基于肠道菌群探讨五子衍宗丸对少弱精子症的作用

Effect of Wuzi Yanzong Pill(五子衍宗丸)on Oligoasthenospermia Based on Intestinal Flora

目的探讨肠道菌群探讨五子衍宗丸对少弱精子症的作用。方法选取2020年1月—2021年12月间就诊的少弱精子症患者82例为研究对象,以就诊顺序排序采用随机数字表法分为观察组(42例)与对照组(40例),对照组给予左卡尼汀口服液,观察组在对照组基础上给予五子衍宗丸,治疗3个月后评价临床疗效、中医证候积分变化、精液相关指标变化、肠道菌群及安全性。结果观察组总有效率(90.47%,38/42)高于对照组(67.50%,27/40)(P<0.05);治疗后中医证候积分比较低于治疗前(P<0.05);观察组中医证候积分比较低于对照组(P<0.05);治疗后两组精液量、精子密度、存活率、精子向前运动(PR)、精子总活力(PR±NP)高于治疗前,精子液化时间低于治疗前(P<0.05);观察组精液量、精子密度、存活率、PR、PR±NP高于对照组,精子液化时间低于对照组(P<0.05);治疗后,两组香浓(Shannon)指数升高(P<0.05),且观察组Shannon指数高于对照组(P<0.05);治疗后,两组双歧杆菌、乳酸杆菌高于治疗前,大肠杆菌低于治疗前(P<0.05);观察组双歧杆菌、乳酸杆菌高于对照组,大肠杆菌低于对照组(P<0.05);治疗过程中及治疗3个月后均未见不良事件发生,两组患者血常规及肝肾功能检查结果无显著变化。结论五子衍宗丸治疗少弱精子症可显著缓解临床症状,提高精子质量,无明显不良反应,其机制可能与调节肠道菌群有关。

Objective To explore the effect of Wuzi Yanzong Pill(五子衍宗丸)on oligoasthenospermia based on intestinal flora.Methods A total of 82 patients with oligosthenospermia treated between January 2020 and December 2021 were selected as the research subjects.According to the medical treatment order,they were divided into observation group(42 cases)and control group(40 cases)by random number table method.The control group was given levocarnitine oral solution,and the observation group was given Wuzi Yanzong Pill on the basis of the control group.After 3 months of treatment,the clinical efficacy,TCM syndrome score,semen related indicators,intestinal flora and safety were evaluated.Results The total effective rate in the observation group was 88.09%,higher than 67.50%in the control group(P<0.05).The TCM syndrome score after treatment was lower than that before treatment(P<0.05).The TCM syndrome score of the observation group was lower than that of the control group(P<0.05).After treatment,the semen volume,sperm density,survival rate,sperm forward motion(PR)and sperm total activity(PR±NP)of the two groups were higher than those before treatment,and sperm liquefaction time was lower than those before treatment(P<0.05).The semen volume,sperm density,survival rate,PR and PR±NP in the observation group were higher than those in the control group,and sperm liquefaction time was lower than that in the control group(P<0.05).After treatment,Shannon index in both groups increased(P<0.05),and Shannon index in the observation group was higher than that in the control group(P<0.05).After treatment,bifidobacteria and lactobacillus were higher than those before treatment,while Escherichia coli was lower than that before treatment(P<0.05).Bifidobacteria and lactobacillus in the observation group were higher than those in the control group,while Escherichia coli was lower than that in the control group(P<0.05).There were no adverse events during this treatment and 3 months after treatment,and no significant changes were observed in blood routine examinations or function tests of liver and kidney in two groups.Conclusion Wuzi Yanzong Pill can significantly relieve clinical symptoms and improve sperm quality in the treatment of oligoasmatospermia,and there is no obvious adverse reaction.The mechanism may be related to the regulation of intestinal flora.