清瘀育精湯治療精索靜脈曲張性不育（瘀熱搏結(jié)證）的臨床研究
發(fā)布時間：2018-09-11 15:25
【摘要】：目的:通過臨床對照研究,觀察清瘀育精湯對精索靜脈曲張性不育患者精液質(zhì)量的影響,評價其臨床療效及安全性;同時觀察主要性激素和精漿生化指標的變化情況,以及對精索靜脈內(nèi)徑、中醫(yī)臨床癥狀的影響,探討?zhàn)鰺岵C在精索靜脈曲張性不育中的關(guān)鍵作用,從而豐富瘀熱病機理論,更好地服務于臨床實踐。方法:將65例符合納入標準的精索靜脈曲張性不育(瘀熱型)的患者,隨機分為治療組34例、對照組31例。治療組予口服清瘀育精湯(江蘇省中醫(yī)院中藥飲片),對照組予口服邁之靈片(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。治療周期為3個月。觀察治療前后兩組患者精子濃度、精子活力、精子活率、正常形態(tài)精子率、T、LH、FSH、精漿生化(精漿鋅、果糖、精漿αα-葡萄糖苷酶)、精索靜脈內(nèi)徑,以及中醫(yī)癥狀評分的變化,并行安全性指標檢測。結(jié)果:(1)兩組患者治療后,精子濃度、精子活力、前向運動精子、正常形態(tài)精子率、精子活率與治療前比較均有升高(P0.05);兩組間對比顯示,治療組的精子濃度、精子活力、前向運動精子、正常形態(tài)精子率、精子活率升高更顯著,組間比較具有統(tǒng)計學意義(P0.05)。(2)兩組患者治療后,T均較治療前有升高,治療組前后差異具有統(tǒng)計學意義(P0.05),對照組治療前后差異無統(tǒng)計學意義(P0.05);兩組間對比,治療組T較對照組升高顯著,組間比較有統(tǒng)計學意義(P0.05)。兩組患者LH、FSH水平較治療均有所下降,兩組治療前后及兩組間比較差異均無統(tǒng)計學意義(P0.05)。(3)治療后兩組的精漿αα-葡糖苷酶、精漿鋅、精漿果糖均有升高,其中精漿α-葡糖苷酶兩組治療前后比較及兩組組間比較均具有統(tǒng)計學意義(P0.05),精漿鋅、精漿果糖兩組治療前后比較及組間差異比較均無統(tǒng)計學意義(P0.05)。(4)兩組治療前后,精索靜脈內(nèi)徑較治療前降低,但前后差異不具有統(tǒng)計學意義(P0.05),組間比較變化不明顯,無統(tǒng)計學差異(P0.05)。(5)治療后,兩組患者中醫(yī)癥狀評分均較治療前下降,前后差異均具有統(tǒng)計學意義(P0.05);兩組間比較,差異具有統(tǒng)計學意義(P0.05)。(6)臨床療效比較:治療組總有效率為91.5%,而對照組總有效率則為74.2%,治療組總有效率明顯高于對照組(P0.05)。結(jié)論:清瘀育精湯及邁之靈合五子衍宗丸均能不同程度地改善精索靜脈曲張不育患者精液質(zhì)量及中醫(yī)癥狀,但清瘀育精湯效果更為顯著,具有明顯優(yōu)勢。
[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 偽 -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 偽 -glucosidase, seminal plasma zinc, seminal plasma fructose were all increased in the two groups. The seminal plasma 偽 -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.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：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 偽 -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 偽 -glucosidase, seminal plasma zinc, seminal plasma fructose were all increased in the two groups. The seminal plasma 偽 -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.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.5
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