Objective:To investigate the efficacy and safety of L-carnitine compound nutrient (Xiweili)for treatment of idiopathic asthenospermia and/or teratozoospermia in male infertility.Methods:A total of 133 patients with idiopathic asthenospermia and/or teratozoospermia were randomly divided into two groups,68 patients taking L-carnitine compound nutrients in the study group,and 65 patients taking Co-Q10 and vitamin E in the control group.All patients were treated for three months and their semen parameters including sperm concentration,percentage of forward movement spermatozoon were analyzed by computer-aided semen analysis system before treatment,two months after treatment and in the end of treatment.Sperm morphology is assessed by Pap staining.The sperm motility and morphology before and after treatment,and also side effects of taking L-carnitine compound nutrient were observed.Results:There were 60 patients in study group and 63 in control yroup completing the treatment course.The mean sperm concentration was 33.88 × 106/ml,41.11 × 106/ml & 46.97 × 106/ml;the percentage of forward motile spermatozoon was 22.95％,27.96％ & 31.17％;and the percentage of normal morphology spermatozoon was 2.48％,3.12％ & 3.67％ before treatment,two months after treatment and the end of treatment respectively in the study group.While the mean sperm concentration was 31.78×106/ml,30.61× 106/ml & 33.44× 106/ml,the percentage of forward motile spermatozoon was 21.05％,22.76％ & 24.17％ and the normal morphology spermatozoon was 2.56％,2.78％ & 3.12％ before treatment,two months after treatment and the end of treatment respectively in the control group.The sperm concentration,percentage of forward motile spermatozoon and normal morphology spermatozoon were significantly improved two or three months after treatment in study group compared with before treatment(P＜0.05).The significant difference was also found between two months and three months after treatment(P＜0.05).However,the percentages of forward motile spermatozoon and the normal morphology spermatozoon were only improved three months after treatment in the control group(P＜0.05).Compared with control group in the same period,the parameters of the semen in the study group were more significantly improved (P＜0.05).Two patients(3.33 ％) experienced slight sore throat during the treatment period,and 3 patients(5.00％)experienced slight gastrointestinal discomfort,and no other adverse reactions occurred in the study group;no adverse reactions occurred in the control group.Conclusions:Xiweili can effectively improve the percentage of forward motile spermatozoon,normal morphology spermatozoon,and sperm concentration for patients with idiopathic asthenospermia and teratozoospermia and it has clinical application safety.However,further multi-center studies are still needed to confirm the results.%目的 探讨左卡尼汀复合营养素(希维力)治疗特发性弱/畸精子症男性不育患者的临床有效性及安全性.方法 选取2016年11月至2017年11月于江门市中心医院男性不育门诊就诊的特发性弱/畸精子症患者133例,随机分为2组:实验组68例,口服左卡尼汀复合营养素;对照组65例,口服辅酶Q10+维生素E.疗程均为3个月,分别于治疗前及治疗第2个月末和疗程结束时,采用计算机辅助精液分析检测治疗前后患者精液各项参数(精子浓度、精子前向运动百分比等),采用巴氏染色行精子形态学检测,观察治疗效果及不良反应. 结果 最终实验组60例,对照组63例完成整个疗程,纳入统计.实验组在治疗前、用药2个月、用药3个月精子浓度平均值分别为33.88×106/ml、41.11×106/ml、46.97×106/ml,前向运动精子百分比平均值分别为22.95％、27.96％、31.17％,精子正常形态百分比平均值分别为2.48％、3.12％、3.67％;对照组在治疗前、用药2个月、用药3个月精子浓度平均值分别为31.78×106/ml、30.61×106/ml、33.44×106/ml,前向运动精子百分比平均值分别为21.05％、22.76％、24.17％,精子正常形态百分比平均值分别为2.56％、2.78％、3.12％.实验组精子浓度、前向运动精子百分比、正常形态精子百分比于治疗2个月、3个月时较治疗前均显著改善,且治疗3个月时较2个月时显著改善,差异均具有统计学意义(P＜0.05);对照组仅治疗3个月时较治疗前前向运动精子百分比和正常形态精子百分比有显著改善(P＜0.05);与对照组相同时段相比,实验组精液各参数均改善更显著(P＜0.05).实验组治疗期间有2例(3.33％)出现轻微咽喉肿痛,3例(5.00％)轻微胃肠不适,无其他不良反应出现;对照组无明显不良反应出现. 结论 希维力可有效改善特发性弱/畸精子症患者的前向运动精子百分比及正常形态精子百分比,提升患者的精子浓度,临床应用安全.但仍需进一步的多中心研究证实.
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