滋阴败火方治疗阴虚火旺型弱精症46例临床分析

Clinical analysis of Ziyin Baihuo Recipe in treating 46 cases of asthenospermia of yin deficiency and fire hyperactivity type

目的观察滋阴败火方治疗阴虚火旺型弱精症的临床疗效。方法纳入符合标准的2019年10月~2020年1月在我院男科的46例阴虚火旺型弱精症患者和40例正常对照,均记录临床症状,行精液质量分析和精子DNA断裂率(DFI)检查,并抽取晨起空腹静脉血,测定T、E2、CORT、FT4、FT3、NO﹑NOS﹑iNOS浓度,然后治疗组开始服用滋阴败火中药方剂,3个月为1个疗程。1个疗程结束后再次复查以上各项进行比较。结果喜寒畏热(92.4%)﹑舌红苔薄(89.7%)是阴虚火旺的主要症状,滋阴败火方治疗3个月后阴虚火旺症状发生率明显下降(P<0.05),患者精子活力﹑精子形态正常率与治疗前相比均有明显改善(P<0.05),而精子DNA断裂率(DFI)与治疗前相比显著下降(P<0.05)。阴虚火旺患者治疗前iNOS、CORT浓度较正常对照组明显升高(P<0.05),治疗后iNOS、CORT浓度明显下降(P<0.05)。T、E2、FT4、FT3、NO﹑NOS浓度治疗前后无改变(P>0.05)。结论iNOS、CORT浓度升高是阴虚火旺的生化特征,滋阴败火方通过降低iNOS和CORT浓度,可以显著改善阴虚火旺弱精症患者的临床症状和精子活力。

Objective To observe the clinical efficacy of Ziyin Baihuo Recipe in treating asthenospermia of yin deficiency and fire hyperactivity type.Methods A total of 46 cases of asthenospermia with yin deficiency and fire hyperactivity type and 40 normal controls meeting the standard were included in the Department of Andrology in our hospital from October 2019 to January 2020.All clinical symptoms were recorded.Semen quality analysis and sperm DNA fragmentation index(DFI)examination were performed.And fasting venous blood in the morning was collected to determine the concentration of T,E2,CORT,FT4,FT3,NO,NOS,iNOS.Then the treatment group began to take Chinese medicine Ziyin Baihuo Recipe.Three months was a course of treatment.After one course of treatment,the above items were rechecked for comparison.Results Liking cold and hating heat(92.4%)and a red tongue with little fur(89.6%)were the main symptoms of yin deficiency and fire hyperactivity.After treatment with Ziyin Baihuo Recipe for three months,the incidence of yin deficiency and fire hyperactivity decreased significantly(P<0.05),the patient's sperm motility and sperm morphology normal rate were significantly improved compared with before treatment(P<0.05),while the sperm DNA fragmentation index(DFI)was significantly lower than before treatment(P<0.05).The concentrations of iNOS and CORT in patients with yin deficiency and fire hyperactivity were significantly higher than those of normal controls(P<0.05).The concentrations of iNOS and CORT decreased significantly after treatment(P<0.05).The concentrations of T,E2,FT4,FT3,NO and NOS did not change before and after treatment(P>0.05).Conclusion The increase of iNOS and CORT concentration is the biochemical characterization of yin deficiency and fire hyperactivity.Ziyin Baihuo Recipe can significantly improve the clinical symptoms and sperm motility of patients with yin deficiency and fire hyperactivity by reducing the concentration of iNOS and CORT.