目的：探讨高压氧（HBO）治疗特发性男性不育的临床疗效及机制。方法将特发性男性不育患者210例随机分成三组：A组96例，单纯行药物治疗；B组30例，单纯行高压氧治疗；C组84例，行高压氧联合药物治疗。结果 A组、B组、C组在治疗3个月后精子密度、精子活力、精子活率、正常形态精子数方面都有改善，与治疗前比较，差异均有统计学意义（P＜0.01或P＜0.05），治疗后C组较A组、B组改善更明显，差异均具统计学意义（P＜0.05），A、B两组治疗后各项参数比较差异无统计学意义。三组治疗后精子穿透卵子百分率（SPA）值均有升高（P＜0.01或P＜0.05），其中C组治疗后较A、B两组治疗后升高更显著（P＜0.05），A、B两组治疗差异无统计学意义。B、C两组治疗后精浆超氧化物歧化酶（SOD）有改善（P＜0.01或P＜0.05），且C组较B组治疗后改善更明显（P＜0.05）。另外C组治疗后1~3月、3~6月、6~12月、1~12月配偶受孕率较A、B两组都高，差异具统计学意义（P＜0.01或P＜0.05），A、B两组比较差异无统计学意义。结论 HBO治疗能够改善特发性男性不育患者精液质量，提高精子功能，改善精子细胞抗氧化能力，提高受孕率。HBO联合药物治疗较单纯HBO或单纯药物治疗疗效更好。%Objective To study the clinical effect of hyperbaric oxygenation(HBO) in the treatment of idiopathic male infertility. Methods All 210 patients with idiopathic male infertility were randomly divided into Group A (96 patients, treated by medicine only), Group B(30 patients, treated by HBO only), and Group C (84 patients, treated by HBO and medicine). Results The sperm density, sperm motility, sperm vigor and normal sperm were improved in all the three groups(P<0.01 orP<0.05), moreover these parameters in the group C were improved better than those in group A and group B(P<0.05), and there were no differences between the group A and group B. SPA was improved in all the three groups (P<0.01 or P<0.05), while SPA in the group C was improved better than that in group A and group B (P<0.05), and there was no difference between the group A and group B. The semen SOD were improved in group B and group C (P<0.01 or P<0.05), moreover SOX in group C were improved better than that of group B (P<0.05). The pregnant rate of patients´ spouses were improved in the three groups, while the pregnant rate of patients’ spouse in group C was improved better than that in group A and group B (P<0.05), and there was no difference between the group A and group B. Conclusion HBO can improve semen quality, sperm ability, sperm oxidation resistance , pregnant rate of spouses of patients with idiopathic male infertility. The effect of HBO with medicine is better than that of HBO or medicine only for treatment of this disease.
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