补肾填精方联合抗氧化剂治疗肾精亏亏虚型特发性弱精子症的临床观察
发布时间：2018-07-24 14:44
【摘要】：目的:弱精子症是导致男性不育的重要原因之一,而特发性弱精子症的病因病机尚不明确,现代医学对本病尚缺乏有效的治疗手段,目前治疗方法主要有激素治疗和非激素治疗,其中激素治疗又存在一定的风险,而中医药在治疗本病方面颇有优势。为了提高治疗特发性弱精子症的临床疗效,重视"肾藏精,主生殖,,在不育治疗中的作用,本研究探讨补肾填精方联合维生素E、硒酵母片的治疗效果,以便更好的指导临床治疗,为临床治疗特发性弱精子症提供参考。方法:通过纳入、排除标准筛选合格受试者,将符合标准的75名患者纳入研究,按随机数字表法分为中药组(n=25)、西药组(n=25)、中西药组(n=25)。中西药组口服补肾生精方联合维生素E、硒酵母片;对照西药组口服维生素E、硒酵母片;对照中药组口服补肾填精方,疗程为12周。3组患者分别于治疗开始前、治疗结束后,分别检测患者计算机辅助精液分析(CASA)精子密度、前向运动精子(PR)百分率、精子活力(PR +NP)、非前向运动精子(NP)百分率、肾精亏虚症状评分,并对其进行统计分析,评定其临床疗效。结果:1.中药组、西药组和中西药组在治疗前,患者的年龄、病程、精子密度、pR、PR+NP、肾虚精亏症状评分均未见明显差异(P0.05)。2.经治疗后,中药组的平均精子密度由治疗前的(41.80±24.60)106/ml增加到治疗后的(49.06±29.19)106/ml,PR由治疗前的(19.03±9.26)%提升到治疗后的(25.98± 12.13)%,精子活力由治疗前的(38.91 ± 11.63)%提升到治疗后的(50.81±13.44)%,肾精亏虚症状评分由治疗前的(13.84±3.46)分降到治疗后的(8.80±3.20)分;西药组的平均精子密度由治疗前的(48.59±22.20)106/ml增加到治疗后的(57.99±23.58)10/ml,PR由治疗前的(21.56±6.93)%提升到治疗后的(28.46±7.12)%,精子活力由治疗前的(44.77±14.49)%提升到治疗后的(56.51±14.62)%,肾精亏虚症状评分由治疗前的(12.84±2.39)分降到治疗后的(8.96±2.88)分;中西药组的平均精子密度由治疗前的(47.59± 26.55)106/ml增加到治疗后的(79.36±42.71)106/ml,PR 由治疗前的(21.64±8.73)%提升到治疗后的(35.01±13.89)%,精子活力由治疗前的(42.54± 11.31)%提升到治疗后的(66.83±20.46)%,肾精亏虚症状评分由治疗前的(12.32±3.15)分降到治疗后的(6.88±3.54)分,治疗后三组的精子密度、PR、PR+NP均较前提高,肾虚精亏症状也较前改善,差异有统计学意义(P0.05)。3.治疗后,三组间的精子密度、PR、PR+NP、肾精亏虚症状评分差异有统计学意义,中西药组优于中药组和西药组(P0.05),而中药组和西药组间的差异无统计学意义(P0.05)。4.治疗后,中药组有效率为:44.00%,西药组有效率为52.00%,中西药组有效率为80.00%,中西药组有效率明显优于中药组和西药组(P0.05),而中药组和西药组的有效率未见明显差异(P0.05)。5.三组肾虚精亏症状改善情况的比较,中药组治疗前后的症状评分差值为(5.04±2.21)分,西药组治疗前后的症状评分差值为(3.88±2.22)分,中西药组治疗前后的症状评分差值为(5.44±2.26)分,中西药组和中药组之间的疗效无明显差别(P0.05),两组中医症候疗效明显优于西药组(P0.05)。6.治疗后,三组间的中医症候有效率差异无统计学意义(P0.05),但中药组和中西药组中医症候有效率(72%、76%)高于西药组(48%)。结论:补肾填精方在改善患者肾精亏虚症状上效果明显,与维生素E和硒酵母片联合使用,能显著改善精子活力和肾精亏虚症状,优于单纯使用补肾填精方或者维生素E和硒酵母片。中西医结合治疗特发性弱精子症,优势明显,值得推广,其机制值得进一步探索。
[Abstract]:Objective: asthenospermia is one of the important causes of male infertility. The etiology and pathogenesis of idiopathic asthenospermia is not clear. Modern medicine is still lack of effective treatment for this disease. At present, the main treatment methods are hormone therapy and non hormone treatment, in which hormone therapy has certain risk, and traditional Chinese medicine is in the treatment of this disease. In order to improve the clinical efficacy of treatment of idiopathic asthenospermia, pay attention to the role of "kidney essence, main reproduction, and the effect of infertility treatment. This study explores the therapeutic effect of vitamin E, vitamin E and vitamin A, so as to provide better guidance for clinical treatment and provide a reference for clinical treatment of idiopathic asthenospermia. 75 patients were included in the study. According to the random digital table method, 75 patients were divided into Chinese medicine group (n=25), western medicine group (n=25), Chinese and Western medicine group (n=25). The Chinese and Western medicine group took tonifying kidney Shengjing prescription combined vitamin E and Selenious Yeast Tablets; the Western medicine group took vitamin E, Selenious Yeast Tablets and the control Chinese medicine group took orally tonifying kidney fill. After 12 weeks of treatment, the patients were treated with 12 weeks of treatment. After the treatment, the sperm density, the percentage of forward motile sperm (PR), the motility of sperm (PR +NP), the percentage of non forward motile sperm (NP), the percentage of NP, and the symptom score of kidney essence deficiency were measured, and the clinical effect was evaluated and the clinical effect was evaluated. Results: 1. Chinese medicine group, western medicine group and Western medicine group before treatment, the patient's age, course of disease, sperm density, pR, PR+NP, kidney deficiency syndrome scores have no significant difference (P0.05).2. after treatment, the average sperm density in the Chinese medicine group increased from (41.80 + 24.60) 106/ml before treatment (49.06 + 29.19) 106/ml, PR by the treatment (19) 3 + 9.26% increased to (25.98 + 12.13)% after treatment. The sperm motility was increased from (38.91 + 11.63)% before treatment to (50.81 + 13.44)% after treatment. The symptom score of kidney deficiency deficiency was reduced to (13.84 + 3.46) before treatment (13.84 + 3.46) to after treatment (8.80 + 3.20). The average sperm density in the western medicine group was increased from (48.59 +%) 106/ml to treatment before treatment to treatment. After (57.99 + 23.58) 10/ml, PR increased from (21.56 + 6.93)% before treatment to (28.46 + 7.12)% after treatment. Sperm motility was increased from (44.77 + 14.49)% before treatment to (56.51 + 14.62)% after treatment. The symptom score of kidney deficiency deficiency was reduced to (12.84 + 2.39) before treatment (8.96 +%). The average sperm density of Chinese and Western medicine group was from the average sperm density. Before treatment, (47.59 + 26.55) 106/ml increased to (79.36 + 42.71) 106/ml after treatment, and PR increased from (21.64 + 8.73)% before treatment to (35.01 + 13.89)% after treatment, and the sperm motility was increased from (42.54 + 11.31)% before treatment to (66.83 + 20.46)% after treatment, and the symptom score of kidney deficiency deficiency was reduced to after treatment (12.32 + 5). .88 + 3.54), after treatment, the sperm density, PR, PR+NP were all higher in the three groups, and the symptoms of kidney deficiency and sperm deficiency were also improved. The difference was statistically significant (P0.05) after.3. treatment, the difference of sperm density between the three groups, PR, PR+NP, and the deficiency of kidney essence deficiency were statistically significant. The Chinese and Western medicine group were superior to the traditional Chinese medicine group and the western medicine group (P0.05), while the Chinese medicine group and the western medicine group were better than the traditional Chinese medicine group and the western medicine. There was no statistically significant difference between the groups (P0.05).4. treatment, the effective rate of Chinese medicine group was 44%, the effective rate of Western medicine group was 52%, the effective rate of Chinese and Western medicine group was 80%, the effective rate of Chinese and Western medicine group was obviously superior to that of the traditional Chinese medicine group and the western medicine group (P0.05), but the effective rate of the Chinese medicine group and the western medicine group had no significant difference (P0.05) the improvement of the deficiency symptoms of kidney deficiency in the.5. three groups. The difference of symptom score of Chinese medicine group before and after treatment was (5.04 + 2.21), the difference of symptom score of Western medicine group before and after treatment was (3.88 + 2.22), the difference of symptom score between Chinese and Western medicine group was (5.44 + 2.26), there was no significant difference between Chinese and Western medicine group and Chinese medicine group (P0.05), and the two groups of TCM syndrome had obvious curative effect. After the treatment of the western medicine group (P0.05).6., there was no significant difference in the efficiency of TCM syndrome between the three groups (P0.05), but the Chinese medicine group and the Chinese and Western medicine group were more effective (72%, 76%) than the western medicine group (48%). Conclusion: the effect of the kidney filling prescription in improving the symptoms of kidney deficiency deficiency is obvious, and the combination of vitamin E and Selenious Yeast Tablets can be significantly changed. The symptoms of sperm motility and deficiency of kidney essence are better than the simple use of kidney filling prescription or vitamin E and Selenious Yeast Tablets. The combination of traditional Chinese and Western medicine in the treatment of idiopathic asthenospermia is obvious. It is worth popularizing, and its mechanism is worth further exploring.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5
[Abstract]:Objective: asthenospermia is one of the important causes of male infertility. The etiology and pathogenesis of idiopathic asthenospermia is not clear. Modern medicine is still lack of effective treatment for this disease. At present, the main treatment methods are hormone therapy and non hormone treatment, in which hormone therapy has certain risk, and traditional Chinese medicine is in the treatment of this disease. In order to improve the clinical efficacy of treatment of idiopathic asthenospermia, pay attention to the role of "kidney essence, main reproduction, and the effect of infertility treatment. This study explores the therapeutic effect of vitamin E, vitamin E and vitamin A, so as to provide better guidance for clinical treatment and provide a reference for clinical treatment of idiopathic asthenospermia. 75 patients were included in the study. According to the random digital table method, 75 patients were divided into Chinese medicine group (n=25), western medicine group (n=25), Chinese and Western medicine group (n=25). The Chinese and Western medicine group took tonifying kidney Shengjing prescription combined vitamin E and Selenious Yeast Tablets; the Western medicine group took vitamin E, Selenious Yeast Tablets and the control Chinese medicine group took orally tonifying kidney fill. After 12 weeks of treatment, the patients were treated with 12 weeks of treatment. After the treatment, the sperm density, the percentage of forward motile sperm (PR), the motility of sperm (PR +NP), the percentage of non forward motile sperm (NP), the percentage of NP, and the symptom score of kidney essence deficiency were measured, and the clinical effect was evaluated and the clinical effect was evaluated. Results: 1. Chinese medicine group, western medicine group and Western medicine group before treatment, the patient's age, course of disease, sperm density, pR, PR+NP, kidney deficiency syndrome scores have no significant difference (P0.05).2. after treatment, the average sperm density in the Chinese medicine group increased from (41.80 + 24.60) 106/ml before treatment (49.06 + 29.19) 106/ml, PR by the treatment (19) 3 + 9.26% increased to (25.98 + 12.13)% after treatment. The sperm motility was increased from (38.91 + 11.63)% before treatment to (50.81 + 13.44)% after treatment. The symptom score of kidney deficiency deficiency was reduced to (13.84 + 3.46) before treatment (13.84 + 3.46) to after treatment (8.80 + 3.20). The average sperm density in the western medicine group was increased from (48.59 +%) 106/ml to treatment before treatment to treatment. After (57.99 + 23.58) 10/ml, PR increased from (21.56 + 6.93)% before treatment to (28.46 + 7.12)% after treatment. Sperm motility was increased from (44.77 + 14.49)% before treatment to (56.51 + 14.62)% after treatment. The symptom score of kidney deficiency deficiency was reduced to (12.84 + 2.39) before treatment (8.96 +%). The average sperm density of Chinese and Western medicine group was from the average sperm density. Before treatment, (47.59 + 26.55) 106/ml increased to (79.36 + 42.71) 106/ml after treatment, and PR increased from (21.64 + 8.73)% before treatment to (35.01 + 13.89)% after treatment, and the sperm motility was increased from (42.54 + 11.31)% before treatment to (66.83 + 20.46)% after treatment, and the symptom score of kidney deficiency deficiency was reduced to after treatment (12.32 + 5). .88 + 3.54), after treatment, the sperm density, PR, PR+NP were all higher in the three groups, and the symptoms of kidney deficiency and sperm deficiency were also improved. The difference was statistically significant (P0.05) after.3. treatment, the difference of sperm density between the three groups, PR, PR+NP, and the deficiency of kidney essence deficiency were statistically significant. The Chinese and Western medicine group were superior to the traditional Chinese medicine group and the western medicine group (P0.05), while the Chinese medicine group and the western medicine group were better than the traditional Chinese medicine group and the western medicine. There was no statistically significant difference between the groups (P0.05).4. treatment, the effective rate of Chinese medicine group was 44%, the effective rate of Western medicine group was 52%, the effective rate of Chinese and Western medicine group was 80%, the effective rate of Chinese and Western medicine group was obviously superior to that of the traditional Chinese medicine group and the western medicine group (P0.05), but the effective rate of the Chinese medicine group and the western medicine group had no significant difference (P0.05) the improvement of the deficiency symptoms of kidney deficiency in the.5. three groups. The difference of symptom score of Chinese medicine group before and after treatment was (5.04 + 2.21), the difference of symptom score of Western medicine group before and after treatment was (3.88 + 2.22), the difference of symptom score between Chinese and Western medicine group was (5.44 + 2.26), there was no significant difference between Chinese and Western medicine group and Chinese medicine group (P0.05), and the two groups of TCM syndrome had obvious curative effect. After the treatment of the western medicine group (P0.05).6., there was no significant difference in the efficiency of TCM syndrome between the three groups (P0.05), but the Chinese medicine group and the Chinese and Western medicine group were more effective (72%, 76%) than the western medicine group (48%). Conclusion: the effect of the kidney filling prescription in improving the symptoms of kidney deficiency deficiency is obvious, and the combination of vitamin E and Selenious Yeast Tablets can be significantly changed. The symptoms of sperm motility and deficiency of kidney essence are better than the simple use of kidney filling prescription or vitamin E and Selenious Yeast Tablets. The combination of traditional Chinese and Western medicine in the treatment of idiopathic asthenospermia is obvious. It is worth popularizing, and its mechanism is worth further exploring.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5
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