阳化气理论在弱精子症及精子DNA损伤中的临床研究

Clinical Study of “Yanghuaqi” Theory in Weak Sperm Disease and Sperm DNA Damage

目的:观察以温补肾阳为原则制方的"壮精汤"改善弱精子症患者前向运动精子活动率(Progressive motility, PR)、快速前向运动精子活动率(Quick Progressive motility, QPR)、精子DNA碎片率(DNA fragmentation index, DFI)、精子浓度、精子总数及中医证候评分的疗效,探讨中医"阳化气"理论治疗男性弱精子症的作用机制。方法:采取随机、对照的方法,将72例符合精子DNA损伤的弱精子症患者分为试验组、対照组,两组各36例,试验组予壮精汤免煎颗粒、对照组予金匮肾气丸免煎颗粒干预,通过观察受试者服药12周前后精子PR、QPR、DFI、精子浓度、精子总数及中医证候评分的变化评价疗效。结果:通过对72例患者上述指标数据分析,试验组患者精子PR、DFI、QPR及中医证候评分四组数据治疗前后比较,差异具有统计学意义(P<0.05)。精子总数及精子浓度两组数据治疗前后比较,差异不具有统计学意义(P>0.05)。对照组患者精子DFI及中医证候评分两组数据治疗前后比较,差异具有统计学意义(P<0.05)。精子PR、QPR、精子总数及精子浓度四组数据治疗前后比较,差异不具有显著的统计学意义(P>0.05)。两组患者治疗前后精子PR、DFI及QPR差值,以上数据行组间统计分析,差异无统计学意义(P>0.05)。两组患者治疗前后中医证候评分差值进行分析,差异具有统计学意义。试验组总体有效率76.47%,对照组总体有效率54.55%。结论:1.壮精汤可以改善弱精子症患者精液参数中精子PR、QPR及DFI,提高弱精子症患者精液质量及改善精子DNA损伤。2.壮精汤对弱精子症患者精液参数中精子总数及浓度无改善作用。3.壮精汤及金匮肾气丸皆可改善弱精子症患者中医症状,且壮精汤疗效优于金匮肾气丸。

Objective: To observe the effect of "Zhuangjing decoction" based on warming and tonifying kidney yang on forward motile sperm motility(Progressive motility, PR), fast forward motile sperm motility rate(Quick Progressive motility, QPR), sperm DNA fragmentation rate(DNA fragmentation index, DFI), sperm concentration, total sperm count and TCM syndrome score, and to explore the mechanism of "Yang Hua Qi" theory in the treatment of male azoospermia. Method: adopt 72 patients with oligozoospermia in accordance with sperm DNA injury were randomly divided into experimental group(n=36) and control group(n=36). The experimental group was treated with Zhuangjing decoction(n=36) and the control group(n=36). The sperm PR,QPR,DFI, sperm concentration, sperm count and TCM syndrome score were evaluated by observing the sperm concentration, sperm count and TCM syndrome scoreabout 12 weeks before and after treatment. Results: through the analysis of the above indexes of 72 patients, there was significant difference in sperm PR, DFI,QPR and TCM syndrome score between the four groups before and after treatment(P< 0.05). Total sperm There was no significant difference in the number of sperm and sperm concentration between the two groups before and after treatment(P> 0.05). There was significant difference in sperm DFI and TCM syndrome score between the two groups before and after treatment(P< 0.05). There was no significant difference in sperm PR, QPR, sperm count and sperm concentration between the four groups before and after treatment(P> 0.05). There was no significant difference in sperm PR,DFI and QPR between the two groups before and after treatment(P> 0.05). Waiting Evaluation of traditional Chinese Medicine Syndrome before and after treatment in the two groups The difference was statistically significant. The overall effective rate was 76.47% in the experimental group and 54.55% in the control group. Conclusion: 1. Zhuangjing decoction can improve sperm PR,QPR and DFI, in semen parameters of patients with azoospermia, improve semen quality and improve DNA damage of spermatozoa. 2. Zhuangjing decoction had no effect on the total number and concentration of spermatozoa in semen parameters of patients with azoospermia. Both Zhuangjing decoction and Jinkui Shenqi Pill can improve the TCM symptoms of patients with azoospermia, and the curative effect of Zhuangjing decoction is better than that of Jinkui Shenqi Pill.