男性不育肾虚症不同证型治疗前后的精液酶学检测

Semen enzymatic changes of male infertility with nephrasthenia syndrome in different syndrome type before and after treatment

目的观察男性不育肾虚症不同证型者经五子衍宗丸治疗前后的实验室精液酶学变化。方法将正常对照组、男性不育症肾精气不足型、肾阴虚衰型、肾阳不足型各20例进行精子顶体酶、精浆弹性硬蛋白酶、乳酸脱氢酶X同工酶(LDHx)、酸性磷酸酶(ACP)和中性α-葡萄糖苷酶(α-GLU)的定量联合检测;并在使用五子衍宗丸治疗后再次检测酶活性。结果男性不育症肾虚型肾精气不足型、肾阴虚衰型和肾阳不足型3组精子顶体酶活性明显低于对照组(P均<0.01),弹性硬蛋白酶明显高于对照组(P均<0.01);LDHx、α-GLU与对照组比较无显著性差异(P>0.05);肾阳不足型ACP明显高于对照组(P<0.01)。3型两两比较,ACP、弹性硬蛋白酶有显著性差异(P均<0.01)。在五子衍宗丸治疗后,5种酶中有3种酶的活性较治疗前有明显变化。结论男性不育症肾虚型多项酶与对照组相比具有显著性差异,可将酶学检测列为男性不育肾虚型辨证分型的重要依据和治疗监测指标。

Objective It is to observe the semen enzymatic changes of male infertility with nephrasthenia syndrome in different syndrome type before and after treatment of the Wuzi Yanzong Pilular. Methods For 20 cases of normal control group, essence insufficiency group, kidney-yin deficiency group and kidney-yang deficiency group, the activities of five kinds of en- zymes which include sperm acrosome, lactic acid dehydrogenase X （LDHx）, acid phosphatase, α-glucose glycosidation en- zyme （ α - GLU） , and seminal plasma of elasticin enzyme were measured before and after treatment of Wuzi ~anzong Pilular. Results Compared with control group, the activities of sperm acrosome of the other three group were lower significantly （ P 〈 O. 01 ） ; and the elasticin enzyme were higher significantly （ P 〈 0.01 ） ; LDHx and α- GLU had no difference （ P 〉 0.05 ） ; ACP of kidney - yang deficiency group was higher than that of control group （P 〈 0. O1 ）. ACP and elasticin enzyme had difference in the three groups of pairwise comparisons （ P 〈 O. 01 ）. There were significant changes in three kinds of enzyme activity com- pared with before treatment of Wuzi Yanzong Pilular. Conclusion There is significant difference in activities of semen enzymatic between male infertility with nephrasthenia syndrome and the controls, which can be tested as a basis for resolve nephrasthenia syndrome type of male infertility and an indicator of treatment monitoring.