大艾段温针灸法治疗弱精症肾虚肝郁型疗效观察

Therapeutic effect of Da Ai Duan warm acupuncture-moxibustion on asthenospermia of type of kidney deficiency and liver depression

目的评价大艾段温针灸法治疗弱精症肾虚肝郁型的疗效及对中医症状、精液常规、精浆生化的调节作用。方法选择2018年3月—2019年12月来南京中医药大学连云港附属医院课题病例招募组治疗的140例弱精症肾虚肝郁型患者,随机分为观察组、药物组、常规温针组、普通针刺组,每组35例。观察组使用4 cm艾段行温针灸治疗,药物组采用维生素E软胶囊、硫酸锌片、五子衍宗丸治疗,常规温针组应用2.5 cm艾段行温针灸治疗,普通针刺组只针不灸。4组均以4周为1个疗程,治疗2个疗程后观察4组中医症状积分、精液常规指标、精浆生化指标变化情况,统计4组临床疗效。结果治疗后4组患者中医症状总积分均显著降低(P均<0.05),但4组间比较差异均无统计学意义(P均>0.05)。治疗后4组患者的精子活率、a级精子率、a+b级精子率、精浆中果糖和中性α-葡萄糖糖苷酶含量及药物组的精液量、精浆中锌含量均明显高于治疗前(P均<0.05),精子畸形率均明显低于治疗前(P均<0.05);且观察组a级精子率、a+b级精子率、精浆中果糖和中性α-葡萄糖糖苷酶含量均明显高于其他3组(P均<0.05),精子活率明显高于常规温针组、普通针刺组(P均<0.05),精子畸形率均明显低于其他3组(P均<0.05)。观察组和药物组总有效率均明显高于普通针刺组(P均<0.05),其余各组间疗效比较差异均无统计学意义(P均>0.05)。结论大艾段温针灸法治疗弱精症肾虚肝郁型患者疗效肯定,在降低精子畸形率,提高a级精子率、a+b级精子率、精浆中果糖和中性α-葡萄糖苷酶含量方面效果优于药物疗法、常规温针法和普通针刺法。

Objective It is to evaluate the therapeutic effect of Da Ai Duan warm acupuncture and moxibustion on asthenospermia of type of kidney deficiency and liver depression and its regulating effect on TCM syndrome,semen routine and seminal plasma biochemistry.Methods 140 patients with asthenospermia of type of kidney deficiency and liver depression treated in Lianyungang Affiliated Hospital of Nanjing University of TCM from March 2018 to December 2019 were randomly divided into observation group,drug control group,conventional warm acupuncture and moxibustion control group and common acupuncture control group.Each group had 35 cases.The observation group was treated with warm acupuncture and moxibustion with 4 cm mugwort segment,the drug group was treated with vitamin E soft capsule,zinc sulfate tablet,Wuziyanzong pill,the conventional warm acupuncture and moxibustion group was treated with warm acupuncture and moxibustion with 2.5 cm mugwort segment,the common acupuncture group was treated with acupuncture without moxibustion.4 weeks as a course of treatment,after 2 courses,the changes of scores of TCM symptoms,indexes of semen routine and seminal plasma biochemistry were observed,and the curative effects of the 4 groups were analyzed.Results The total score of TCM symptoms in the 4 groups was lower than that before treatment(P<0.05),but there was no significant difference among the 4 groups.After treatment,the sperm motility rate,aclass sperm rate,a+b class sperm rate,the content of fructose and neutralα-glucosidase in seminal plasma,the volume of semen in the drug group,and the zinc content in seminal plasma of the 4 groups were significantly higher than those before treatment(all P<0.05),the sperm deformity rate was significantly lower than that before treatment(all P<0.05),and the a class sperm rate,a+b class sperm rate,the contents of fructose and neutralα-glucosidasein in seminal plasma in the observation group were significantly higher than those in the other 3 groups(all P<0.05),the sperm motility rate was significantly higher than that in the conventional warm acupuncture group and the ordinary acupuncture group(all P<0.05),and the rate of sperm deformity was significantly lower than that in the other 3 groups(P<0.05).The total effective rates of the observation group and the drug group were significantly higher than those of the ordinary acupuncture group(all P<0.05),and there was no statistically significant difference in curative effect between the other groups(all P>0.05).Conclusion The therapeutic effect of Da Ai Duan warm acupuncture and moxibustion on asthenospermia of type of kidney deficiency and liver depression is definite.It is superior to drug therapy,conventional warm acupuncture-moxibustion and common acupuncture in improving deformity rate,a class sperm,a+b class sperm,and the contents of seminal plasma fructose and neutralα-glucosidase.