益肾生精饮治疗肾阳虚型弱精子症

Clinical Observation of Yishen Shengjing Decoction in Treating Weak Sperm Caused by Kidney-yang Deficiency

目的:观察益肾生精饮治疗肾阳虚型弱精子症的临床疗效,及对患者精子DNA完整率(DNA integrity rate of testosterone sperm,DFI)的影响。方法:将160例患者采用随机数字表法分为对照组和观察组,每组80例。对照组采用左卡尼汀治疗,观察组在对照组治疗基础上联合益肾生精饮(菟丝子30 g,补骨脂25 g,淫羊藿20 g,肉苁蓉30 g,枸杞子20 g,党参30 g,当归15 g,黄芪15 g,山萸肉20 g,五味子10 g,墨旱莲20 g)治疗。两组患者均以3个月为1个疗程。比较两组患者临床疗效、精液质量[包括精液量、精子密度、精子活力(a+b级精子比例)和精子畸形率]、生殖激素水平[包括尿促卵泡素(follicle-stimulating hormone,FSH)、促黄体生成素(luteotrophic hormone,LH)和睾酮(testosterone,T)]、精子DFI和不良反应发生情况。结果:治疗后,两组患者精液量、精子密度和a+b级精子比例明显升高,精子畸形率降低,并且观察组患者精液量、精子密度和a+b级精子比例高于对照组,精子畸形率低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者FSH和LH降低,T升高,其中观察组患者FSH和LH低于对照组,T高于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者DFI均下降,且观察组DFI低于对照组,差异均有统计学意义(P<0.05);对照组有效率为71.25%,低于观察组的85.00%,差异有统计学意义(P<0.05);对照组不良反应率为10.0%,与观察组的7.5%比较,差异无统计学意义(P>0.05)。结论:益肾生精饮联合左卡尼汀治疗肾阳虚型弱精子症疗效显著,能够提高患者精液质量,可能与调节患者生殖激素水平,修复精子DNA损伤有关,并且安全性好。

Objective: To observe the clinical efficacy of Yishen Shengjing Decoction in treating weak sperm caused by kidney-yang deficiency and its effects on sperm DNA integrity rate. Method: 160 patients were divided into control group and observation group by random number table method,80 cases in each group. The control group was treated with L-carnitine and the observation group was combined with Yishen Shengjing Decoction on the basis of the control group( dodder seed 30 g,malaytea scurfpea fruit 25 g,epimedium herb 20 g,desertliving cistanche 30 g,barbary wolfberry fruit 20 g,tangshen 30 g,Chinese angelica 15 g,milkvetch root15 g,asiatic cornelian cherry fruit 20 g,Chinese magnoliavine fruit 10 g,eclipta prostrata 20 g). Both groups of patients took 3 months as a course of treatment and the clinical efficacy and semen quality [including semen volume,sperm density,sperm motility( a + b sperm ratio) and sperm deformity rate],reproductive hormone levels [including follicle-stimulating hormone( FSH),Luteotrophic hormone( LH),testosterone( T) levels],DNA integrity rate of testosterone sperm( DFI) and adverse reactions were compared. Result: After treatment,the semen volume,sperm density and a + b sperm ratio increased significantly. The sperm deformity rate decreased,and the semen volume,sperm density and a + b sperm ratio in the observation group were higher than the control group while the sperm deformity rate was lower than the control group. The difference was statistically significant( P <0. 05). After treatment,FSH and LH decreased and T increased in both groups. The FSH and LH in the observation group were lower than the control group and T was higher than the control group. The difference was statistically significant( P < 0. 05). After treatment,the DFI in both groups decreased,and the DFI in the observation group was lower than that of the control group. The difference was statistically significant( P < 0. 05). The effective rate of the control group was 71. 25% which was lower than85. 00% of the observation group. The difference was statistically significant( P < 0. 05). The adverse reaction rate of the control group was 10. 0%. Compared with 7. 5% of the observation group,the difference was not statistically significant( P > 0. 05). Conclusion: The curative effect is remarkable by using Yishen Shengjing Decoction combined with L-carnitine in the treatment of patients with weak sperm caused by kidney-yang deficiency,which can improve the quality of semen in patients with good security,possibly by regulating the level of reproductive hormones,repairing sperm DNA damage.