補(bǔ)腎填精方聯(lián)合抗氧化劑治療腎精虧虧虛型特發(fā)性弱精子癥的臨床觀察
發(fā)布時間：2018-07-24 14:44
【摘要】：目的:弱精子癥是導(dǎo)致男性不育的重要原因之一,而特發(fā)性弱精子癥的病因病機(jī)尚不明確,現(xiàn)代醫(yī)學(xué)對本病尚缺乏有效的治療手段,目前治療方法主要有激素治療和非激素治療,其中激素治療又存在一定的風(fēng)險,而中醫(yī)藥在治療本病方面頗有優(yōu)勢。為了提高治療特發(fā)性弱精子癥的臨床療效,重視"腎藏精,主生殖,,在不育治療中的作用,本研究探討補(bǔ)腎填精方聯(lián)合維生素E、硒酵母片的治療效果,以便更好的指導(dǎo)臨床治療,為臨床治療特發(fā)性弱精子癥提供參考。方法:通過納入、排除標(biāo)準(zhǔn)篩選合格受試者,將符合標(biāo)準(zhǔn)的75名患者納入研究,按隨機(jī)數(shù)字表法分為中藥組(n=25)、西藥組(n=25)、中西藥組(n=25)。中西藥組口服補(bǔ)腎生精方聯(lián)合維生素E、硒酵母片;對照西藥組口服維生素E、硒酵母片;對照中藥組口服補(bǔ)腎填精方,療程為12周。3組患者分別于治療開始前、治療結(jié)束后,分別檢測患者計算機(jī)輔助精液分析(CASA)精子密度、前向運動精子(PR)百分率、精子活力(PR +NP)、非前向運動精子(NP)百分率、腎精虧虛癥狀評分,并對其進(jìn)行統(tǒng)計分析,評定其臨床療效。結(jié)果:1.中藥組、西藥組和中西藥組在治療前,患者的年齡、病程、精子密度、pR、PR+NP、腎虛精虧癥狀評分均未見明顯差異(P0.05)。2.經(jīng)治療后,中藥組的平均精子密度由治療前的(41.80±24.60)106/ml增加到治療后的(49.06±29.19)106/ml,PR由治療前的(19.03±9.26)%提升到治療后的(25.98± 12.13)%,精子活力由治療前的(38.91 ± 11.63)%提升到治療后的(50.81±13.44)%,腎精虧虛癥狀評分由治療前的(13.84±3.46)分降到治療后的(8.80±3.20)分;西藥組的平均精子密度由治療前的(48.59±22.20)106/ml增加到治療后的(57.99±23.58)10/ml,PR由治療前的(21.56±6.93)%提升到治療后的(28.46±7.12)%,精子活力由治療前的(44.77±14.49)%提升到治療后的(56.51±14.62)%,腎精虧虛癥狀評分由治療前的(12.84±2.39)分降到治療后的(8.96±2.88)分;中西藥組的平均精子密度由治療前的(47.59± 26.55)106/ml增加到治療后的(79.36±42.71)106/ml,PR 由治療前的(21.64±8.73)%提升到治療后的(35.01±13.89)%,精子活力由治療前的(42.54± 11.31)%提升到治療后的(66.83±20.46)%,腎精虧虛癥狀評分由治療前的(12.32±3.15)分降到治療后的(6.88±3.54)分,治療后三組的精子密度、PR、PR+NP均較前提高,腎虛精虧癥狀也較前改善,差異有統(tǒng)計學(xué)意義(P0.05)。3.治療后,三組間的精子密度、PR、PR+NP、腎精虧虛癥狀評分差異有統(tǒng)計學(xué)意義,中西藥組優(yōu)于中藥組和西藥組(P0.05),而中藥組和西藥組間的差異無統(tǒng)計學(xué)意義(P0.05)。4.治療后,中藥組有效率為:44.00%,西藥組有效率為52.00%,中西藥組有效率為80.00%,中西藥組有效率明顯優(yōu)于中藥組和西藥組(P0.05),而中藥組和西藥組的有效率未見明顯差異(P0.05)。5.三組腎虛精虧癥狀改善情況的比較,中藥組治療前后的癥狀評分差值為(5.04±2.21)分,西藥組治療前后的癥狀評分差值為(3.88±2.22)分,中西藥組治療前后的癥狀評分差值為(5.44±2.26)分,中西藥組和中藥組之間的療效無明顯差別(P0.05),兩組中醫(yī)癥候療效明顯優(yōu)于西藥組(P0.05)。6.治療后,三組間的中醫(yī)癥候有效率差異無統(tǒng)計學(xué)意義(P0.05),但中藥組和中西藥組中醫(yī)癥候有效率(72%、76%)高于西藥組(48%)。結(jié)論:補(bǔ)腎填精方在改善患者腎精虧虛癥狀上效果明顯,與維生素E和硒酵母片聯(lián)合使用,能顯著改善精子活力和腎精虧虛癥狀,優(yōu)于單純使用補(bǔ)腎填精方或者維生素E和硒酵母片。中西醫(yī)結(jié)合治療特發(fā)性弱精子癥,優(yōu)勢明顯,值得推廣,其機(jī)制值得進(jìn)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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.5
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