补肾活血方剂与迈之灵改善精索静脉曲张性精子异常的疗效对比研究

Comparison of Therapeutic Effect of Kidney-tonifying Blood-activating Recipe and Aescuven Forte Tablets in Treating Varicocele-induced Sperm Abnormality

【目的】比较补肾活血方剂与迈之灵在改善精索静脉曲张性不育男性精子质量方面的差异,为优化临床治疗方案提供依据。【方法】将102例行保守治疗的精索静脉曲张合并精子参数异常的不育症患者随机分为补肾活血方剂治疗组(治疗组)53例和迈之灵对照组(对照组)49例,治疗组给予补肾活血方剂配合天然维生素E治疗,对照组给予迈之灵配合天然维生素E治疗,2组均连续治疗8周,检验2组患者治疗前后精液质量,分析精子总数(TNS)、前向运动精子总数(TNPS)、正常形态精子总数(TNNS)和正常形态前向运动精子总数(TNNPS)等精子总体量化指标治疗前后变化情况,并比较2组精子总体参数的改善率情况。【结果】(1)治疗前,2组TNS、TNPS、TNNS、TNNPS等各项精子总体参数比较,差异均无统计学意义(P>0.05);治疗后,除对照组TNNS变化无统计学意义(P>0.05)外,其余指标2组均较治疗前显著改善(P<0.01),且治疗组对各项指标的改善作用均优于对照组(P<0.05)。(2)治疗组精子总体参数TNS、TNPS、TNNS和TNNPS改善率分别为90.57%、79.25%、67.92%和77.36%,对照组分别为75.51%、73.47%、28.57%和61.22%,治疗组在TNS和TNNS改善率方面优于对照组,差异均有统计学意义(P<0.05或P<0.01)。【结论】精索静脉曲张性不育症患者常表现为肾虚血瘀证,仅调理局部脉络循环障碍的迈之灵对于提升精子总体参数的作用有限,而补肾活血方剂治疗方案更适用于改善此类不育患者的精子质量。

Objective To compare the effect of kidney-tonifying blood-activating recipe （KBR） and Aescuven Forte Tablets （ AFT） in improving the sperm quality of varicocele-induced male sterility, thus to optimize the therapeutic therapy for varicocele-induced male sterility. Methods A total of 102 varicocele-induced male sterility with abnormal sperm parameters after conservative treatment were randomized into KBR group （N=53） and AFT group （ N=49） . KBR group was given KBR plus natural vitamin E and AFT group was given AFT plus natural vitamin E, and the treatment lasted for 8 continuous weeks. Before and after treatment, the quality of seminal fluid was analyzed, sperm quantization parameters such as total number of sperm （TNS） , total number of progressive motility sperm （ TNPS） , total number of normal form sperm （ TNNS） and total number of nor mal form and progressive motility sperm （ TNNPS） were observed, and the improvement rate of sperm quantization parameter was compared. Results （1） Before treatment, the differences of TNS, TNPS, TNNS and TNNPS were insignificant between the two groups （ P〉0.05） . After treatment, TNNS was not improved in AFT group （ P〉0.05） , but TNS, TNPS, TNNPS were much improved in both groups （ P〈0.01 compared with those before treatment） . The improvement of KBR group was superior to that of AFT group （ P〈0.05） . （ 2） The improvement rate for TNS, TNPS, TNNS, TNNPS was 90.57%, 79.25%, 67.92%, 77.36%in KBR group, and was 75.51%, 73.47%, 28.57%, 61.22% in AFT group respectively. The improvement rate for TNS and TNNS in KBR group was superior to that in AFT group （ P〈0.05 or P〈0.01） . Conclusion Varicocele-induced male sterility patients usually have the syndrome of kidney deficiency and blood stasis, so KBR, which has the function of tonifying kidney and activating blood, has synergistic action on the effect of AFT in improving sperm quality of varicocele-induced male sterility patients.