不育症合并生殖道感染患者中医体质分布研究

Study on Chinese Medicine Constitution Distribution of Patients with Infertility Complicated with Reproductive Tract Infections

目的:探究不育症合并生殖道感染患者的中医体质分布特点。方法:收集2015年6月—2018年5月广东省中医院男科门诊不育患者656例的临床资料,根据是否合并生殖道感染分为感染组(204例)和对照组(452例),并进行中医体质量表调查和统计学分析。结果:感染组以湿热质(54.9%)、阴虚质(17.6%)和血瘀质(15.7%)为主,对照组以痰湿质(29.2%)、气郁质(19.9%)、湿热质(17.3%)为主,且体质的分布与病程具有一定相关性。感染组的精子总数、精子总活力、前向运动精子、正常形态精子等水平低于对照组,差异均有统计学意义(P <0.05),而2组精液PH值、精子浓度比较,差异无统计学意义(P>0.05)。感染组患者精浆弹性蛋白酶(SPE)、精子DNA碎片指数(DFI)均高于对照组,差异有统计学意义(P <0.05)。在感染组中,湿热质、阴虚质和血瘀质患者SPE、DFI均高于气郁质患者(P <0.05);阴虚质和血瘀质患者DFI值高于湿热质患者(P <0.05)。在对照组中,气郁质、痰湿质和湿热质患者SPE、DFI (气郁质除外)均高于平和质患者(P <0.05)。结论:气郁质、痰湿质和湿热质是不育症的易感体质;而湿热质在合并生殖道感染的不育症患者中最为常见,且随着病情发展多夹杂阴虚质和血瘀质;不育症是否合并生殖道感染、不育症的不同体质患者其SPE、DFI水平存在一定差异性。

Objective:To explore the characteristics of Chinese medicine constitution distribution of patients with infertility complicated with reproductive tract infections.Methods:Collected 656 cases of patients with infertility in the andrology outpatient clinic of Guangdong provincial hospital of traditional Chinese medicine from June,2016 to May,2018.Divided them into two groups according to the occurrence of reproductive tract infections,204 cases in the infection group and 452 cases in the control group.An instigation via Chinese medicine constitution scale and a statistical analysis were conducted respectively.Results:Dampness-heat constitution(54.9%),yin-deficiency constitution(17.6%)and blood-stasis constitution(15.7%)mainly appeared in the infection group,while phlegm-dampness constitution(29.2%),qi-depression constitution(19.9%)and dampness-heat constitution(17.3%)mainly appeared in the control group;there existed certain correlation between the distribution of constitution types and the course of disease.The total sperm count,total sperm motility,progressive sperms and morphologically normal sperms in the infection group were lower than those in the control group,differences being significant(P<0.05);comparing the PH value and concentration of semen in both groups,there was no significant difference being found(P>0.05).The level of seminal plasma elastase(SPE)and the value of sperm DNA fragmentation index(DFI)in the infection group were both higher than those in the control group,difference being significant(P<0.05).In the infection group,the level of SPE and the value of DFI in patients of dampness-heat constitution,yin-deficiency constitution and blood-stasis constitution were higher than those in patients of qi-depression constitution(P<0.05);the valueof DFI in patients of yin-deficiency constitution and blood-stasis constitution was higher than that in patients of dampness-heat constitution(P<0.05).In the control group,the level of SPE and the value of DFI(except that in patients of qi-depression constitution)in patients of qi-depression constitution,phlegm-dampness constitution and dampness-heat constitution were respectively higher than those in patients of balanced constitution(P<0.05).Conclusion:Qi-depression constitution,phlegm-dampness constitution and dampness-heat constitution are susceptible to infertility;phlegm-dampness constitution is most common among patients with infertility complicated with reproductive tract infections,which is intermingled with yin-deficiency constitution and blood-stasis constitution as disease develops.There exist differences in whether infertility is complicated with reproductive tract infections and the levels of SPE and DFI in patients with infertility of different constitution types.