中药六合丹外敷治疗男性脊髓损伤后并发急性附睾炎的疗效及对精液质量的影响

Efficacy of External Application of Traditional Chinese Medicine Liuhe Medicinal Pills for Males with Acute Epididymitis after Spinal Cord Injury and Its Effects on Semen Quality

目的:研究中药六合丹外敷治疗男性脊髓损伤后并发急性附睾炎的疗效及对精液质量的影响。方法:遵循随机对照原则,将142例男性脊髓损伤后行清洁间歇导尿且发生急性附睾炎的患者随机均分为观察组(常规抗生素+中药六合丹外敷)和对照组(常规抗生素)各71例,均持续治疗14d,比较两组临床治疗效果、中医证候积分、精液质量[精子浓度、活动率、(a+b)活力、液化时间]、疼痛程度[数字分级法(NRS)]及彩色多普勒血流成像(CDFI)血流分级,并记录其不良反应发生情况。结果:观察组及对照组临床有效率分别为92.86%和80.28%,在临床治疗效果方面有明显差异(P<0.05);治疗14d后,两组中医证候积分、精液液化时间均明显降低(P<0.05),而精子浓度、活动率、(a+b)活力明显升高(P<0.05),且观察组变化幅度更大(P<0.05);治疗7d后,观察组NRS评分明显低于对照组(P<0.05);治疗14d后,两组患者附睾血流分级明显降低(P<0.05),且观察组附睾血流分级更低(P<0.05);治疗期间,两组均未产生任何不良反应。结论:中药六合丹外敷治疗男性脊髓损伤后并发急性附睾炎疗效理想,可有效改善其症状体征的同时提升精液质量,改变附睾血流动力学,值得推广。

Objective:To study the efficacy of external application of traditional Chinese medicine Liuhe Medicinal Pills in the treatment of males with acute epididymitis after spinal cord injury and its effects on semen quality.Methods:Following the randomized control principle,142 male patients with acute epididymitis who underwent clean intermittent catheterization after spinal cord injury were randomly divided into an observation group(conventional antibiotics+external application of traditional Chinese medicine Liuhe Medicinal Pills)and a controlled group(conventional antibiotics),with 71 cases in each group.Both group were continuously treated for 14 d.The clinical treatment effects,TCM syndromes scores,semen quality[sperm concentration,activity rate,(a+b)vitality,liquefaction time],pain level[Numeric Rating Scale(NRS)]and blood flow classification of color Doppler blood flow imaging(CDFI)were compared between the two groups,and the occurrence of adverse reactions were recorded.Results:The clinical effective rates of the two groups were 92.86%and 80.28%respectively,and there were obvious differences in clinical treatment effects(P<0.05).After 14 d of treatment,the scores of TCM syndromes and semen liquefaction time were significantly reduced in the two groups(P<0.05)while sperm concentration,activity rate and(a+b)vitality were significantly increased(P<0.05),and the changes were greater in the observation group(P<0.05).The NRS score of the observation group after 7 d of treatment was significantly lower than that of the controlled group(P<0.05).After 14 d of treatment,the epididymal blood flow classification of the two groups was significantly reduced(P<0.05),and the epididymal blood flow classification was lower in the observation group(P<0.05).During treatment,there were no adverse reactions in the two groups.Conclusion:Traditional Chinese medicine Liuhe Medicinal Pills can have an ideal efficacy in the treatment of males with acute epididymitis after spinal cord injury.And it can effectively improve the symptoms and signs,enhance the semen quality and change the epididymal hemodynamics.Therefore it is worthy of promotion.