化瘀解毒生精方治疗精索静脉曲张性弱精子不育症的临床研究

Huayu Jiedu Shengjing Decoction improves semen quality and reduces TCM syndrome scores in patients with varicocele-induced asthenospermic infertility

目的:观察化瘀解毒生精方治疗精索静脉曲张(VC)性弱精子性不育症的临床疗效;分析精子活力、精子DNA碎片指数、精浆NO、精浆ROS、精浆SOD、精索静脉多普勒超声数值之间的相关性,初步探讨化瘀解毒生精方的作用机制。方法:用计算机产生随机数法将符合试验的88例患者随机分为两组,试验组44例、对照组44例。试验组给予化瘀解毒生精方加减,对照组给予迈之灵片和左卡尼汀口服液。治疗12周后复查精子活力、精索静脉超声指标、精浆NO、精浆ROS、精浆SOD、DFI等,评价两组临床疗效,并对各项指标进行相关性分析。结果:试验组总有效率为86.04%,对照组总有效率为73.74%,试验组在改善中医证候评分、精子活力、精子DNA碎片指数、精浆NO、精浆ROS、精浆SOD方面优于对照组(P<0.05)。结论:化瘀解毒生精方能改善VC性弱精子性不育症患者的精液质量、降低中医证候评分,且无不良反应;其作用机制可能与提高机体抗氧化性,改善局部血流有关。

Objective: To observe the clinical efficacy of "Huayu Jiedu Shengjing Decoction"(HJSD) in the treatment of varicocele(VC)-induced asthenospermic infertility and its action mechanism. Methods: Using computer-generated random numbers, we equally divided 88 patients meeting the study criteria into an experimental and a control group, the former treated orally with HJSD plus or minus, while the latter with Maizhiling Tablets and levocarnitine, both for a course of 12 weeks. After medication, we obtained TCM syndrome scores, sperm motility, sperm DNA fragmentation index(DFI), the seminal cord venous ultrasonographic index, and levels of nitric oxide(NO), reactive oxygen species(ROS) and superoxide dismutase(SOD) in the seminal plasma from the patients, compared the therapeutic effects between the two groups, and analyzed the correlation among the obtained parameters. Results: The total effectiveness rate was dramatically higher in the experimental than in the control group(86.04% vs 73.74%, P < 0.01). The TCM syndromes scores, sperm motility, sperm DFI, and seminal plasma NO, ROS and SOD were all more significantly improved in the former than in the latter group(P < 0.05). Conclusion: Huayu Jiedu Shengjing Decoction can improve semen quality and reduce TCM syndrome scores without adverse reactions in patients with VC-induced asthenospermic infertility, which may be attributed to its effect of improving antioxidation and local blood flow.