疏肝益阳胶囊改善手淫取精成功率的临床研究
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摘要
目的:探索疏肝益阳胶囊应用于手淫取精困难患者的疗效和安全性。方法:将58例手淫取精困难患者随机分为疏肝益阳胶囊联合行为疗法组(治疗组,30例)和单用行为疗法组(对照组,28例)。对照组在进入体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕周期前1~3个月练习手淫取精。治疗组不仅练习手淫取精,且提前4~6周口服疏肝益阳胶囊至女方行取卵手术前一日。结果:治疗组和对照组患者的年龄分别为(37.13±6.04)岁和(36.54±5.63)岁,其差异无统计学意义(P>0.05)。治疗组23例手淫取精成功,成功率为76.67%(23/30);对照组13例手淫取精成功,成功率为46.43%(13/28)。χ~2检验显示,两组差异具有统计学意义(χ~2=5.63,P<0.05)。治疗组患者治疗后的精液指标(精液量、精子浓度、活动率、前向运动精子百分率)比治疗前有所提高,其差异无统计学意义(P>0.05)。两组患者的受精率、卵裂率、优胚率、配偶妊娠率等指标的差异均无统计学意义(均P>0.05)。结论:疏肝益阳胶囊可以提高手淫取精困难患者的取精成功率,且具有良好的安全性,可以作为取精困难患者的一种有效疗法。
Objective: To study the efficacy and safety of Shugan Yiyang capsule in improving the success rate of semen collection of infertile men with masturbation difficulty. Methods: 58 male infertile patients with masturbation difficulty were randomly assigned to receive Shugan Yiyang capsule combined with behavior therapy( treatment group,n = 30) and behavior therapy only( control group,n = 28). The control group was trained to masturbate for 1 to 3 months before entering the IVF cycle. Treatment group not only practiced masturbation training,but also took Shugan Yiyang capsule for at least 4 ~ 6 weeks. Results: The age between the treatment group of( 37. 13± 6. 04) years old and the control group of( 36. 54 ± 5. 63) years old was not significantly different( P > 0. 05).The success rate of semen collection was 76. 67%( 23/30) in the treatment group which was significantly higher than that of the control group of 46. 43%( 13/28),( χ~2= 5. 63,P < 0. 05). The semen parameters including semen volume,sperm concentration,total motility and progressive motility of treatment group were improved,without statistically significant difference( P > 0. 05). There were no significant differences in fertilization rate,cleavage rate,good-quality embryo rate and pregnancy rate between the two groups( all P > 0. 05). Conclusions: Shugan Yiyang capsule is safe and effective in improving the success rate of semen collection in patients with masturbation difficulty.
Objective: To study the efficacy and safety of Shugan Yiyang capsule in improving the success rate of semen collection of infertile men with masturbation difficulty. Methods: 58 male infertile patients with masturbation difficulty were randomly assigned to receive Shugan Yiyang capsule combined with behavior therapy( treatment group,n = 30) and behavior therapy only( control group,n = 28). The control group was trained to masturbate for 1 to 3 months before entering the IVF cycle. Treatment group not only practiced masturbation training,but also took Shugan Yiyang capsule for at least 4 ~ 6 weeks. Results: The age between the treatment group of( 37. 13± 6. 04) years old and the control group of( 36. 54 ± 5. 63) years old was not significantly different( P > 0. 05).The success rate of semen collection was 76. 67%( 23/30) in the treatment group which was significantly higher than that of the control group of 46. 43%( 13/28),( χ~2= 5. 63,P < 0. 05). The semen parameters including semen volume,sperm concentration,total motility and progressive motility of treatment group were improved,without statistically significant difference( P > 0. 05). There were no significant differences in fertilization rate,cleavage rate,good-quality embryo rate and pregnancy rate between the two groups( all P > 0. 05). Conclusions: Shugan Yiyang capsule is safe and effective in improving the success rate of semen collection in patients with masturbation difficulty.
引文
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[11]Lu S,Cui Y,Li X,et al.Sperm retrieval in anejaculatory diabetic men who failed in drug treatment and penile vibratory stimulation during blood sugar under control.Andrologia,2014,46(4):370-373.
[12]Zamli AH,Ismail NA,Ong KG.Retrospective review on effectiveness of high-amplitude penile vibratory stimulation for conservative sperm retrieval in anejaculatory men with spinal cord injury:An Asian case series.Spinal Cord Ser Cases,2016(2):15038-15041.
[13]Pastuszak AW,Sigalos JT,Lipshultz LI.The role of the urologist in the era of in vitro fertilization-intracytoplasmic sperm injection.Urology,2017,103:19-26.
[14]费前进,潘承双,黄学锋.5型磷酸二酯酶抑制剂治疗辅助生殖技术中偶发ED.中华男科学杂志,2013,19(11):991-995.
[15]吴欢,张静静,贺小进,等.取卵日男方取精困难的应对策略及助孕结局分析.生殖与避孕,2014,34(10):813-818.
[16]王琦,杨吉相,李国信,等.疏肝益阳胶囊治疗勃起功能障碍多中心随机对照试验.北京中医药大学学报,2004,27(4):72-75.
[17]杨克冰,黄晓军,张士更,等.小剂量他达拉非联合疏肝益阳胶囊治疗轻中度勃起功能障碍的疗效分析.中华男科学杂志,2014,20(3):267-272.
[18]王琦,倪平,吴卫平,等.疏肝益阳胶囊治疗勃起功能障碍的作用机理研究.中国中药杂志,2005,30(1):59-64.
[19]王济,白明华,刘保兴,等.疏肝益阳胶囊对动脉性勃起功能障碍大鼠性功能及性腺质量的作用.安徽中医学院学报,2013,32(2):54-57.
[20]史亚磊,张敏建,程宛钧,等.疏肝益阳胶囊治疗肝郁肾虚型弱精子症的临床研究.中华男科学杂志,2015,21(7):634-636.
[21]李宏军.辅助生殖技术前应重视男性不育患者的常规处理.生殖与避孕,2017,37(4):343-346.
[22]翟丹梅,江莉,李慕军,等.取卵日取精困难患者11例助孕结局分析.微创医学,2009,4(6):601-602.
[2]Ojha K,Nargund V,Nargund G.Emergency sperm extraction for transient erectile dysfunction prior to assisted conception.J Assist Reprod Genet,2001,18(1):34-35.
[3]唐文豪,姜辉,马潞林,等.他达拉非联合行为疗法应用于男性手淫取精失败患者的临床研究.中华男科学杂志,2013,19(5):439-442.
[4]Junsheng L,Quan B,Ying L,et al.The impact of surgical sperm retrieval on the in vitro fertilization outcomes of infertile patients with temporary ejaculation failure on their oocyte retrieval day.Fertil Steril,2013,99(2):362-366.
[5]Lu S,Zhao Y,Hu J,et al.Combined use of phosphodiesterase-5 inhibitors and selective serotonin reuptake inhibitors for temporary ejaculation failure in couple undergoing assisted reproductive technologies.Fertil Steril,2009,91(5):1806-1808.
[6]周俐媛,施晓波,王新,等.影响不育男性手淫法取精液行常规检查的相关因素分析.中南大学学报(医学版),2012,37(7):725-729.
[7]Li L,Zhang Y,Zeng D,et al.Depression in Chinese men undergoing different assisted reproductive technique treatments:Prevalence and risk factors.J Assist Reprod Genet,2013,30(9):1161-1167.
[8]Gat I,Maman E,Yerushalmi G,et al.Electroejaculation combined with intracytoplasmic sperm injection in patients with psychogenic anejaculation yields comparable results to patients with spinal cord injuries.Fertil Steril,2012,97(5):1056-1060.
[9]Khurana KK,Sabanegh ES,Jr.Office-based sperm retrieval for treatment of infertility.Urol Clin North Am,2013,40(4):569-579.
[10]Alrabeeah K,Yafi F,Flageole C,et al.Testicular sperm aspiration for nonazoospermic men:Sperm retrieval and intracytoplasmic sperm injection outcomes.Urology,2014,84(6):1342-1346.
[11]Lu S,Cui Y,Li X,et al.Sperm retrieval in anejaculatory diabetic men who failed in drug treatment and penile vibratory stimulation during blood sugar under control.Andrologia,2014,46(4):370-373.
[12]Zamli AH,Ismail NA,Ong KG.Retrospective review on effectiveness of high-amplitude penile vibratory stimulation for conservative sperm retrieval in anejaculatory men with spinal cord injury:An Asian case series.Spinal Cord Ser Cases,2016(2):15038-15041.
[13]Pastuszak AW,Sigalos JT,Lipshultz LI.The role of the urologist in the era of in vitro fertilization-intracytoplasmic sperm injection.Urology,2017,103:19-26.
[14]费前进,潘承双,黄学锋.5型磷酸二酯酶抑制剂治疗辅助生殖技术中偶发ED.中华男科学杂志,2013,19(11):991-995.
[15]吴欢,张静静,贺小进,等.取卵日男方取精困难的应对策略及助孕结局分析.生殖与避孕,2014,34(10):813-818.
[16]王琦,杨吉相,李国信,等.疏肝益阳胶囊治疗勃起功能障碍多中心随机对照试验.北京中医药大学学报,2004,27(4):72-75.
[17]杨克冰,黄晓军,张士更,等.小剂量他达拉非联合疏肝益阳胶囊治疗轻中度勃起功能障碍的疗效分析.中华男科学杂志,2014,20(3):267-272.
[18]王琦,倪平,吴卫平,等.疏肝益阳胶囊治疗勃起功能障碍的作用机理研究.中国中药杂志,2005,30(1):59-64.
[19]王济,白明华,刘保兴,等.疏肝益阳胶囊对动脉性勃起功能障碍大鼠性功能及性腺质量的作用.安徽中医学院学报,2013,32(2):54-57.
[20]史亚磊,张敏建,程宛钧,等.疏肝益阳胶囊治疗肝郁肾虚型弱精子症的临床研究.中华男科学杂志,2015,21(7):634-636.
[21]李宏军.辅助生殖技术前应重视男性不育患者的常规处理.生殖与避孕,2017,37(4):343-346.
[22]翟丹梅,江莉,李慕军,等.取卵日取精困难患者11例助孕结局分析.微创医学,2009,4(6):601-602.