经皮穴位电刺激治疗肾精不足型弱精子症临床观察

Clinical observation of effects of transcutaneous electrical acupoint stimulation on asthenospermia patients with deficiency of kidney essence

目的观察经皮穴位电刺激(TEAS)治疗肾精不足型弱精子症的临床疗效。方法将符合纳入标准的肾精不足型弱精子症患者随机分为治疗组、安慰组和针刺组。治疗组予TEAS,治疗频率为2 Hz;安慰组予TEAS,但频率为无效刺激频率;针刺组予常规针刺,用补法。均每日1次,30次为1疗程,共治疗3个疗程。评估各组患者治疗前后的中医证候评分,检测精子活力及血清激素与精浆抗穆勒氏管激素(AMH)水平。结果与治疗前比较,治疗组与针刺组治疗后患者的中医证候评分明显降低,前向运动精子百分比(PR)、精子总活力(PR+NP)与精浆AMH均较治疗前明显提高(P<0.05),血清促卵泡激素(FSH)均明显降低,显著优于安慰组(P<0.05),且治疗组与针刺组间比较差异无统计学意义(P>0.05);在血清促黄体生成素(LH)和睾酮(T)方面,治疗组均较治疗前有明显改善(P<0.05),而针刺组与安慰组均无明显变化(P>0.05)。结论 TEAS治疗能改善肾精不足型弱精子症患者的临床症状,改善精子活力与血清激素水平。

Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation（ TEAS） on asthenospermia patients with deficiency of kidney essence. Methods Asthenospermia patients with deficiency of kidney essence who met the inclusion criteria were randomly divided into the treatment group,placebo group and acupuncture group. Patients in the treatment group were treated with TEAS at the frequency of 2 Hz,patients in the placebo group were treated with TEAS on ineffective stimulative frequency,patients in the in acupuncture group were treated with routine acupuncture with reinforcing method. All patients were treated once a day,30 times in one course and 3 courses in total. The TCM syndrome scores of all patients were assessed before and after treatment. The sperm motility,serum hormone and anti mullerian hormone（ AMH） in seminal plasma were detected. Results Compared with treatment before,the TCM syndrome scores of patients in the treatment group and acupuncture group were obviously decreased after treatment,the percentage of forward movement sperm（ PR）,sperm vitality（ PR ＋ NP） and seminal plasma AMH were obviously increased（ P〈0. 05）,the serum follicle stimulating hormone（ FSH） were obviously reduced（ P〈0. 05）. The effects in the two groups were significantly better than those in the placebo group（ P〈0. 05）,but there were no statistically significant differences between the treatment group and acupuncture group（ P〉0. 05）. Compared with treatment before,the serum luteinizing hormone（ LH） and testosterone（ T） in the treatment group were significantly improved after treatment（ P〈0. 05）,but there were no obviously changes in the acupuncture group and placebo group（ P〉0. 05）. Conclusion The therapy of TEAS can improve the clinical symptom of asthenospermia patients with deficiency of kidney essence,as well as the sperm motility and serum hormone levels.