Clinical Study On The Treatment In Male Infertility With Varicocele Using Levocarnitine And Pancreatic Kininogenase

Objective: To observe and assess the clinical effects and practicality of the combined use of levocarnitine with pancreatic kininogenase in the treatment of male infertility caused by varicocele.Methods: A total of 120 male infertility patients with varicocele were collected in reproductive medicine and andrology clinics,aged between 22 to 35 years old.All the patients were in accordance with the diagnostic criteria of varicocelein the consensus of Chinese Medical Association andrology experts: the sexual function and ejaculation function were normal,excluding the factor of female infertility(only be able to start taking the drug after a 3-month washout period).The test were divided into three groups: Levocarnitine group,pancreatic kininogenase group and combination group(Levocarnitine+pancreatic kininogenase).40 samples are assigned in each group.The treatment was according to the WHO sperm test manual criteria to test the preoperative patient sperm concentration,the total number of motile sperm,the proportion of motile sperm and the survival rate of sperms.(1)Levocarnitine group: Levocaniting Oral Solution(10 mL: 1 g),10 mL each time,3 times a day;(2)Pancreatic kininogenase group: Pancreaic Kininogenase Enteric-coated Tablets(120U),120 U each time,3 times a day;(3)combination group: taking pancreatic kininogenase based on the levocarnitine group,taking 120 U each time,3 times a day.Eachtests index were examined and semen parameters were analyzed after 1 month,2 months,3 months,and 6 months respectively.This study mainly focuses on observing the sperm concentration,the total number of motile sperm,the proportion of motile sperm,and the survival rate of sperm.The clinical efficacy was measured after the end of treatment in three groups of patients,and concluded as following categories,the cure: successful pregnancy or semen examination index returned to be normal;markedly effective: not pregnant,but the semen index was significantly improved after treatment;invalid: no significant change in the index of semen examination.Meanwhile,we also assessed the adverse drug reactions by liver and kidney function check,hematuria and other tests before and after? Treatment.The data before and after treatment was analyzed by application of SPSS21.0,interpreted by comparison between means(using variance)and standard deviation through paired t test.The counting data was analyzed by chi-square test,and the correlation analysis adopts regression analysis and calculate the corresponding OR value.Results: After one month of drug treatment,there was no successful pregnancy case in any of the three groups;after 2 months of drug treatment,there was no successful pregnancy case in any the three groups;After 3 months of drug treatment,the number of pregnancy case was 4 from combined treatment group,and 2 from both levocarnitine group and pancreatic kininogenase group,which indicating the combined treatment effect is better.After 6 months of treatment,the number of pregnant case was 9,4 and 5,respectively,and the effect of combined treatment was much better than that of the other 2 groups,with a pregnancy rate up to 26.47%.Six months later,the cure rate of the combined treatment group was 26.47%.The cure rate was 11.43% and 13.89% in the levocarnitine group and the pancreatic kininogenase group.The treatment effect of the combined treatment was much better than that of the other two treatments.Six months later,the incidence of adverse reactions in the combination group was 17.65%,17.14% in the Levocarnitine group,and 22.22% in the pancreatic kininogenase group.The combination drug treatment of levocarnitine and pancreatic kininogenase can increase the sperm concentration,forward motility sperm,sperm motility and the percentage of motile sperm among patients,however,the incidence of adverse reactions in the combination treatment group was not significantly higher than that in the levocarnitine group and the pancreatic kininogenase group.Conclusion: The combined use of levocarnitine and pancreatic kininogenase can significantly improve the sperm quality parameters and clinical pregnancy rate in patients with varicocele,and is safe and worthy of clinical application.