归附益肾汤联合左卡尼汀治疗肾阳虚型特发性弱畸精子症的临床观察

Clinical study on Guifu Yishen decoction combined with L-carnitine in treating idiopathic asthenoteratozoospermia with kidney Yang deficiency type

目的探讨归附益肾汤联合左卡尼汀治疗特发性弱畸精子症(肾阳虚型)患者的临床疗效。方法80例入选患者分为治疗组(归附益肾汤联合左卡尼汀口服液)和对照组(左卡尼汀口服液)各40例,治疗12周后比较中医症状疗效率、精液相关参数及总体疗效。结果治疗组治疗前后正常形态精子百分率、前向运动精子百分率(PR)、总活力、精子浓度、精液体积、精子DNA碎片指数(DFI)、精浆α-葡糖苷酶(α-Glu)、果糖(Fru)、精子畸形指数(SDI)、畸形精子指数(TZI)比较存在统计学意义(P<0.001)。对照组治疗前后精液体积有统计学意义(P<0.05),α-Glu、TZI有显著性变化(P<0.01),PR、总活力、正常形态精子百分率、SDI差异均具有统计学意义(P<0.001),其余参数没有显著性变化(P>0.05)。两组DFI疗效差值比较有统计学意义(P<0.05),其余参数无显著变化(P>0.05)。两组中医症状疗效率有统计学意义(P<0.01),且两组疗法与肾阳虚型特发性弱畸精子症的治疗效果为强相关。结论名中医经验方归附益肾汤联合左卡尼汀口服液对肾阳虚型特发性弱畸精子症疗效显著,无明显不良反应,可显著改善精液质量,且降低精子DFI水平和改善肾阳虚症状优于单用左卡尼汀。

Objective To investigate the clinical efficacy of Guifu Yi kidney decoction combined with levocarnitine in the treatment of patients with idiopathic asthenozoospermia(kidney Yang insufficiency).Methods Total of 80 patients with idiopathic asthenozoospermia(kidney Yang insufficiency)were enrolled and divided into the treatment group(40 cases,Guifu Yi kidney decoction combined with levocarnitine)and the control group(40 cases,levocarnitine).The treatment efficiency,semen related parameters and overall efficacy of TCM were comparatively analyzed after 12 weeks treatment.Results There were significant differences in semen volume,sperm concentration,forward motility sperm percentage(PR),total motility,sperm DNA fragmentation index(DFI),normal sperm percentage,seminal plasmaα-glucosidase(α-Glu),fructose(Fru),sperm malformation index(SDI)and abnormal sperm index(TZI)in the treatment groups before and after treatment(P<0.001).There were significant differences in semen volume(P<0.05),α-Glu and TZI(P<0.01),and PR,total motility,percentage of normal sperm and SDI(P<0.001)in the control group before and after treatment,but no significant changes in other parameters(P>0.05).After treatment there was a statistically significant difference in DFI between the two groups(P<0.05),and no significant change in other parameters(P>0.05).There was a significant difference in the efficiency of TCM symptom treatment DFI the two groups(P<0.01),and the treatment effect of the two groups was strongly correlated with the treatment effect of kidney Yang deficiency idiopathic asthenozoospermia.Conclusion The famous TCM experience prescription Guifu Yi kidney decoction combined with levocarnitine has a good effect on treatment of kidney Yang deficiency idiopathic asthenozoospermia,and no obvious adverse reactions occur.They can significantly improve semen quality,and reduce sperm DFI level and improve the symptoms of kidney Yang deficiency which is better than levocarnitine alone.