目的 觀察知柏地黃丸聯(lián)合右歸膠囊治療腎虛型少弱精子癥的臨床療效。方法 選取2017年3月—2020年8月天津市寧河區(qū)醫(yī)院收治的100例少弱精子癥患者，根據(jù)信封抽簽法分為對照組（50例）和治療組（50例）。對照組早晚餐后口服右歸膠囊，4粒/次，3次/d。治療組在對照組的基礎上口服知柏地黃丸，8丸/次，3次/d。兩組均治療3個月。觀察兩組患者臨床療效，比較治療前后兩組患者向前運動精子百分率、精子密度、活動精子百分率、中醫(yī)證候積分及性激素指標睪酮（T）、雌二醇（E₂）和黃體生成素（LH）水平。結果 治療后，治療組總有效率明顯高于對照組（90.00%vs 70.00%，P<0.05）。治療后，兩組前向運動精子百分率、精子密度、活動精子百分率明顯升高（P<0.05），且治療組高于對照組（P<0.05）。治療后，兩組患者中醫(yī)癥候積分明顯降低（P<0.05），且治療組明顯低于對照組（P<0.05）。治療后，兩組T、LH水平明顯高于治療前，而E₂明顯低于治療前（P<0.05），且治療組T、LH和E2水平明顯好于對照組（P<0.05）。結論 知柏地黃丸聯(lián)合右歸膠囊治療腎虛型少弱精子癥，可促進臨床癥狀改善，有效調節(jié)性激素水平、精子質量。

Objective To observe the clinical effect of Zhibai Dihuang Pills combined with Yougui Capsules in treatment of oligoasthenospermia of kidney deficiency type. Methods Patients (100 cases) with oligoasthenospermia of kidney deficiency type in Tianjin Ninghe Hospital from March 2017 to August 2020 were divided into control (50 cases) and treatment (50 cases) groups according to the envelope lottery. Patients in the control group were po administered with Yougui Capsules after breakfast and dinner, 4 grains/time, three times daily. Patients in the treatment group were po administered with Zhibai Dihuang Pills, 8 pills/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the PR sperm percentage, sperm density, motile sperm percentage, TCM syndrome scores, the levels of sex hormone indexes T, LH and E2 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (90.00% vs 70.00%, P<0.05). After treatment, the percentage of forward motile sperm, sperm density, and the percentage of motile sperm were significantly increased in two groups (P<0.05), and which in the treatment group were higher than those in the control group (P<0.05). After treatment, the symptom score in two groups were significantly decreased (P<0.05), and which in the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the levels of T and LH in two groups were significantly higher than those before treatment, while the levels of E₂ were significantly lower (P<0.05), and the levels of T, LH, and E₂ in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Zhibai Dihuang Pills combined with Yougui Capsules in treatment of oligoasthenospermia of kidney deficiency type can promote the improvement of clinical symptoms and effectively regulate the level of sex hormones and sperm quality.

R983

國家自然科學基金重點項目（81330088）