【摘要】 目的 探讨知柏地黄丸(ZBDHW)与醋酸泼尼松分别治疗抗精子抗体(AsAb)阳性女性不孕症的临床疗效与副作用，对比两种药物的临床疗效及副作用的差异。方法 选择2023年1月—2024年5月在莆田九十五医院中医科就诊的AsAb阳性女性不孕症患者共130例作为研究对象，随机分为实验A组(46例)、实验B组(41例)和对照组(43例)三组。实验A组予以醋酸泼尼松治疗，实验B组予以知柏地黄丸治疗，对照组拒绝药物治疗。实验组均治疗2个疗程，一个疗程为2个月，治疗完成后，观察并比较三组患者后续的AsAb转阴率，妊娠率及药物副作用(包括消化道溃疡、皮疹、发胖及痤疮)发生率。结果 实验A组的AsAb转阴率为80.5%,妊娠率为60.9%;实验B组的AsAb转阴率为87.8%,妊娠率为65.9%,对照组的转阴率为30.2%,妊娠率为16.3%。两个实验组AsAb转阴率及妊娠率均高于对照组，差异具有统计学意义(P<0.05),实验A组与实验B组的AsAb转阴率及妊娠率相似，差异无统计学意义(P>0.05),但是实验B组的药物四种副作用发生率均明显低于实验A组，差异具有统计学意义(P<0.05)。结论 醋酸泼尼松与知柏地黄丸治疗女性AsAb阳性不孕症均可明显提高AsAb转阴率及妊娠率，且知柏地黄丸的药物副作用更小、更安全，更容易被患者接受，值得临床大面积推广。更多还原

【Abstract】 Objective To explore the clinical efficacy and adverse effects of Zhi-Bai-Di-Huang-Wan（ZBDHW） and prednisone acetate in the treatment of infertility women positive in anti-sperm antibody（AsAb）. The therapeutic efficacy and side effects of the two treatments were compared.Methods A total of 130 AsAb-positive female infertility cases who were admitted to the Department of TCM in Putian 95^th Hospital during January 2023 and May 2024 were enrolled as study subjects, and they were randomly assigned to three groups: 46 patients in experimental group A, 41 in experimental group B, and 43 in the control group. Group A was treated with prednisone acetate, group B with Zhibai Dihuang Pills, and the control group refuse to receive drug treatment. Both experimental groups were treated for two cycles（one cycle being two months）. After treatment, the negative conversion rate of AsAb, pregnancy rate, and incidence of adverse effects（including gastrointestinal ulcers, rash, weight gain, and acne） were observed and compared across the three groups. Results In group A, the negative conversion rate of AsAb was 80.5%, and the pregnancy rate was 60.9%. In group B, the negative conversion rate of AsAb was 87.8%, and the pregnancy rate was 65.9%. In the control group, the negative conversion rate of AsAb was 30.2%, and the pregnancy rate was 16.3%. Both experimental groups showed significantly higher negative conversion rates of AsAb and pregnancy rates than the control group, with statistically significant differences（P<0.05）. The negative conversion rates of AsAb and pregnancy rates between Group A and Group B were similar, with no statistically significant differences（P>0.05）. However, the incidence rates of all four drug-related side effects in Group B were significantly lower than those in Group A, with statistically significant differences（P<0.05）.Conclusions Both prednisone acetate and ZBDHW significantly improved the negative conversion rate of AsAb and pregnancy rate in female infertility patients with AsAb-positive. However, ZBDHW demonstrated fewer side effects and better safety, making them more acceptable to patients and worthy of wide clinical application.更多还原