中医辨证治疗男性不育少弱精子症的作用机制及实验室指标

Mechanism and Laboratory Indexes of Treating Male Sterility and Weak Spermatospermia by Chinese Medicine Syndrome Differentiation

目的:临床研究中医辨证治疗男性不育少弱精子症的作用机制及实验室指标。方法:选取2017年1月至2017年7月徐州市中医院收治的诊断为少弱精子症的不育患者88例作为研究对象,按照不同治疗方案分为对照组(n=42)和观察组(n=46)。观察组接受中医辨证法治疗,对照组接受常规药物治疗。记录患者在治疗期间的相关指标变化,用于比较分析。结果:1)精子相关指标检测:观察组治疗后精液量(3.14±1.16)mL、精子密度(29.27±5.16)×10~6/mL、存活率(55.19±6.77)%、PR(40.85±4.84)%、PR+NP(73.94±7.27)%和精子液化时间(20.26±3.49)min。对照组治疗后精液量(2.75±0.79)mL、精子密度(20.85±4.69)×10~6/mL、存活率(41.67±4.28)%、PR(32.65±4.49)%、PR+NP(44.81±5.02)%和精子液化时间(38.70±5.46)min。2)激素相关指标检测:观察组治疗后FSH(5.27±0.61)mU/mL、T(5.85±0.84)mU/mL、LH(4.26±1.49)mU/mL。对照组治疗后FSH(6.85±1.05)mU/mL、T(4.65±1.13)mU/mL、LH(5.70±2.46)mU/mL。3)中医证候积分:观察组经过治疗从(14.45±0.40)总分改善至(4.46±0.26),对照组经过治疗从(14.12±0.44)总分改善至(8.14±0.32)。4)组间比较临床效果:治疗结束后,1年内统计观察组患者成功受孕率为80.43%,对照组患者成功受孕率为59.52%。合计2组不育患者治疗前后精液和血常规指标改善程度,观察组总有效率为93.48%,对照组总有效率71.43%。结论:中医辨证治疗男性不育少弱精子症效果显著,随症加减,针对性治疗比常规药物服用对改善患者实验室指标等应用价值更高。

Objective:To study the mechanism and laboratory indexes of treating male sterility and weak spermatospermia by Chinese medicine syndrome differentiation.Methods:From January 2017 to July 2017,88 infertile patients with oligozoospermia admitted to Xuzhou City Hospital of TCM were selected retrospectively.According to different treatment schemes,46 patients who received TCM syndrome differentiation were classified as the syndrome differentiation group and 42 patients who received routine drug therapy were classified as the routine group.The changes of related indexes during treatment were recorded for comparative analysis.Results:1)sperm related indexes:in the syndrome differentiation group after treatment,spermatozoa volume was(3.14±1.16)mL,sperm density was(29.27±5.16)10~6/mL,survival rate was(55.19±6.77)%,PR(40.85±4.84)%,PR+NP(73.94±7.27)%and sperm liquefaction time was(20.26±3.49)min.In the routine group,the spermatozoa density was(2.75±0.79)mL,sperm density was(20.85±4.69)10~6/mL,the survival rate was(41.67±4.28)%,PR(32.65±4.49)%,PR+NP(44.81±5.02)%and the sperm liquefaction time was(38.70±5.46)min.2)hormone related indexes:in the syndrome differentiation group after treatment,FSH(5.27±0.61)mU/mL,T(5.85±0.84)mU/mL,LH(4.26±1.49)mU/mL.In the routine group after treatment,FSH(6.85±1.05)mU/mL,T(4.65±1.13)mU/mL,LH(5.70±2.46)mU/mL.3)TCM syndromes integral:the total score of the syndrome differentiation group was improved from(14.45±0.40)to(4.46±0.26)after treatment,and the total score of the routine group was improved from(14.12±0.44)to(8.14±0.32).4)Clinical effect comparison between groups:after the treatment,the successful pregnancy rate was 80.43%in the syndrome differentiation group and 59.52%in the routine group.The improvement degree of semen and blood routine in the 2 groups were 93.48%in the syndrome differentiation group and 71.43%in routine group.Conclusion:The effect of TCM differentiation on male infertility and weak spermatozoa is remarkable.The targeted therapy is more valuable than conventional drugs in the application of laboratory indicators,according to syndromes.