益精汤联合西药治疗弱精子症脾肾两虚证的临床观察

Yijing Decoction plus Western medicine for asthenospermia of spleen-kidney deficiency pattern

目的观察益精汤联合西药左卡尼汀及辅酶Q_(10)治疗弱精子症脾肾两虚证的临床疗效。方法将68例弱精子症脾肾两虚证患者随机分为治疗组34例、对照组34例,剔除脱落病例后治疗组33例、对照组33例。对照组予西药左卡尼汀口服液和辅酶Q_(10)片治疗,治疗组在对照组西药治疗的基础上加用益精汤。观察前向运动精子(progressive motility,PR)、精子总活力(PR+非前向运动精子(non-progressive,NP)),临床疗效,中医证候积分,中医证候疗效。结果 2组治疗后PR,PR+NP较本组治疗前均明显升高,差异均有统计学意义(P<0.05);治疗组PR及PR+NP较对照组升高明显,2组治疗前后评分差值比较,差异均有统计学意义(P<0.05),治疗组优于对照组。治疗组33例中,痊愈9例,显效10例,有效8例,无效6例,总有效27例,总有效率为81.81%;对照组33例中,痊愈5例,显效3例,有效9例,无效16例,总有效17例,总有效率为51.52%。经秩和检验,Z=-2.754,P=0.006,P<0.05,治疗组临床疗效优于对照组。2组治疗后中医证候积分较本组治疗前均降低,差异均具有统计学意义(P<0.05),治疗组较对照组降低明显,2组治疗前后差值比较,差异具有统计学意义(P<0.05),治疗组优于对照组。治疗组33例中,治愈9例,显效3例,有效16例,无效5例,总有效28例,总有效率为84.85%;对照组33例中,治愈0例,显效1例,有效14例,无效18例,总有效15例,总有效率为45.46%。经秩和检验,Z=-4.077,P<0.01,治疗组中医证候疗效优于对照组。结论益精汤联合西药左卡尼汀及辅酶Q_(10)治疗弱精子症脾肾两虚证具有较好的疗效。

Objective To observe the clinical efficacy of Yijing Decoction plus Levocarnitine and Coenzyme Q10(CoQ10) for asthenospermia of the spleen-kidney deficiency pattern. Methods 68 patients with asthenospermia of the spleen-kidney deficiency pattern were randomly assigned to the treatment group and control group, with 34 cases in each group. After shedding cases were removed, there were 33 left in each group. The patients in the control group were treated with Levocarnitine Oral Solution and CoQ10 Pill while the patients in the treatment group additionally received Yijing Decoction in addition to the Western medical treatment.The progressive motility(PR), total motility(progressive+non-progressive motility, PR+NP), clinical efficacy, TCM syndrome score and therapeutic effect of TCM syndromes were observed. Results After treatment, PR and PR+NP in both groups were significantly increased, as compared with that before treatment and the differences were statistically significant(P<0.05). PR and PR+NP were more markedly elevated in the treatment group than in the control group, and the differences in scores before and after treatment in both groups were statistically significant(P<0.05), better in the treatment group than in the control group. Among the 33 patients in the treatment group, 9 were cured, 10 were significantly effective, 8 were effective and 6 were ineffective, the total number of effective cases was 27 and the total effective rate was 81.81%. In the control group, there were 5 cured cases, 3 obvious cases, 9 effective cases and 16 ineffective cases, the total number of effective cases was 17, and the total effective rate was 51.52%. After rank sum test, Z=-2.754, P=0.006, P<0.05, the clinical efficacy of the treatment group was better than that of the control group. After treatment, TCM syndrome scores of the two groups were lower than those before treatment, and the differences were statistically significant(P<0.05), significantly lower in the treatment group than in the control group(P<0.05). Among the 33 patients in the treatment group, 9 were cured, 3 were significantly effective, 16 were effective and 5 were ineffective. With a total of 28 effective cases, the total effective rate was 84.85%. In the control group, there was no cured case, 1 obvious case, 14 effective cases and 18 ineffective cases. With a total of 15 effective cases, the total effective rate was 45.46%. Rank sum test showed Z=-4.077, P=0.000(P<0.01), indicating that the therapeutic effect of TCM syndromes was better in the treatment group than in the control group. Conclusions Yijing Decoction plus Levocarnitine and CoQ10 has good effects on asthenospermia of the spleen-kidney deficiency pattern.