清瘀育精汤治疗精索静脉曲张性不育（瘀热搏结证）的临床研究
发布时间：2018-09-11 15:25
【摘要】：目的:通过临床对照研究,观察清瘀育精汤对精索静脉曲张性不育患者精液质量的影响,评价其临床疗效及安全性;同时观察主要性激素和精浆生化指标的变化情况,以及对精索静脉内径、中医临床症状的影响,探讨瘀热病机在精索静脉曲张性不育中的关键作用,从而丰富瘀热病机理论,更好地服务于临床实践。方法:将65例符合纳入标准的精索静脉曲张性不育(瘀热型)的患者,随机分为治疗组34例、对照组31例。治疗组予口服清瘀育精汤(江苏省中医院中药饮片),对照组予口服迈之灵片(每次2片,每日2次),合五子衍宗丸(每次6g,每日2次),早晚服用。治疗周期为3个月。观察治疗前后两组患者精子浓度、精子活力、精子活率、正常形态精子率、T、LH、FSH、精浆生化(精浆锌、果糖、精浆αα-葡萄糖苷酶)、精索静脉内径,以及中医症状评分的变化,并行安全性指标检测。结果:(1)两组患者治疗后,精子浓度、精子活力、前向运动精子、正常形态精子率、精子活率与治疗前比较均有升高(P0.05);两组间对比显示,治疗组的精子浓度、精子活力、前向运动精子、正常形态精子率、精子活率升高更显著,组间比较具有统计学意义(P0.05)。(2)两组患者治疗后,T均较治疗前有升高,治疗组前后差异具有统计学意义(P0.05),对照组治疗前后差异无统计学意义(P0.05);两组间对比,治疗组T较对照组升高显著,组间比较有统计学意义(P0.05)。两组患者LH、FSH水平较治疗均有所下降,两组治疗前后及两组间比较差异均无统计学意义(P0.05)。(3)治疗后两组的精浆αα-葡糖苷酶、精浆锌、精浆果糖均有升高,其中精浆α-葡糖苷酶两组治疗前后比较及两组组间比较均具有统计学意义(P0.05),精浆锌、精浆果糖两组治疗前后比较及组间差异比较均无统计学意义(P0.05)。(4)两组治疗前后,精索静脉内径较治疗前降低,但前后差异不具有统计学意义(P0.05),组间比较变化不明显,无统计学差异(P0.05)。(5)治疗后,两组患者中医症状评分均较治疗前下降,前后差异均具有统计学意义(P0.05);两组间比较,差异具有统计学意义(P0.05)。(6)临床疗效比较:治疗组总有效率为91.5%,而对照组总有效率则为74.2%,治疗组总有效率明显高于对照组(P0.05)。结论:清瘀育精汤及迈之灵合五子衍宗丸均能不同程度地改善精索静脉曲张不育患者精液质量及中医症状,但清瘀育精汤效果更为显著,具有明显优势。
[Abstract]:Objective: to observe the effect of Qingyu Yujing decoction on semen quality of patients with varicocele infertility, to evaluate its clinical efficacy and safety, and to observe the changes of main sex hormones and seminal plasma biochemical indexes. And the influence on the internal diameter of spermatic vein and the clinical symptoms of traditional Chinese medicine, to explore the key role of blood stasis fever in varicocele infertility, so as to enrich the theory of blood stasis fever, and better serve clinical practice. Methods: 65 patients with varicocele infertility were randomly divided into treatment group (34 cases) and control group (31 cases). The treatment group was treated with Qingyu Yujing decoction (traditional Chinese medicine tablet), the control group was given two tablets of Mai Zhi Ling (2 tablets per day, 2 times a day), and Wuzi Yanzong pill (6 g each time, 2 times a day) was taken in the morning and evening. The treatment period was 3 months. The changes of spermatozoa concentration, sperm motility, normal morphology sperm rate, seminal plasma biochemistry (seminal plasma zinc, fructose, seminal plasma 伪 -glucosidase), spermatic vein diameter and TCM symptom score were observed before and after treatment. Parallel security index detection. Results: (1) after treatment, sperm concentration, sperm motility, forward motility sperm rate, sperm motility rate and sperm motility rate in both groups were higher than those before treatment (P0.05). Forward motility sperm, normal sperm morphology, sperm motility were significantly higher than those of control group (P0.05). (2). Treatment group before and after the difference was statistically significant (P0.05), the control group before and after treatment had no statistical significance (P0.05); the comparison between the two groups, the treatment group T was significantly higher than the control group, there was statistical significance between the two groups (P0.05). The level of LH,FSH in the two groups was lower than that in the treatment group. There was no significant difference between the two groups before and after treatment (P0.05). (3). After treatment, the seminal plasma 伪 -glucosidase, seminal plasma zinc, seminal plasma fructose were all increased in the two groups. The seminal plasma 伪 -glucosidase group before and after treatment and the comparison between the two groups were statistically significant (P0.05), seminal plasma zinc, seminal plasma fructose group before and after treatment and the difference between the two groups were not statistically significant (P0.05). (4) before and after treatment. The internal diameter of spermatic vein was lower than that before treatment, but there was no significant difference before and after treatment (P0.05). There was no significant difference between the two groups (P0.05). (5) after treatment, the TCM symptom scores of the two groups were lower than those before treatment. The difference between the two groups was statistically significant (P0.05); the difference was statistically significant (P0.05). (6): the total effective rate of the treatment group was 91.5 and the total effective rate of the control group was 74.2. The total effective rate of the treatment group was significantly higher than that of the control group (P0.05). Conclusion: Qingyu Yujing decoction and Mai Zhi Ling he Wu Zi Yan Zong Pill can improve semen quality and TCM symptoms of infertile patients with varicocele to varying degrees, but Qingyu Yujing decoction is more effective and has obvious advantages.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5
[Abstract]:Objective: to observe the effect of Qingyu Yujing decoction on semen quality of patients with varicocele infertility, to evaluate its clinical efficacy and safety, and to observe the changes of main sex hormones and seminal plasma biochemical indexes. And the influence on the internal diameter of spermatic vein and the clinical symptoms of traditional Chinese medicine, to explore the key role of blood stasis fever in varicocele infertility, so as to enrich the theory of blood stasis fever, and better serve clinical practice. Methods: 65 patients with varicocele infertility were randomly divided into treatment group (34 cases) and control group (31 cases). The treatment group was treated with Qingyu Yujing decoction (traditional Chinese medicine tablet), the control group was given two tablets of Mai Zhi Ling (2 tablets per day, 2 times a day), and Wuzi Yanzong pill (6 g each time, 2 times a day) was taken in the morning and evening. The treatment period was 3 months. The changes of spermatozoa concentration, sperm motility, normal morphology sperm rate, seminal plasma biochemistry (seminal plasma zinc, fructose, seminal plasma 伪 -glucosidase), spermatic vein diameter and TCM symptom score were observed before and after treatment. Parallel security index detection. Results: (1) after treatment, sperm concentration, sperm motility, forward motility sperm rate, sperm motility rate and sperm motility rate in both groups were higher than those before treatment (P0.05). Forward motility sperm, normal sperm morphology, sperm motility were significantly higher than those of control group (P0.05). (2). Treatment group before and after the difference was statistically significant (P0.05), the control group before and after treatment had no statistical significance (P0.05); the comparison between the two groups, the treatment group T was significantly higher than the control group, there was statistical significance between the two groups (P0.05). The level of LH,FSH in the two groups was lower than that in the treatment group. There was no significant difference between the two groups before and after treatment (P0.05). (3). After treatment, the seminal plasma 伪 -glucosidase, seminal plasma zinc, seminal plasma fructose were all increased in the two groups. The seminal plasma 伪 -glucosidase group before and after treatment and the comparison between the two groups were statistically significant (P0.05), seminal plasma zinc, seminal plasma fructose group before and after treatment and the difference between the two groups were not statistically significant (P0.05). (4) before and after treatment. The internal diameter of spermatic vein was lower than that before treatment, but there was no significant difference before and after treatment (P0.05). There was no significant difference between the two groups (P0.05). (5) after treatment, the TCM symptom scores of the two groups were lower than those before treatment. The difference between the two groups was statistically significant (P0.05); the difference was statistically significant (P0.05). (6): the total effective rate of the treatment group was 91.5 and the total effective rate of the control group was 74.2. The total effective rate of the treatment group was significantly higher than that of the control group (P0.05). Conclusion: Qingyu Yujing decoction and Mai Zhi Ling he Wu Zi Yan Zong Pill can improve semen quality and TCM symptoms of infertile patients with varicocele to varying degrees, but Qingyu Yujing decoction is more effective and has obvious advantages.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5
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