芪精方治疗痰湿内阻型肥胖男性不育症的临床疗效观察

Clinical Observation of Qijing Formula(芪精方) Treating Obese Male Infertility with Internal Obstruction of Phlegm-Dampness

目的 观察并评估痰湿内阻型肥胖男性不育症患者,应用芪精方治疗12周的效果。并探究芪精方对精液常规参数、男性生殖激素及血脂的影响。优化痰湿内阻型肥胖男性不育症患者的中医药治疗方案。方法 收集于2019年9月—2020年12月期间,辽宁中医药大学附属医院男科门诊就诊的初诊患者,将辨证为痰湿内阻型的患者,以BMI计算方法从纳入标准中筛选出70例肥胖男性不育症患者,按照随机数表法分为观察组和对照组,两组均为35例。给予观察组服用芪精方,给予对照组服用还少胶囊进行治疗,1个治疗疗程为12周,两组均治疗观察1个疗程。其中每4周复查1次实验室指标,包括正常精子形态和精液质量主要参数等,并于治疗12周后进行血脂、生殖激素和精子DNA完整性检测,录入并分析其精液量、精子浓度、精子数量、精子活动性、正常精子形态、核蛋白组型转换、生殖激素水平、血脂和中医临床症状变化评分等观察指标。最后运用SPSS 26软件对所搜集的数据进行统计学分析,根据结果评价其临床疗效,从而取得结论。结果 临床研究分别有33例对照组和34例观察组,共67例完成了为期12周的临床研究。其后随访12周,随访率80.60%,统计结果,观察组配偶妊娠5例,妊娠率为14.71%,对照组配偶妊娠2例,妊娠率为6.06%。组内对照:两组前后的精液主要参数、精子核蛋白组型转换及中医临床症状评分相比,差异均具有统计学意义(P<0.05);两组治疗前后的生殖激素(T、E_(2)、PRL、LH、FSH)、血脂(血清甘油三酯、总胆固醇)水平比较,差异无统计学意义(P>0.05)。组间对照:两组治疗后的两组治疗前后的生殖激素(T、E_(2)、PRL、LH、FSH)、血脂(血清甘油三酯、总胆固醇)水平比较,差异无统计学意义(P>0.05)。两组治疗后的精液主要参数、精子核蛋白组型转换和中医临床症状评分相比,差异均有统计学(P<0.05),且观察组优于对照组。结论 芪精方与还少胶囊治疗痰湿内阻型肥胖男性不育症患者均具有一定的疗效,芪精方的总疗效优于还少胶囊。在芪精方的治疗下,痰湿内阻型肥胖男性不育患者的精液质量参数显著提高,达到正常水平范围,并且临床症状明显好转。

Objective To observe and evaluate the effect of Qijing Formula(芪精方) on obese male infertility patients with internal resistance of phlegm and dampness for 12 weeks.To explore the effect of this prescription on semen routine parameters,male reproductive hormones and blood lipids.To optimize the TCM treatment plan for obese male infertility patients with internal resistance of phlegm and dampness.Method From September 2019 to December 2020,the first-diagnosed patients with internal resistance of phlegm and dampness in the Andrology Clinic of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were selected.Seventy cases of obese male infertility patients were collected according to the inclusion criteria by BMI calculation method.According to the random number table method,they were divided into observation group and control group,with 35 cases in each group.The observation group was given Qijing Formula and the control group was given Huanshao Capsule(还少胶囊) for treatment.One treatment course was 12 weeks and both groups were treated and observed for one course.The laboratory indicators,including normal sperm morphology and main parameters of semen quality,would be reviewed every 4 weeks.Blood lipids,reproductive hormones and sperm DNA integrity would be tested after 12 weeks of treatment,and their semen volume,sperm concentration and sperm would be entered and analyzed.The observation indicators such as quantity,sperm motility,normal sperm morphology,nuclear protein group conversion,reproductive hormone levels,blood lipids and scores of changes in TCM clinical symptoms were observed.Finally,SPSS 26 software was used to perform statistical analysis on the collected data,and evaluate its clinical efficacy based on the results,so as to reach a conclusion.Results The clinical study included 33 cases in the control group and 34 cases in the observation group.A total of 67 cases completed the 12-week clinical study.After 12 weeks of follow-up,the follow-up rate was 80.60%.According to statistics,5 spouses in the observation group were pregnant,and the pregnancy rate was 14.71%,and 2 spouses in the control group were pregnant,and the pregnancy rate was 6.06%.There were significant differences between the two groups in semen main parameters,sperm nuclear protein histotype conversion and TCM clinical symptom score before and after treatment(P0.05).Inter group control:There was no significant difference in the levels of reproductive hormones(T,E_(2),PRL,LH,FSH) and blood lipids(serum triglycerides,total cholesterol) between the two groups after treatment(P>0.05).There were significant statistical differences between the two groups in semen main parameters,sperm nuclear protein histotype conversion and TCM clinical symptom score after treatment(P<0.05),and the observation group was better than the control group.Conclusion Qijing Formula and Huanshao Capsules have certain curative effects in the treatment of obese male infertility patients with internal resistance of phlegm and dampness,and the total curative effect of Qijing Formula is better than that of Huanshao Capsules.Under the treatment of Qijing Formula,the semen quality parameters of obese male infertility patients with internal resistance of phlegm and dampness were significantly improved,reaching the normal range,and the clinical symptoms were significantly improved.