隔药灸脐法联合益肾通络方治疗肾阳虚络阻型特发性弱精子症不育的临床观察  

Clinical Observation on Herb-partitioned Moxibustion on Navel Combined with Yishen Tongluo Prescription in Treatment of Infertility Induced by Idiopathic Asthenozoospermia with Kidney-Yang Deficiency and Collateral Obstruction Syndrome

作　　者：张芳[1] 赵沛沛 孙自学[2] 陈建设[2] 陈翔[2] 李鹏超[2] ZHANG Fang;ZHAO Peipei;SUN Zixue;CHEN Jianshe;CHEN Xiang;LI Pengchao(The Second Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450008,China;Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南中医药大学第二临床医学院,郑州450008 [2]河南省中医院,郑州450002

出　　处：《中国实验方剂学杂志》2023年第4期97-103,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81974573);河南省“中原英才计划”项目(ZYMY201809);河南省中医药科学研究重大专项(2022ZYZD09);河南省防治生殖障碍疾病中医药重点实验室项目(2021ZDSYS10);河南省重点科技攻关课题(222102310100)。

摘　　要：目的:观察隔药灸脐法联合益肾通络方治疗肾阳虚络阻型特发性弱精子症不育的临床有效性及对精子DNA损伤和精浆超氧化物歧化酶(SOD)的影响。方法:将112例符合纳入标准的患者随机分为观察组和对照组各56例,观察组给予隔药灸脐法联合益肾通络方,对照组给予左卡尼汀口服液,主要观察指标为配偶妊娠率,前向运动精子率、精子总活力,次要观察指标为精子DNA碎片指数(DFI)、精浆SOD及中医证候改善状况。治疗周期为12周,治疗前后检查记录患者前向运动精子活率、精子总活力、精子DFI、精浆SOD及中医证候评分,并随访12周,记录24周(半年)内配偶妊娠情况,评价两组临床疗效。结果:观察组配偶受孕率15.69%(8/51),对照组3.85%(2/52),观察组配偶受孕率高于对照组,差异有统计学意义(χ^(2)=4.118,P<0.05);观察组总有效率88.24%(45/51),优于对照组的69.23%(36/52)(Z=-3.402,P<0.01);与本组治疗前比较,两组患者治疗后前向运动精子活率、精子总活力、精子DFI、精浆SOD及中医证候改善有显著性差异(P<0.05),且与对照组治疗后比较,观察组优于对照组(P<0.05)。结论:隔药灸脐法联合益肾通络方治疗肾阳虚络阻型特发性弱精子症不育患者,可提升前向运动精子百分率、精子总活力及精浆SOD水平,降低精子DFI,改善患者中医症状,提高配偶受孕率,这可能与该疗法通过升高患者精浆中的SOD水平,增强机体抗氧化功能,保护精子免受氧化应激损伤,进而降低精子DFI有关。Objective:To observe the clinical efficacy of herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription in the treatment of infertility induced by idiopathic asthenozoospermia(iAZS)with kidney-Yang deficiency and collateral obstruction syndrome and its effect on sperm DNA damage and superoxide dismutase(SOD)in the seminal plasma.Methods:A total of 112 eligible patients who met the inclusion criteria were randomly divided into an observation group(56 cases)and a control group(56 cases).The patients in the observation group were treated with herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription,while those in the control group received levocarnitine oral liquid.The primary observation indicators included spouse pregnancy rate,progressive motility(PR),and total sperm motility,and the secondary observation indicators included sperm DNA fragmentation index(DFI),SOD in the seminal plasma,and improvement of TCM syndromes.The treatment cycle was 12 weeks.Before and after treatment,the PR,total sperm motility,sperm DFI,SOD in the seminal plasma,and TCM syndrome scores were recorded.The patients were followed up for 12 weeks and the pregnancy status of spouses within 24 weeks(half a year)was recorded.The clinical efficacy of the two groups was evaluated.Result:The pregnancy rate of spouses in the observation group was 15.69%(8/51),higher than 3.85%(2/52)in the control group(χ^(2)=4.118,P<0.05).The total effective rate of the observation group was 88.24%(45/51),superior to 69.23%(36/52)in the control group(Z=-3.402,P<0.01).After treatment,PR,total sperm motility,sperm DFI,SOD in the seminal plasma,and TCM syndromes of the two groups were improved compared with those before treatment(P<0.05),and the observation group was superior to the control group(P<0.05).Conclusion:Herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription in the treatment of iAZS-induced infertility patients with kidney-Yang deficiency and collateral obstruction syndrome c

关 键 词：男性不育症 肾阳虚络阻 隔药灸脐法 特发性弱精子症 益肾通络方 

分 类 号：R242[医药卫生—中医临床基础] R2-031[医药卫生—中医学] R287R256.56R698.2