麒麟加减方辨治男性不育肾精亏损证临床研究  

Clinical Study on Modified Qilin Prescription for the Dialectical Treatment of Male's Infertility with Kidney Essence Deficiency Syndrome

作　　者：李艳春[1] 

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医学报》2017年第12期2448-2451,共4页Acta Chinese Medicine

基　　金：河南省中医科技计划项目(20150367A)

摘　　要：目的:探讨麒麟加减方辨治男性不育肾精亏损证的临床疗效与安全性。方法:将120例患者随机分为对照组和观察组。对照组采用左卡尼汀口服溶液和枸橼酸氯米芬片治疗,连续治疗25 d,停药5 d。观察组在对照组基础上采用麒麟加减方治疗。两组连续治疗3个月,并进行3个月随访。记录6个月内配偶妊娠情况;治疗前后精液分析和促卵泡激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)、催乳素(prolactin,PRL)和雌二醇(Estradiol,E2)等生殖激素检测,并进行治疗前后肾虚精亏证评分及安全性评价。结果:观察组配偶妊娠23例,妊娠率38.33%,对照组配偶妊娠13例,妊娠率21.67%,观察组配偶妊娠率显著优于对照组(χ2=3.968,P<0.05);治疗后观察组患者精子密度、a级精子比例、精子活率和顶体酶活性显著优于对照组,精子畸形率显著低于对照组(P<0.05);治疗后观察组患者FSH、LH和PRL水平显著低于(P<0.01),T水平显著高于对照组(P<0.01),两组E2水平比较,差异无统计学意义(P>0.05);治疗后观察组肾精亏损证评分显著低于对照组(P<0.01)。结论:在西医常规治疗的基础上,采用麒麟加减方治疗肾精亏损型男性不育,能提高患者精子质量,改善患者内分泌水平,从而提高配偶妊娠率,并能减轻肾精亏损证评分,临床使用安全。Objective： To study the clinical effect and safety of modified Qilin prescription for the dialectical treatment of male＇s infertility with kidney essence deficiency syndrome. Methods： 120 patients were divided into control group and observation group randomly. The control group was given Levocarnitine oral solution and Clomifene Citrate tablets,and pause for 5 days after 25-day continuous treatment. The observation group was treated with modified Qilin prescription on the basis of control group. Two groups received a treatment of three months and were followed up to record the gestation status of their spouses. Analyzed the sperm before and after treatment and checked the reproductive hormones such as follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,testosterone（ T）,prolactin（ PRL）,estradiol（ E2）,and made evaluation of kidney essence deficiency before and after treatment and safety evaluation. Results： 25 spouses of observation group patients had gestation,gestation rate at 38. 33%; 13 spouses of control group had gestation,gestation rate at 21. 67%. Gestation rate of the observation group was higher than that of control group（ P 0. 05）. After treatment,the sperm density,grade a sperm ratio,sperm motility and acrosin activity of observation group were higher than those of control group（ P 0. 01）,FSH,LH and PRL of observation group were lower than those of control group（ P 0. 01） and T of observation group was higher than that of control group（ P 0. 01）; the comparison of E2 levels of the twogroups had no statistical significance（ P 0. 05）; kidney essence deficiency scores of observation group were lower than those of control group（ P 0. 01）. Conclusion： On the basis of conventional treatment of Western medicine,the treatment of male infertility caused by kidney essence deficiency with modified Qilin prescription can improve sperm quality,enhance endocrine level,thus improving spouse gestation rate; it can also reduce kidney essence deficiency scores

关 键 词：男性不育 肾精亏损证 麒麟方 生殖激素 精子质量 中西医结合 

分 类 号：R271.14[医药卫生—中医妇科学]