补肾疏肝方联合枸橼酸他莫昔芬片治疗肾虚肝郁型特发性弱精子症临床观察

Clinical observation of Bushen Shugan recipe combined with tamoxifen citrate tablets in the treatment of idiopathic asthenospermia of kidney deficiency and liver depression type

目的观察补肾疏肝方联合枸橼酸他莫昔芬片治疗肾虚肝郁型特发性弱精子症的临床疗效。方法将90例肾虚肝郁型特发性弱精子症患者按照随机数字表法分为3组。中药组30例予补肾疏肝方治疗;西药组30例予枸橼酸他莫昔芬片治疗;联合组30例予补肾疏肝方联合枸橼酸他莫昔芬片治疗。3组疗程均为12周。比较3组临床疗效、中医证候疗效;比较3组治疗前后精液参数指标精子密度、前向运动(PR)精子百分率、活动精子百分率变化;比较3组治疗前后中医证候评分变化。结果临床疗效:中药组总有效率44.0%,西药组总有效率52.0%,联合组总有效率80.0%,联合组临床疗效优于中药组、西药组(P<0.05)。中医证候疗效:中药组总有效率72.0%,西药组总有效率44.0%,联合组总有效率76.0%,中药组、联合组中医证候疗效优于西药组(P<0.05)。3组治疗后精子密度、PR及活动精子百分率均较本组治疗前升高(P<0.05);联合组治疗后精子密度、PR及活动精子百分率均高于中药组、西药组(P<0.05)。3组治疗后性欲减退、精神疲惫、腰膝痠软、烦躁易怒评分及总评分均较本组治疗前降低(P<0.05);治疗后中药组、联合组性欲减退、精神疲惫、腰膝痠软、烦躁易怒评分及总评分均低于西药组(P<0.05)。结论补肾疏肝方联合枸橼酸他莫昔芬片治疗肾虚肝郁型特发性弱精子症,能改善患者精液参数指标及中医证候,疗效优于单纯应用补肾疏肝方或枸橼酸他莫昔芬片治疗。

Objective To observe the clinical efficacy of Bushen Shugan recipe combined with tamoxifen citrate tablets in the treatment of idiopathic asthenospermia of kidney deficiency and liver depression type. Methods 90 patients with idiopathic asthenospermia of kidney deficiency and liver depression were divided into three groups according to random number table method. 30 cases in Chinese medicine group were treated by Bushen Shugan recipe. 30 cases in western medicine group were treated by tamoxifen citrate tablets. 30 cases in combined group were treated by Bushen Shugan recipe and tamoxifen citrate tablets. The course of treatment was 12 weeks in three groups. The clinical efficacy and TCM syndromes of three groups were compared. The changes of sperm density, forward motile sperm (PR) percentage and motile sperm percentage before and after treatment in the three groups were compared. The changes of TCM syndrome scores before and after treatment in the three groups were compared. Results The total effective rate was 44.0% in Chinese medicine group, 52.0% in western medicine group, and 80.0% in combined group. The clinical effect of combined group was better than that of traditional Chinese medicine group and western medicine group ( P <0.05). The total effective rate of TCM syndromes was 72.0% in Chinese medicine group, 44.0% in western medicine group and 76.0% in combined group. The curative effect of TCM syndromes in Chinese medicine group and combined group was better than that in western medicine group ( P <0.05). The sperm dcnsity,PR sperm percentage and motile sperm percentage in the three groups after treatment were higher than those befor treatment( P <0.05).The sperm density,PR sperm percentage and motile sperm percentage in combied group were higher than those in Chinese medicine group and western medicine group after treatment( P <0.05).The scores of decreased libido, mental fatigue, weakness of waist and knee, irritability and angry after treatment in the three groups were lower than those before treatment ( P <0.05).After treatment, the scores of decreased libido, mental fatigue, weakness of waist and knee, irritability and angry in Chinese medicine group and combined group were lower than those in western medicine group ( P <0.05). Conclusion Bushen Shugan recipe combined with tamoxifen citrate tablets in the treatment of idiopathic asthenospermia of kidney deficiency and liver depression type can improve the semen parameters and TCM syndromes of patients, and the curative effect is better than that of using only Bushen Shugan recipe or tamoxifen citrate tablets.