 0.05). After treatment, liquefaction time, sperm deformity rate of sperm, serum FSH, LH, DNA fragmentation index, seminal plasma elastase were reduced in three groups, and the differences were statistically significant before and after treatment in the same group (P < 0.05). Combined treatment group was lower than other two groups, and the difference was statistically significant (P < 0.05). Conclusion Compound Xuanju Capsule combined with Testosterone Undecanoate Capsule has a good clinical efficacy in the treatment of oligoasthenospermia, and can improve sperm related indicators, which is better than that of two drug used alone.

國(guó)家自然科學(xué)基金資助項(xiàng)目（30972994）