益肾活血方治疗高龄肾虚血瘀型男性不育的疗效观察

Yishen Huoxue Decoction for infertility in elderly men with kidney deficiency and blood stasis

目的:观察益肾活血方治疗肾虚血瘀型高龄男性不育的临床疗效。方法:60例肾虚血瘀型高龄男性不育患者随机分为观察组与对照组,每组30例。观察组给予益肾活血方,每天1剂,早晚2次温服;对照组给予生精片联合左卡尼汀口服液,生精片4片,每日3次口服,左卡尼汀口服液10 ml,每日2次口服;两组均治疗3个月。于治疗前后分别检查精液常规、精子形态及生殖激素,比较其精液量、精子活力、精子浓度、精子数量、精子形态、生殖激素水平和中医临床症状评分等变化。结果:共57例患者完成了此次临床研究,其中观察组29例,配偶妊娠2人,妊娠率为6.90%;对照组28例,配偶妊娠1人,妊娠率为3.57%。两组治疗总有效率相比,观察组优于对照组(82.76%vs 71.43%,P<0.05);两组中医证候总体疗效比较,观察组优于对照组(93.10%vs 85.71%,P<0.05)。每组治疗前后精子浓度、精子总数、前向运动(PR)精子百分率、精子总活力(PR+NP)、正常形态精子百分率及中医临床症状评分等方面,均具有显著性差异(P<0.05)。观察组治疗前后精液量结果比较,有显著性差异(P<0.05)。两组治疗后生殖激素(E2、LH、PRL、T、FSH)水平比较,无显著性差异(P>0.05)。两组治疗后在精子浓度、精子总数、PR精子百分率、精子总活力、正常形态精子百分率及中医临床症状评分等方面,均具有显著性差异(P<0.05),且观察组优于对照组。结论:益肾活血方可以明显提高肾虚血瘀型高龄男性不育患者的精液质量参数,改善临床症状。

Objective:To observe the clinical effect of Yishen Huoxue Decoction on infertility in elderly men with kidney deficiency and blood stasis.Methods:We randomly assigned 60 infertility male patients with kidney deficiency and blood stasis to two groups of an equal number to receive Yishen Huoxue Decoction,1 dose a day,twice daily in the morning and evening(the observation group,aged[42.10±3.82]yr)or Shengjing Tablets(4 tablets once,tid)combined with L-carnitine oral solution at 10 ml,bid(the control group,aged[42.79±3.56]yr),both for 3 months.Before and after treatment,we obtained the semen parameters,levels of reproductive hormones and traditional Chinese medicine(TCM)clinical symptoms scores from the patients and compared them between the two groups.Results:A total of 57 patients completed this clinical study,29 in the observation group,with pregnancy achieved in 2 cases(6.90%),and 28 in the control group,with pregnancy achieved in 1(3.57%).The patients in the observation group,compared with the controls,showed significantly higher total effectiveness(82.76%vs 71.43%,P<0.05)and overall therapeutic efficacy on TCM syndromes(93.10%vs 85.71%,P<0.05),as well as higher semen volume,sperm concentration,total sperm count,total sperm motility,percentages of progressively motile sperm(PMS)and morphologically normal sperm(MNS),and TCM clinical symptoms scores(all P<0.05),but no statistically significant difference in the levels of reproductive hormones(E2,LH,PRL,T and FSH)(P>0.05).Remarkable increases were observed in both the observation and control groups after medication in sperm concentration,total sperm count,total sperm motility,PMS,MNS,and TCM clinical symptom scores(all P<0.05).Conclusion:Yishen Huoxue Decoction can significantly improve the semen quality and TCM clinical symptoms of elderly infertility males with kidney deficiency and blood stasis.